El Alma Errante: On one condition.....

It was 11:00 pm in the ED and I returned a page to the ER front desk with what was becoming resignation.

''Hey, is this the MOD (Medical Officer of the Day)? Hey how are ya?! I have another one for you."

Great....I added the 8th patient of the night to an already backlogged list. ''Go on," I said anything but willing to be chatty.

''He's here from the DOC (Department of Corrections) and for foreign body ingestion. GI (gastroenterology) went into scope (endoscope-basically looking down his gut with a tube containing a camera and tools you can operate remotely) him but couldn't retrieve it.''

“And what exactly was ‘it’ ?'' I asked with strained politeness.

Ask anyone who’s been MOD…...you just wish ER would just give you a half decent sign-out (apologies to the ER residents I genuinely like - though crappy sign-outs are usually from antiquated ER attendings and not so much ER residents!). It’s either a scant one liner followed by “This guy really looks sick.” Or vague waffle followed by “This guy looks really sick.” Yeah, they came to the hospital…they better look sick. Sorry, I digress…

''A straightened paper clip.'' ''Why'd he swallow a paper clip? Does he have a psych history?''

''Yeah, probably. But it's the same BS...just trying to get a way out of the DOC.''

Oh, I thought...of course...why didn't I think of that? So we admitted him and the plan was to keep monitoring him in case he perforated his bowels and track the progress of the clip with daily abdominal XRays. Later that night my pager rang with a call from his nurse who wanted me to order a 1:1 sitter for him. A one to one sitter refers to a person who sits with a patient all the time to make sure they don't do something silly or dangerous. Usually for people who are suicidal or agitated. ''Why?'' I asked again knowing that this was already a redundant question. "He keeps trying to eat his EKG leads." Really?! I said I'd take care of it. Not like I wasn’t already drowning in work down in ER.

See the straight white line in front of his vertebrae? That's the clip.

When I saw him the next morning as I rounded I asked about his craving for things not normally featured on a regular hospital menu. Or even a progressive hospital menu. He protested and was visibly embarrassed. As I turned to leave he asked me in a hesitant manner if I could order him some extra drinks since he was on a liquid diet and was hungry.

I turned around, holding the door open to leave and looked at him.

And I saw a guy who just maybe tried to get a break from the ‘slammer’.

To buy himself better surroundings or better food. Or to get away from who knows what in prison. Anyone who thinks opting for hospital food is a better option...well that person has it rough. I said I'd look into it and ordered Boost drinks in between his meals since I needed to keep it liquid. And I even ordered different flavors for each Boost he got through the day. That’s how nice I am. I’m kidding...it was such a pitifully insignificant thing to do for him.

The funny thing was he seemed happy about it the next day and it was obvious that he was warming to me. That's all it took to make him happy.

We're not allowed to ask them what they're in for and rarely do we talk about their life in prison. Sometimes we hear rumours going around about what a patient did. Sometimes it's petty crime and other times it's more shocking.

But I prefer not knowing.

Because it's easier to treat them like people then. They’re not pathetic losers. They’re not monsters. Ignorance is redeeming. I almost don't care what they did. Because they're being punished for it. But someone's got to be able to show some kindness to them. They may not deserve it by most people's judgment (including mine) in the light of their previous actions.

But that's my point.

I need to not know to be able to show them love.

Conditional love.

It makes unconditional love much harder to pass by, right?

PS. We did get the paper clip out eventually after a few days and a few XRays that showed it was going no where!