Choices

It's Monday. I feel scourged.

Nick is trying to choose a college. He's narrowed down his choices to Sewanee and Loyola New Orleans. My father has sent me 7 emails encouraging me to help him pick a college. Duh. My parents have called three times today.

I had 4 patients over the weekend. One was a suicide. His family was mystified. Beautiful family. It came as a complete surprise. Hard not to hope. Fine line to walk. Sometimes he had responses, some times he didn't. His daughter would grasp onto these--"He's in there. Do you think he can hear me? Do you think there's hope? What would you do?"

I cop out of these questions when I can. When I can't, I stick to the truth.

"Have you seen injuries like this get better?"

"Yes." Well, I have. I had a patient whose brains would come out of his nose when I turned him. Unbelievably, he recovered. It's always amazing how much of your brain you can actually do without and not really notice. We would joke when we suctioned him and find grey matter on the pillow--"Oh, look at that...graduation..."

His sister takes me aside. "Please try not to give these girls any hope."

You try to keep yourself clear, open, present. It's hard.

"I'm so sorry," his sister told me at one point. "I'm sorry I tried to take over."

"Designer death," snorts Wiz. "Everyone wants control over everything. "

Wiz has taken a second job, he won't say where. He is clenched like a fist. Short. Exhausted. Noncommunicative and brutal when he is. No joking, no singing, no weird aphorisms or flights of philosophical soap-boxing. Work. He's checking off his tasks. He acts like a prisoner, like a cart horse.

"You have limits, too," I say to him, after Friday's shift.

"Thank you for your opinion." He says, giving me his back as he walks down the hall.

"Sauce for the goose."

"Go tell aunt Rhodie." He can't resist.

"Don't forget your medication tomorrow!" I call after him cheerfully.

He's a little better Saturday. At least he engages in banter. And he's nice to Marcy. I am submerged with my suicide.

Sunday, we have a care conference to discuss palliative and withdrawal of care. It's perfectly awful. I had a flat tire on the way to work, didn't get my cafe con leche. I also found out this week that I have some sort of growth on my thyroid I have to get biopsied. I worry about telling this to Jay. Somehow, I don't think he's the type for the long haul through sickness. My shrink disagreed with me on this point. "Look at his history," he pointed out. "the more screwed up you are, the better."

"How are you holding up?" Wiz asks me, Sunday.

Oh, good. He's back.

Someone leaves a funeral wreath in the ICU waiting room. One of our crazier family members goes screaming about this all the way to the CEO. It's our fault some lunatic leaves a funeral wreath? Now we're supposed to police the waiting room?

I admit a patient from a car accident. Miraculously all right. His buddy who was in the car with him walks out of the emergency room AMA and up into the unit. He has a gash on his head pouring blood and as he walks, you can see that his right leg is clearly broken, because the bone is torquing the skin. "I want to see Ed!" He screams. "I got to see Ed right fucking now."

"Could you please go back to the waiting room. You also might want to go back to the ER."

"I'm fine. Those fucking doctors don't know what they're doing. I want to see Ed." The same woman who screamed about the wreath screams about this, too. "He's upsetting people!" she tells Wiz. "Make him go to the doctor."

"I can't," Wiz tells her, holding her hands, "it's his choice. People make their own choices. He's not threatening anyone, and he has a friend here. If he becomes disruptive, we can call security, but otherwise, there's really nothing we can do."

"He's disrupting me!" She says.

The family decides to withdraw care. We page the palliative team. Everyone wants a piece of this death. The wife and daughters are under siege. Is there anyone out there who knows what it means to really support someone? There's a doctor in the family who goes on and on about what will happen when they remove the vent. There's a friend who keeps interrupting the wife and saying "What she's trying to say is..."

I'm so glad to get out of there. Finally the shift is over. And then at the end, one of the daughters says, "Will you be there, with him when they withdraw care?"

"I'm not working tomorrow." I tell them.

"Oh, that's too bad. Do you know who it will be?"

"No." Shit. So I went today. Put on my twin set and rode my bicycle over. The bike lock's rusted. Couldn't find socks. Is there anything that makes you feel more poverty stricken than not wearing socks? The crazy wife notices. "You're not wearing socks!" She says, pointing at my feet. I wonder if she'll complain about this, too.

"I know. My kids did the wash."

She laughs. "I have socks if you want them," she tells me.

That's my 1/2 hour.