Two stories from The Hospital

"Hey the red light is on, can you check the back door?"

The shuttle driver had just strapped in a wheelchair-bound patient in the back, and was starting to pull away from The Hospital. The woman who asked about the light is concerned that the back door isn't properly closed.

"Naw, that's so it'll be easier for you to jump out during a fire," the driver jokes. The whole shuttle, filled with patients and health care personnel, laughs. Except for me. I don't joke about safety. We drive down the hill, and then the back door flings open. I roll my eyes and count the people in the shuttle. In case you were wondering, no one was hurt.


Today at the Pain Clinic, I sat with Dr. K on six different cases. To give you an idea of what the clinic is like, the patients that we see have some sort of chronic pain. To qualify for acceptance to this program, the pain must be non-cancer-related, and must be inoperable. Patients must sign a pledge to give up illicit street drugs, and commit to a 12-week group psychoeducation program. They also have the option of physical therapy at The Hospital. Most patients are prescribed opiates. Dr. K strongly believes in buprenorphine, and has invited me to join in his clinical research on its effects. I would have to commute to his other office in Mill Valley though, so I'm not entirely on board with the idea yet. And plus, I don't even know much about it myself.


My only job as a volunteer is to bring the patient in from the waiting room. That's it. Totally different from volunteering in the ED. Then I sit and listen to the visit, and bring the patient back out when Dr. K is done.


Each case was more depressing than the last. Patients hobbled in, heavily dependent on canes and railing support because walking is too painful for them. Patients told me about their pending lawsuits against their workplaces that caused their injuries. They talked about staying in bed for two days because they just can't move, work, walk, or eat. Two patients cried today, partly because they ran out of antidepressants, and partly because they can't afford to refill them. One patient said she almost ended her life yesterday because the pain was too unbearable.


It really makes me think, is there anything happy in medicine, or is it just suffering, all the time?


Dr. K just nods and says "Okay" a lot. Then he makes me count their pills, re-evaluates their medications, adjusts them to a higher dosage, and off the patients go. Six pills instead of four, a whole patch instead of a half, cut those tablets in half if you feel too jittery, decrease the medication if you are too drowsy. It's an entirely different type of intervention from what I've experienced before, and I've been in many many different clinical settings. I guess I'd never realized how fluid medicine can be, and how yes, in the end, treatments are experimental and not an exact science. Fancy that, medicine isn't a science. Also, Dr. K wears an iPod earbud in one ear, and so I get the distinct impression that he isn't listening. But I'm sure he is.


When I brought the last patient into the room, I thought that maybe it would be prudent if I left. Sometimes patients don't like volunteers being in the room, which I completely understand--I wouldn't want me sitting in on my doctor visit either, even if no clothes are being removed. But then the patient started talking about her kids' back to school expenses, her weight loss (now she's 198 lbs), and her trip to Memphis. We bonded over that--I've been to Memphis before, also. She said that the medications that she was on were aiding in her life greatly. She testified to the miracle healing powers of epson salt baths (well okay, mixed with Flexeril, a muscle relaxant), and said that her life is starting to look up. That made today worth it. I wanted to tell her that given all she's been through, that she was an amazing woman.


Another heartwarming tidbit: whenever I visit Boss Man at the volunteer office, he always throws up his arms and says, "Connie!" like he's really excited to see me. Today, he handed me a Hospital lanyard with one of those retractable badge holders with a post-it that said "For Connie." I had mentioned a couple of weeks ago that I wanted one, and now I have one. Yay!