I like to check up on my patients, even after they've left the hospital. Sometimes it's because I'm honestly concerned that if they don't get a reminder phone call, they'll forget about that appointment that I set up for them. Sometimes, it's because I want to ensure that they're taking the right medicines at the right times. But most times, it's because I've formed bonds with my patients, and even though curiosity might have killed the cat, I just want to know how they're doing.
So I keep a list (hospital-sanctioned, of course), with all my patients' names, ranging from people I've just started taking care of, to my very first patient. Now, I usually only call them once - no more than two weeks after discharge - and after that, I just stalk their hospital chart every now and then, to make sure they're doing okay.
Today, I was filling out my patient log, and I started thinking about
my patient with pancreatic cancer, wondering if she was able to hold her daughter's hand and coach her through childbirth, or if she and her husband ever got to go on that cruise as a one last hurrah. See, they had bought into the homeopathic and so-called "organic" treatments that Cancer Treatments of America were offering, especially after we had told them there was very little left we could do. She had stopped coming to our hospital, so I had stopped checking her chart.
But today, something told me to recheck, and so I opened up her chart.
The last entry for her was dated in January. Just a couple weeks before her daughter's due date. And the discharge plan at that time was home hospice. Prognosis? Days.
I only spent three or so days with her, but seeing that discharge summary, seeing that prognosis, I broke down and cried for a good five minutes. Because even though we're surrounded by dying patients every day, we're still very much shielded from the actual event of death. Because, besides the occasional code, where everything and everyone is in a panic with chest compressions and intubations, and the patient is already flatlining when we get to the room, I haven't seen anyone actually die.
People come to the hospital for care, and we send people out the door on the premise that they're getting better. And even though I knew last year that she was going to eventually die, finding out that she actually did, was still numbingly shocking to me.
