Friday, August 24, 2012
Empty Black Hole Instead of a Brain
The striking features of most of my patients is their lack of impulse control and their overwhelming sense of entitlement. "I want juice. Give me juice. Oh my God. I just asked her for some juice and she is still sitting there, when she should have been getting my juice."
Because of the incessant demands, we are not permitted to give patients anything outside their schedule: pills, meals, afternoon and evening snacks. No extra food. No pens, books, notebooks, music, hair pins, combs, lotion, towels, and on and on. They don't stop with a laundry list of demands. If you give in and give them what they have been repeatedly asking for, they are satisfied at most for five seconds. Then they start the barrage of demands for the next random item on their list. "Can I use the phone? I want to call my mother. I don't know her number. Can you look it up? Is it in my chart? Can you just call my sister instead and tell her to bring me Burger King to eat. No. Make that McDonald's. And tell her that I want my X Box here. I can have that here. My doctor at the other hospital said that you would let me play X Box, but so far, you have not given me an X Box, so you have to call my sister to get me one." They then follow me around, demanding to know why I have not called the sister yet.
It doesn't stop. They don't sleep. They might cat-nap every now and then. They bounce off the walls, draining the energy from everyone around them and using it for themselves to keep going and going.
People who don't work with these non-stop demands all day will flag me down with the same fervor as the ignored patient to say, "He just wants his mother's phone number from the chart. That's not hard."
That's not the point. Most of the desired tasks are easy. The point is that I am not their Fairy Godmother, here to grant their minute-by-minute whims. I have work to do. One of their reasons that their lives are such a mess is that they don't stop harassing the life out of everyone. Family members often don't pick up their phones when the hospitalized member calls because they are enjoying the peace and quiet while their Energizer Bunny is away.
An attendant who knows better kept coming to me with a patient's requests for juice, cups, napkins, paper, information, and so forth. Each time I turned her down. Finally she pointed out to me that the patient was becoming upset because he want HIS NURSE [read: Fairy Godmother] to be doing all of this for him. [Do I get to stroll into a business and bark out one demand after another and choose an employee who has to do it all? NO.]
I told the attendant that the patient was a "bottomless pit of need." She nodded her head, as if she understood. She did not.
"So you want to throw him in a pit?" was her reply, half scared, half confused.
"No. He is LIKE a bottomless pit." She couldn't be that stupid, or could she?
"He is already in the pit? He is not," she tried to respond.
"How much can you put into a bottomless pit?" I proceeded, trying to make something click in her dense head.
"Everything," she answered, as if she knew something.
"The patient is LIKE a bottomless pit because no matter how much you give him, he always wants more." I waited for the wheels to turn. They didn't.
"So that is why you want to put him in a pit?" she continued again.
She didn't get it. Nobody I work with gets it. They understand very little of what I say and the rest they interpret as an insult or threat.