poured out before bed
“He was transferred from the unit to the floor yesterday. He is severely de-conditioned at this point – PT/OT is working with him just to help him to feed himself. Neuropsych saw him this morning – he is decisional, but he has no family or friends to appoint as POA should he become non-decisional. Surgery has seen him and they’re willing to operate, but anesthesia won’t clear him unless the cocaine is out of his system. We sent a urine drug screen yesterday, but it was still pending this morning…. Mmm, let me check now, it should be back. I expect it to be clear, though – this is hospital day #19 for him.”
The intern opens up Mr. Jones’ EMR and clicks the laboratory section.
“Oh, they’re here. No cocaine, so that’s good…” He gasps a little. “But look at his ethanol! And the cannabinoids! Good Lord, he’s positive for both! And he had neither on board when he came in!”
The whole team leans in to look at the screen. Then, as one, we all turn to look out the team room window at the room opposite where our cachectic 76 year old patient, a pleasant poly-substance abuser quite possibly on his death-bed, lays motionless watching cartoons.
Our attending sighs.
“If only he had put that ingenuity and go-getting spirit into some other pursuit in his life, eh?”