Two ward stories stand out to me at the moment, from one long shift (13 hours) in which I was on Stroke Cover…
I attended a Code Stroke first thing in the morning. The patient was relatively young, in her 60's. She had lots of risk factors and woke up with stroke deficits. As soon as her family realised something was wrong, she was rushed in - but sadly the damage had already been done. We could tell when we examined her - dysarthric, with dense left hemiparesis - that this was likely to be serious. The CT imaging was devastating, with a large area of ischaemia. She was rushed from clot evacuation, which was successful, but died within 12 hours due to haemorrhagic transformation. Still images like photographs stand out to me from that event. Learning her name, and speaking to her gently after the chaos of the code subsided, stroking her arm to try and reassure her. And seeing her try to reassure me back by smiling, and saying "you're alright" whenever we apologised for cannulating her. Seeing her family standing in the corner of the Resus room, that gravity of the situation hitting them so much slower than it hit us, as they smiled along to collateral history taking and were jovial with the nursing staff. The CT images of her brain, both initially and as the day progressed, and the fact that such an intimate image did not in any way capture this woman's personality the same way that her fluffy dressing gown and sheep printed pyjama pants did.
Later that day, as part of my ward round, I had a chance to sit and talk with a patient who had a new diagnosis of Motor Neurone Disease. As a fresh RMO, I'm usually at the back writing the notes, and on a Saturday it was quite nice to be able to take my time, sit down, and talk to the patients. We talked about his diagnosis, his friends and family, his prognosis, the aspects of treatment he was finding most difficult, and long-term plans of getting him home to the country. I learned about his early life, his job, his hobbies, his ancestry. We both remarked that it was a beautiful day and decided it would be far better for him to be outside in the sunshine than inside on the sixth floor. So we walked out of the ward together, and parted ways at the elevators, where he continued on to the courtyard. My next day of work was back to the same - standing at the back of the team, writing notes. When we had finished and everyone said their goodbyes, I was last to leave. He said to me "and thank YOU especially!" Outside, my Reg jokingly asked "what makes you so special?" I smiled and said "it must just be me!". But I think it was taking the opportunity to talk to this man as a whole person, rather than a set of signs, diagnoses and procedures. It was only something small, in the scheme of things, but it meant a lot.
I saw both patients on the same day. We are all full of little idiosynchracies, nuances, subtleties of personality that combine to make US. I caught glimpses of who these two patients really were, in different ways, and with very different outcomes. I think it's so important to pay attention to the little things that make each person unique, to maintain the human connection between clinicians and patients rather than just seeing pathologies or 'cases' everywhere.
Dr. Jessica Willis