When I was an ER nurse many moons ago, there were two girls who came in all. the. time. "Frequent Fliers", as we would call them. In addition to "diabetes" (plus a host of other miscellaneous diagnoses), they both had End Stage Renal Disease (ESRD), and their blood pressures were NEVER less than 200/100.
They were both in their early 20's. They were rude, impatient, demanding, and...well...MEAN. And, by "mean" I don't mean mean. I mean name-calling, cussing, throwing-emesis-basins-at-you, downright M E A N.
I swear if one wasn't there, the other one was. The only thing worse than having the charge nurse assign one of them to your team, was being assigned both of them.
After a few years in that ER, I took a position in the PACU (aka "Recovery Room"), and must admit that part of me was happy knowing I wouldn't have to deal with them any longer.
Or so I thought.
Turns out dialysis shunts require revisions more often than I realized. Shunts are revised in the OR under anesthesia...which means these patients need to be recovered from anesthesia...which means...
I could run, but I couldn't hide.
And you know what else?
Their surgeries were usually "add ons". Meaning, more often than not, they were added on at the end of the day, after the scheduled procedures were finished.
I *ALWAYS* worked evening shifts.
So, unlike the ER, when there was a chance that they'd come in earlier or later than the time I was working...in the PACU, I was pretty much guaranteed to see one or both of them ALL. OF. THE. TIME.
Dammit! Why didn't they take care of themselves? Huh? Have a flippin' vegetable. Stop skipping your insulin. Exercise a little. And lighten up on all that salt you must be adding to everything you put in your mouth, because your blood pressure is out of control. Quit getting yourself into these quandaries, leaving you no choice but to come here...AGAIN. Have a little self respect. Do better for yourself.
And get out of my life.
These are things that jumbled my mind as soon as I saw one (or both) of their names added to the schedule.
One day I was behind the curtain helping one of them with something. I was frustrated. I was tired...and I'm sure it showed.
Then I felt her hand brush against mine.
Not in a M E A N way.
More like a soft nudge. A call for attention in the midst of her drowsy state of mind.
"My mom couldn't figure it out, and my dad wasn't ever around."
Really??? Do we have to talk right now? I just want to get out of here before you decide to start throwing something at me.
"My diabetes. She just couldn't figure it out and I tried as best as I could, but I was just a little kid. She had lots of boyfriends and I have all these brothers and sisters and stuff, but I don't really know where everyone is. Some of them are in jail. Some of them went to foster homes. She couldn't really take care of herself, and it was hard trying to take care of me. I went to a foster home a couple times, but no one ever kept me for long because it was hard to deal with the sugars. When the other kids were gone, they gave me back to my mom. I dropped out of school when I was 16. Just like she did when she got pregnant with me."
I felt a lump in my throat.
"I'm not going to live much longer. The doctors told me that already. I just wanted to tell someone that I tried, but when I was old enough to understand it better my kidneys were already failing. You medical people are the only people I ever see. I don't really have anyone else to talk to."
She was right. She didn't live much longer. I think I might have seen her once or twice after that.
That conversation happened 11 or 12 years ago.
Fast forward a few years, and my daughter was diagnosed with Type 1 Diabetes.
I had no idea.
I was shocked when I figured out the amount of effort, time, and brainpower it was going to take to keep her alive. Vegetables, reducing sodium, more exercise, self-respect...while they're all fine and dandy, THEY WON'T MAKE THE PROBLEM GO AWAY.
Over the years, I've thought about that patient of mine from long ago.
She taught me a lesson, and I had no idea just how close to home her lesson would hit. What if her mom had a community of support? What if SHE had a community of support?
What if a million things.
What would she have become? What could she have become?
What has the world lost, because she didn't have a chance?
So...WORLD?? Are you there?
She tried. She tried her best.
And, to my patient...
Maybe your family hardly remembers you.
But I do.
Thank you for sharing your heart with me.
I will take your message to the top. I will tell them. And I will do whatever I can to make sure another child doesn't succumb the same fate.