My First Geriatric Patient

I had only been working at my new preceptor’s office for about two weeks. I had been following him and learning what his program was, but was still not comfortable with dealing with the geriatric patients he had in his practice. I guess however he felt it was time for me to get my feet wet.

The doctor said, “OK, this one is all yours. You do everything..treatment, meds, charting her case, writing the orders..the whole ball of wax." Then he looked me up and down and said, "You may have a problem with those shoes..." I thought he was nuts. What in the hell did my shoes have to do with seeing patients? Well, I walked in and introduced myself, and my first patient’s words to me were..."You’re a fat old man, and I don't like you!!!" So I said, "Well I guess we don't need to examine your eyes! But please, don't beat around the bush, just tell me what you think...I can take it." She had her arms crossed on her chest and wouldn't let me examine her. She said, "You need to leave!" When I finally convinced her that I couldn't leave till I had examined her she uncrossed her arms, and let me in. I put my stethoscope in my ears, and bent over to listen, and she grabbed a hold of stethoscope, and just about flipped me over the bed. My ears are now a quarter of an inch forward from where they were originally. She is 93 years old, and only weighs about 85 pounds, but this gal is strong!! By the time I wrestled my stethoscope away from her, I was worn completely out, and had to buy a new diaphragm for my stethoscope. After about 15 minutes I had completed my exam…the longest 15 minutes I can remember.

When I came out, my preceptor was about to choke he was laughing so hard. He said, "WOW, she really went personal on you...with me she just hated my shoes!"

She is terminal, and has complete kidney failure, so she will probably not be around very long, but over the last week I have won her over, and the other day she asked if I would hold her hand for a while. At first I though it was a ploy to rip my arm off, but we sat and talked for a while, and it was a wonderful moment. After a while, she turned and looked right at me and said, "Would you sing me The Yellow Rose of Texas?" It was so sweet.

So I leaned over, got real close to her ear and as gently as I could sang..."Boomer Sooner, Boomer Sooner..."

Justice is a wonderful thing...

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Follow up…

My patient’s condition was irreversible and terminal. A week ago we made the decision to take her off of all her medications, and only provided her with comfort care. Within a few days however, her condition began to improve, and last Friday she was doing so well we could not keep her in the hospital any longer. I wrote her discharge to send her to nursing care, had my last visit with her and said good bye. She was awake and alert, very kind, and as I was getting ready to leave she squeezed my hand and gave me a wink and a smile. I knew this was the last time I would see her.

Shortly after her transfer, she passed away.

This morning before I got to work I received a call from the receptionist at my last rotation which had been in the same town. She told me she was sorry for the loss of my patient, and that I needed to look at my patient’s obituary in the paper. I thought that was strange. Because of HIPPA laws, I had not told her who my patient was, and I had no idea how she knew of her death or my connection to her. She knew where I was currently working and had heard of the patient, but I had never identified her.

When I read the obituary, to my amazement, her family had named me as an honorary pallbearer. They told me they were sorry for the abuse that she had given me. The fact is I never felt abused. I had a relationship with this little old lady, and I would not change it for the world. As I told the family; years from now I may not remember any of the patients on this rotations, but there is no doubt that I would remember this lady forever.

I have learned a lot this rotation, but I think I will never forget the lesson this little old lady taught me…humility.

God bless her and keep her in the palm of His hand.
May she rest in peace and God’s eternal light shine upon her.

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