I was perched on the edge of the hospital bed watching the second hand on my watch close in on “11” when Eva reached up with her free hand and grabbed my wrist, surprising me. I lost track of her blood pressure.
Her worried, crinkled eyes looked searchingly into mine.
“I really, really need to go home, Dr. Bair. Please, can you send me home?”
I couldn’t send Eva home. And not just because I was only a medical student. Even though her partial colectomy three days ago had been successful, Eva had lost a significant amount of blood during surgery and her immune system was still weak. At this point, I couldn’t even hazard a guess at when she might be ready for home.
I smiled and nodded empathetically. “Miss your own bed, Eva?”
She looked down as she shifted awkwardly under her blankets and winced at something I couldn’t see. When she looked back at me, her face was drawn. “I miss everything. I miss my own bed. I miss Ms. Kitty, my Siamese cat. For all the noise in here at night, I miss the sound of my cuckoo clock ticking and chiming in the hallway. I’ve got every sound on the planet in here at night except for the ones I want. I miss Ben the mailman. He’s more timely than Big Ben.”
“I get it, Eva. I really do. I’ll see what I can do to get you out of here as soon as possible. Also, I’m still a medical student, so call me Henry.”
Medically speaking, there were many things the care team could do for this patient, yet it seemed we were powerless to accomplish the one thing that in her mind was the goal—getting home—even if she knew as well as we did that getting well was a step in that direction.
I looked around her room. There were flower arrangements, balloons, cards, and stuffed animals from well-wishers on every surface. “It’s pretty homey in here for a room in the general surgery inpatient unit, though, isn’t it?” I asked, attempting to sound cheerful.
She looked at me and arched an eyebrow. “Your home is filled with flowers, balloons, and stuffed bears, is it?” She smiled wanly. “You live in a Hallmark store?”
I shook my head and sighed. “Fair enough, Eva, fair enough.”
Later that day, I brought up Eva’s feelings of displacement to my attending.
“Well,” he pondered, stirring his coffee slowly, “you might consider the question differently.”
“Obviously, you can’t get her the chiming clock or the mailman, unless he should decide to visit, I suppose. But you might devote some attention to the greater question of what those particular attachments do for her.”
I thought about it. The things Eva pined for all spoke to predictability, routine, and familiarity. For patients, inpatient units are a hive of the unknown, with schedules seldom communicated to patients—and even then, often contingent on fluctuations in their condition and in staffing availabilities. It is as if we, as providers, are conducting an orchestra to which the patient is a captive audience, with an undisclosed program subject to change without notice. To know when one is going home is to know when one will regain a modicum of control, some degree of autonomy, some semblance of mental and physical freedom . . . which are all hard to come by when other adults appear seemingly arbitrarily and help themselves to one’s blood, urine, stool, and vitals.
I went back to see Eva the next morning. She was staring in the direction of her window, though bundles of flowers on the windowsill prevented much of a view.
“Good morning, Eva.”
She nodded at me.
I sat down in the chair next to her bed. “How are we doing today?”
She chuckled. “We? I’m the same, obviously. How are you?”
“I’m fine, thanks. I have something for you.”
“Ooh, I bet you’ve got more fun things for me to not read and then sign.”
Now I laughed. “Almost as good.” I reached under my tablet and pulled out a small stack of papers held together by a binder clip. “Here.” I extended them to her.
“Great. More documents.”
I pointed at the top sheet of the stack she was holding. “Look, they’re all schedules. I did some splicing, so what you have there is your treatment schedule for the next four days—or at least the parts that are scheduled—and the alternating sheets between them are the schedule of things happening in the hospital. There’s a book fair, some kind of jewelry display, a few concerts, and a whole bunch of lunch presentations. There’s no reason you couldn’t go to these, so long as we grab a nursing assistant to take you in a chair.”
She looked at the papers in her hands. “But what about the random medical stuff that I might miss if I’m not here?”
“Well, this is important. So if you find things you’d like to see or do, let’s make sure we touch base with the charge nurse and plan accordingly so that you can feel less like a hostage up here. We just need to plan, and I think it’ll be fine—”
“There’s a farmers’ market in the north building!?”
“Sure looks like it. Do you enjoy going to them?”
Her face lit up. “Since I became a vegetarian a few years back, I’ve made it a habit to go every weekend with my sister.” She tapped the second page. “It says it’s at ten this morning.”
I glanced at my watch and stood up. “That’s in an hour. I better get the charge nurse so we can arrange things and make sure you are free to go.”
She beamed. “I’ll call my sister. I bet she’d love to come with me.”
I was halfway out the door when Eva called out, “Wait, Henry—thanks for giving me a taste of life before the hospital.”