Another day at work

She’s been very, very sick for two months. Unable to move, unable to feed herself, unable to talk, scared by hallucinations that are vivid and frightening. Treatment with antipsychotics has only made her worse.

We bring her into the hospital, not knowing what’s going on. The expensive work- up begins, looking at infections that could cause delirium, brain scans  to look for a severe type of dementia, vascular work up to make sure she’s not having mini-strokes.

She starts getting slightly, slightly better. When I ask her the usual questions, she says yes and no, but not much more. She repeats my words back at me, says them over and over. (We call this echolalia and perseveration, both signs of brain injury.)

Then he drops by. He’s another patient on the floor- I don’t know why he’s here.

Well, aren’t you the prettiest woman on the floor?

She smiles at him- a rare smile that has just started emerging. Certainement!

Oh, my lady knows French! My belle. He touches her hand, gentle but not afraid. She’s so fragile.

She smiles again. Certainement!

I’m Joe, you know. Giuseppe. I’m Italian! When you came in, I thought, she don’t look good.

She just looks at him, still smiling.

You look better now. Maybe this one (pointing to me with a mock-respectful thumb flick) knows what she’s doing, you think?

She looks back at me. Giuseppe. Joe.

I’ll come back and visit you, ma belle.





About purplesque

Psychiatrist, cook, bookworm, photographer. Not necessarily in that order.
This entry was posted in Work. Bookmark the permalink.

13 Responses to Another day at work

  1. zottavox says:

    That sounds very rewarding, Sumpsimus!

  2. I sometimes wonder if the mental and physical health of older people declines because they feel unloved. Maybe if this woman had someone at home like Giuseppe, she wouldn’t need to be in a hospital, so sick and lost.

  3. phantomxii says:

    Confession: the last three words primarily make me think of a particular Tom & Jerry cartoon, probably from the 50s. (I wonder if any of your patients saw and chuckled at it when it was new—although they would have been younger adults, not kids.)

  4. aubrey says:

    I very much suspect that you know what you’re doing.

    Such a sweet, rewarding dialogue.

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