Reading Lips

Most of my patients can't talk. Some of them can mouth words. They talk to me and talk to me and I can't understand what they're saying. The worst are the people that die. People often wake up right before they die. They catch your hand, look at you for the first time and say something. Their mouths move, but there's no sound. And they need to say it, whatever it is is probably the most important thing they've ever said (Tell Myra I always loved her, even though I married Nancy. All my gold is buried under the McBain Oak, and it's yours, dear Nurse. Who knows?) and it's so absurd. Luck of the draw. They get me. Who can't read lips.
"What?"
"One word at a time. Let me get the word board! Can you point? Hang on! Oh. Oops. Bye."
What an idiot, they probably think, as they lapse back into darkness. Of all the people to get stuck with. And I'm not even going to get to live to fill out the Press Ganey on that one! Darn. Oh, there's the light!
No, I don't know what they think or say, and it's just awful. We are in such isolation, so dependent on externals. Wiz, of course, can always understand what they're saying. In detail. "No, I don't think Oprah's on right now. It's a Sunday. You've been unconscious for about 2 days. " he'll reply. "Your elbow itches? I'll get that for you. Your cast is twisted."
But yesterday, I was taking care of this woman I'd taken care of several months before. She was in a car wreck, then sent to a rehab facility, then returned to us septic, in terrible condition. Her hair matted and dirty--with mold in it, her trach ties reeking and green, yeast under her breasts, pressure ulcers under her braces, starving. Terrible. We were horrified. We had gotten her in such good shape--what had they done? I felt I'd been punched in the stomach when she came in. I took everything off, drenched it in hydrogen peroxide (hydrogen peroxide can solve almost everything--and it's only 80 cents!) She's doing better now, after a week. Most of her hair has fallen out, but we combed it and cut it and put it in little braids on top of her head. Lavished her with care. Sometimes, putting someone right is so satisfying. She wasn't septic, just neglected and starving. Wiz taught me that. I came in to nursing contemptuous of the little things. I liked things that made me think--I liked out diagnosing the doctors. I still like that, but the other stuff is just as important. Maybe more so. People give Wiz a lot of crap. I remember my preceptor saying, after Wiz had made a comment about our patient's fingernails, still dirty after a week in the unit, that if he liked all that nurse tech stuff, he could just do that--save the hassle of being a clinical supervisor. As if it was beneath us.
So anyways, I'm fussing over my patient. She was having a lot of gas. We'd had one ostomy bag explode, and I was burping her new one. She mouths something, and--it was the strangest feeling--I heard her words in my tummy--silent but there--like my own thoughts, but located in a different place in my body--she says, I don't think I can take this any more. And without thinking, I respond. "This is all part of the process, Gretel. You've been starving. Your gut is waking up."
They were so mean to me there. Will I have to go back?
"No. You don't have to go back."
It was the strangest thing.
I remember when Spanish finally clicked for me. I had really been trying to learn Spanish, since everyone speaks it in Miami, with very little success. I listened to Spanish radio all the time and I was driving home from work, listening to Radio Ritmo! and an advertisement came on. I never understood the ads, but all the sudden, I found myself musing "That's a really good price on pillows! And we need new towels." It was an ad for Bed, Bath & Beyond and I'd understood it without even realizing it. Language is only one part of communication, I think. Listening is getting your ego, your overactive "I'll figure this out!" part of you out the way and being present with where you are. Letting go of your own story.
It's a zen task, I think. You have to give over to the other person to really understand what they're saying.
Life can be full of awakenings, can't it?
That's my 1/2 hour.