This post is based on a clinical encounter and has been de-identified to protect patient privacy. Certain identifying details have been omitted or modified.
Among the first patients I’ve admitted early in my clerkship years, one has a name that I’m jealous of. Seven syllables long, and each one rolls into the next. Every morning, among other things, I would ask him his name. He wasn’t fond of many of my questions, but this one he always answered without pause. I hope he realized at some point, as he drifted in and out of sleep, that I didn’t mean to be rude. I could never forget his name. How could I?
I still remember the small panic that set in when I realized that I would be the one to talk through the thing that brought him to the hospital and the growing list of things that was keeping him here. Morning after morning. A group of us trailing up to the front of his door, open enough to hear the tail-end whistle of his exhales. I went through his hypos and his hypers, the periphery of one of my eyes tracking whenever the intern would nod along to my monologue of wayward serum calciums and liters of oxygen.
Morning after morning in front of his room. Still rubbing my hands together with hand sanitizer, I started with my questions: Who are you? Where are you? and Why are you here? Our conversations began and ended in the present tense. It was only when I met his guardian, a member of his extended family, that we spoke of his past. The man he had been. The place he’d come from. And a glimpse of the many “whys” he’d come across throughout his life. This time, I was the one who nodded along to a monologue. One that was far more important than the ones I had been giving each morning. One that didn’t end with a suggestion of fluids or binders but an answer to the question of when enough was enough.
The morning after, the intern told me what had happened overnight. I realized that my time speaking with him and about him was at an end. I wouldn’t be climbing up the stairs, knocking on his door, or making out the number on his oxygen meter with one eye closed. I wouldn’t even write a note. This time a group of us would trail to the room two doors to the left. And as we passed by, I would peek inside to see a man with a mop, cleaning the floor. Missing would be a bed, and a man lying in it, and a name seven syllables long.
In the short time since then, I have learned many more names, each attached to their own problem lists and presentations. And yet, long after I’ve forgotten their problem lists, medications and lab values, I hope to remember their names at least a while longer.
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