Surprise

One of my patients with a poor prognosis was transferred back to our unit after requiring special, focused care.

There were so many things I noticed: the patient looked so much better physically, and what I remember the most from today is almost a change in personality.  There was more eye contact, more smiling.  I always feel better about the status of my patient when I see them out of their hospital bed and in a chair, even if they're just resting and watching television.  It tells me they have the physical strength to do things other than lay down, and that they have to motivation to do so, which I think is a strong predictor of patient outcomes.

I like visiting this patient, and this patient likes having me around.  I sometimes wonder if patients enjoy having students around to visit, we must be a change from serious doctors: we're energetic, very polite and courteous, and there has to be something funny in how we fumble with all the books and papers and pens in our short white coats.

 After the visits, though, the reality of my patient's poor prognosis sinks in further and I really don't know how long they have left.  Especially if they end up with an infection inside or outside of the hospital, or one of their organ systems is tipped in the wrong direction.

I was surprised today, pleasantly, when the patient remembered my name.  I was surprised to see another formerly critically ill patient walking around today with Physical Therapy: I had seen them just a few days ago completely weak, possibly delirious, on an aggressive antibiotics regimen.

I feel like the days have become a little brighter for my patients, and a little lighter on me.  Next week there'll be closure and discharge for the patients I've been following for quite a while.  I'm glad things are headed that way.