Unenviable

“What the hell do you think you’re doing?”

Lydia was recently discharged to home after her second cardiac surgery. The first one, 2 years ago, kicked her ass. Since that time, she has slept alone on the first floor of her home, while her husband still sleeps in their bedroom upstairs. She hasn’t been able to walk up/down stairs without assistance since her initial surgery, which is unfortunate considering that she has to climb 20+ steps from the sidewalk to enter her home. She is, without a doubt, homebound.

“You don’t want to get better!”

My first visit, the Tuesday before last, was cancelled. When the nurse had visited earlier in the morning, Lydia was short of breath and reporting severe abdominal pain. The nurse called emergency services and the EMTs arrived to the home. Lydia sent the ambulance away empty. She remained in her own bed. I would have to wait to meet her.

“You won’t even try to help yourself and get outta this fuckin’ bed!”

Six days (and another nursing visit) later, I finally had an opportunity to meet Lydia – she was exceedingly frail and very weak. She was spending ALL day in bed, lying supine. She fell backwards into my arms 2 times when walking 10 feet to her bathroom, refusing to use a walker for support. Her pain was reduced compared to the week before (6/10) and she expressed an interest in trying to regain some of the strength that she had lost during multiple months of hospitalization as she battled an infection and multiple surgeries (yes, there were others). I arranged to visit again on Wednesday, 2 days later.

“You were just at the hospital – you are fine!”

When I returned on Wednesday, she looked worse. She was lying on her side with her knees curled up to her chest. She was weeping. Her pain was a 9/10 and it was constant, unremitting. She could not find a position or movement to reduce or alter the throbbing pain in her abdomen. I had to call the ambulance, but I asked for to consider going to the hospital before I placed the call.

“Come on, get Up! This is bullshit!”

She told me that she had been considering going to the hospital, but was thinking that she might just be constipated; she preferred to stay home for the night, drink some prune juice and take a stool softener – she would go to the hospital tomorrow if she still felt as bad the following day as she did at the time of my visit.

“Show us what you can really do!”

For 10 minutes, I sat at her bedside. She shared with me why she wanted to stay home. She had been in the hospital long enough already. She would miss her grandson, who lived with her. While empathized with her predicament, I reminded her of the severity of her symptoms and the limitation of home health care in addressing her needs. Easter was only 4 days away; surely she wouldn’t want to wait until then to go the hospital if she could be in and out earlier, I told her.

It took a little bit of time and effort, but she changed her mind and committed to going to the hospital for an assessment.

“You need to be stronger and stop trying to have everyone else get you better!”

I called 9-1-1. Lydia’s husband of 42 years yelled and screamed at her as he collected her identification, medication list and insurance cards.

The ambulance arrived. The EMTs pushed her out the door. They carried her down 20+ steps to the sidewalk. They placed her in the ambulance. They closed the door. They drove her (and her husband) away.

“You keep doing this to us. You keep wasting our fuckin’ time with this shit!”

The next day, I received an appreciative call from the nursing case manager with the agency…thanking me. It turns out that if I hadn’t convinced her to go the hospital, Lydia likely wouldn’t have been available for my next visit – she was found to be septic and bleeding internally when she arrived to the hospital.

I checked the obituaries today, now 4 days later; I don’t see her name yet.

I wonder what her husband has to say about that.

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3 thoughts on “Unenviable

  1. You see this stuff clearly Keith, and you’ve the courage to write it out. A rare combination.

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