Don't Come Back

He wasn’t supposed to return. I had admitted him to our unit the week before in the middle of the night. He was young – 46 – and he was showing early signs of a stroke. He had diabetes and high blood pressure that had never been controlled. He and his family were sweet. He spoke very little English – “thank you,” “yes” “no” – was about the extent of his vocabulary. His son, who must have been 18 or 19, did the translating. I REALLY liked them but I kept thinking…you shouldn’t be here. You are my generation. We are too young to have all these complications. We should have SO much time left.

He had been in the U.S. for several years with his family and it appears he had adopted many of our less than glamorous habits – fast food and a sedentary lifestyle. While we had taught him about McDonalds and big screen televisions, we neglected to teach him about our healthcare system. Now he was paying the price. He didn’t have a regular physician and years of not managing his health had caught up to him. I was having a relatively quiet night and all of my other patients were in good shape so I was able to listen in as the physicians evaluated and talked to him. It broke my heart as they asked his son to relay to his dad the seriousness of his condition and the importance of getting a grip on his health or he might DIE. I remember thinking how awful for a son to have to relay this message to his father. That seems like an enormous burden for a kid. I knew they were right but what a message to have to communicate to your dad.

The patient was just having the beginning signs of blood vessel issues and lack of adequate oxygen to his brain – some dizziness, minor slurring but no numbness or tingling in his arms or legs. This was the good news. Maybe with the right medication and some changes…maybe there was time to manage the condition and stop the progression. I felt hopeful on his behalf. After the doctor’s left, I heard him talking in his native language to his wife. I heard the wife mention the word coffee and I broke in…”would you like some coffee?” She looked at me amazed. “Yes, you understood me? Coffee?” Little did she know who she was dealing with. I understand coffee in every language. After getting them settled, they fell asleep exhausted and I left for the day. When I returned to work a few days later he was gone and I hoped he was on his way to health and a long life.

Last Thursday night around 2 a.m. my charge nurse told me she had a new admit for me and gave me his name. My heart dropped. At first I hoped it was a mistake and she was looking at an old message on her pager. It was the name of my friend from the week before. No mistake. He was back and he was worse. As much as I liked him and his family, it was not a good sign that he was back. Not only was he back but he now couldn’t move his entire right side. His stroke had extended. I talked with his family and he had just started all his medications the day before. It was heart breaking. Once again his son was there to translate – although I suggested to the day nurse that the translating service be called. How awful for a son to have to repeatedly tell his dad that his life was being cut short by years of poor health decisions. Having his son translate just wasn’t right. By now I knew what they liked. I got them coffee and warm blankets. I gave him insulin and medication for his blood pressure and I prayed.

I don’t know if he will still be there when I return to work tonight but I worry about him. He is too young. He should have a lot of life ahead of him with his wife and kids. I want that for him. He came to the States for more opportunities than he had in his native land. I want him to realize these opportunities - not die before he ever sees 50. I want him to be okay and for this to just be a wake-up call. I don’t want it to be too late for him.