He was a large-set man with round shoulders and a round head. He was much larger than me. When I walked into the room, he was sitting on the edge of the bed. I asked him what was going on and he simply replied that he was better and wanted to leave. I listened to his lungs. He wasn’t ready.
I told him that he is wheezing considerably, that his lungs are still tight, and that he needs more treatment of his asthma in the hospital before he could leave safely. He disagreed. I asked the nurse to walk the patient and to check his oxygen level.
“You’re lungs are not ready, I’m concerned that if you leave, your lungs will close up further and you’ll come right back to the ED.”
His head looked straight down to the tiles on the floor. “I feel better, I want to leave.”
I stood there. I saw his thick hands deliberately set calmly on his lap as he sat. I paused, then I sat on the bed next to him and looked at him in the face.
He was young in a way. No gray hair, no wrinkles. Unkempt, brutal, soft.
He was a 50 or so year-old man well-known to our general medical floor team. He was admitted for heroin-induced asthma every month or so for the past few years. As with other frequent visitors, there is always a collective groan when we hear his name again. During one of my first months as an intern I was assigned to care for him. I treated him with the usual (albuterol neb, steroids) but he did not improve quickly.
In the evening, the day time signs out their patients to the night team. During sign-out, I received a call from a nurse, “Your patient is signing out AMA, please come now to have him sign the forms.” I told her it would be a few minutes before I could come but she emphasized the urgency and tersely hung up the phone.
His eyes were still set to the ground as I gazed at him. Next to us was a side table with his dinner. I asked him if he wanted to eat.
“The food doesn’t suit me.”
His face didn’t budge. I thought about all the doctors and nurses he has seen in his life. I thought about all the rooms he has been in. Perhaps he knew the hospital— hallways and elevators, shift changes and staff— better than I did at the time.
“Hey. I’m worried about you. … I’m worried about what will happen to you. This is the first time I’ve taken care of you, but I am worried about what’s going to happen years from now. I know you want to leave— and I know it’s hard— it must be really hard. But you’re gonna come back again. And then we will be here again. … How long can you keep doing this? What do you think is going to happen?”
He turned his head to me. His fingers tightened. “I know. Every time I have an asthma attack, it gets worse. It’s getting harder and harder to get better. But this is it. I know I said I would quit before, but I’ve never really tried. But this time, I’m going to really try.”
We were looking at each other but I could see his hands trembling. I could feel a weight in my chest. I told him that we need to treat him for the rest of the night then I will check on him in the morning. If he gets better he could leave tomorrow.
When I drove home I remembered what I saw. Inside his voice there was something that was so fragile. It was so small— a tiny, wispy, thread. Every fit of passion, every readmission, every failure had beaten his hope into this brittle, lonely sliver. And yet he still held on to it— the hope that he could one day change— his heart was warring inside. Was it ignorance? Was it wishful-thinking? Was it true, life-giving hope that he held on to?
I don’t know. I just knew he needed something to protect him and empower whatever was inside of him. If he lost the fragile that’s inside, he would die. When I came back the next day I learned that he had left during the night.
No temptation has overtaken you except what is common to us all. And God is faithful; he will not let you be tempted beyond what you can bear. But when you are tempted, he will also provide a way out so that you can endure it.
Father, bless my words and my actions when I treat my patients. I alone cannot do it with my own strength and knowledge. Help me remember how all humans are sick and need a healer. Help me recognize my own brokenness so that I can share in the sickness of my patients and empathize with them– for you shared in our brokenness in order to heal us.