We admitted a woman to the hospital last night.
She's seventy four years old and she uses crack cocaine. (74 yo) and she's sexually promiscuous. Go girl. Actually, I think it's more like she sells sexual favors to support her drug habit. That's OK. What ever. I'm not going to judge.
Quite frankly though she's missing half her teeth and the teeth she has are all brown. Makes ya wonder what goes on in those crack houses...
She came to the hospital vomiting blood. I should tell you that she came into the hospital vomiting blood two weeks ago as well. The GI people saw her at that time and they found a bleeding ulcer that they cauterized. She was pretty lucky to be honest. They discharged her on some medications and she never took them. She forgot. Hey, she remembered the crack. No one's perfect.
Anyway, she came back last night and she's been vomiting blood again. Her hemoglobin was 5.6 which is LOW! and we started giving her blood. The nurses were laughing because she kept making passes at the medical student.
Actually... she's kind of inspirational.
The GI people saw her again this morning and they did another endoscopy. Guess what? She has an ulcer. Tadaaa!!!
They say it's covered with a blood clot which they don't want to disturb because that's all that's keeping it from bleeding. If she remains stable we'll discharge her home on medications again. And she won't take them again. So it goes.
Another County story.
We admitted a guy the other day. He's 87 years old, he's homeless and he's a bit demented.
Some one saw him wandering the streets and an ambulance was called. We're not really certain why the ambulance was called but when they got there they found that he had a rather nasty wound on his leg. It was infested with maggots. We still don't know how he got the wound but he says he got shot. We asked him what made him think he had been shot and he said, "Well, just look at it!"
It was hard to see anything but maggots. We asked the wound care specialist to help us manage the wound. The wound care specialist saw the patient and she left a note. This is what the note said I swear to God;
"Wound infested with maggots. Maggots will clear necrotic tissue and not invade healthy tissue. When changing dressing place old bandages in sealed bag to prevent fly contamination."
Dear God.
We're trying to give him IV antibiotics but he keeps pulling out his IV line.
"Just give me my clothes and let me go home." he says.
He doesn't know where he is. He doesn't even know that he doesn't have a home to go to.
"Sir, do you know where you are?"
"What do you think I am, stupid?" He's pissed off and fed up. "I was just fine till I got here. Give me my clothes let me go home."
He won't let us put an IV in him. He won't let us draw labs. He won't even talk to us really. He's just a lonely old guy who has no one and he's on the way out.
A few week ago we admitted a guy who thought he was God.
He was a bit of a lesson in life.
Among other things he was crazy but his overall condition was confounded by the fact that he refused to take antipsycotic medications. He said he didn't like to lose that "God" feeling.
Understandable..
Guess what? I admitted him again last night. He has pneumonia again. He told me he's Shirley Temple. He told me he has a sweet pussy and he wanted me to touch it. He told me he's Italian and I'm his uncle and he's been looking for me.
I took his history and ignored the pussy.
When I left his room he started yelling, "Uncle! Uncle! Uncle!" You could hear it all over the ER. "Uncle! Uncle! Uncle!"
I could hear him as I talked to other patients. "Uncle! Uncle! Uncle!"
Have you ever wanted to tell God to shut up?
The ER staff had put him in restraints but somehow he got his hand free. He shit in his pants and then he reached in and started throwing shit all over the walls. Then he started eating his shit. Then he started spitting shit on the nurses.
Quite frankly it was disgusting.
I guess if you're God your options are wide open.
Whatever but somehow or other the nurses got pissed off at me. I don't know. Go figure.
Hey, last week we admitted a guy who had had a fight with his wife. The story went like this: A guy and his wife had a fight. The guy got all pissed off and stormed out of the house and then he shot up a big dose of heroin and cocaine. Then he went crazy. A while later someone saw him running through the streets and called 911. The EMS people showed up and somehow they got him in the ambulance. Then they brought him to County Hospital.
Thanks.
When the ambulance arrived they opened the door and the guy jumped out. Apparently he ran a few feet and tripped and fell halfway through the ER back door. Then he passed out.
But there was the problem.
He was only halfway through the door. Halfway through the door meant the County Hospital security people wouldn't touch him. You see, as security explained to us, the gentleman is city police jurisdiction until he's ALL the way inside County Hospital. County Security wouldn't touch him. Honest.
And the EMS guys? They were sick of him. He was out of the ambulance and their job was done. Fuck it. End of story.
So the guy lay there halfway in and halfway out of County Hospital with the electric doors trying to close on him over and over again. I swear to God.
Then a miracle happened. The guy woke up and looked around and lit out like a scared rabbit. And he was gone. See ya people!
A while later someone saw him running through the streets and called 911...
He's in the ER now.
He's acidotic with renal failure secondary to Rhabdomyolysis. His kidneys are shot. He's fucked.
When I was admitting him his wife showed up. She's pregnant. Baby makes three.
She asked me what had happened. I looked at her for a second and there were suddenly so many things that I wanted to tell her. I wanted to tell her about the mother who has her 12 year old son sucks old men's dicks so she can get drug money. I wanted to tell her about the 2 year old we admitted who was covered with human bite marks. His mother said the neighborhood girls did it. I wanted to tell her about seventy four year old love druggies. I wanted to tell her about maggots breeding flies. I wanted to tell her about God next door.
Then I had an idea.
"Hey." I said to her, "Follow me. Next door we're taking care of God. He's been shootin' the shit with some of the nurses and maybe he can answer your questions."
She looked at me and...
That, dear reader, is the only thing in this story that didn't happen.
What I really did was I asked her husband if it was OK if I talked to her.
"Yah," he said, "she knows everything." I didn't know about that but I looked at his wife and I said,
"Your husband injected a bunch of drugs and now he's ruined his kidneys. He's fucked himself over and he might die. We're trying not to let that happen."
She looked at me. I looked at her.
I looked at him.
They looked at each other.
I had another patient to see.
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Afterword.
Before you ask, let me field a couple questions.
1) Do I believe in God?
Yes.
2) How can I talk about God like this?
I think that if God is anything then God is everything. Yah, even some shit spitting psycho is God. And if your God is too small to be everything, then I don't want anything to do with it.
Miami 2007
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