Update from the trenches of the workweek


My patient, LB, is 103 years old. She has Einsteinian hair and Beethovian hearing. She is not merely frail: she is a wisp, she is a quiet exhalation of a body. Her eyes are huge in her thin face. She’s shockingly lucid and cogent- until she isn’t. She becomes incensed and wants to know where her dinner guests are. She cannot believe how rude it is of them: you invite people to dinner, you spend all this time preparing, and they don’t even show up! I tell her I’m here, and we can have dinner together.  I hope I can devour strawberries like she can when I’m 103.

Wednesday - Friday:

A new tracheostomy patient comes into my care. Trach patients need swallowing therapy to get them off tube feeding and back on regular food. This patient is fed through a nasograstric tube, which goes up his nose, down his throat, down his esophagus and into his stomach. In the next 48 hours, he will pull out this tube a total of three times. Three times up out of his stomach, up his throat, out his nose. The entire tube. Three times. He will also pull out his trach. It appears we will begin feeding him orally sooner than we expected. 


I call a patient’s son. “How do you say ‘swallow’ in Farsi?”

Friday, 9 pm:

This late, it’s quiet in the nursing facility. One of my favorite patients, G, is playing UNO with some other ladies in the small dining room. She’s always perfectly and fully done up: lipstick and earrings, a shawl. All the more impressive because G can’t move the right side of her body. She puts herself together left-handed and does a smashing job. Several years ago, G had a left hemisphere stroke resulting in fluent aphasia. Her auditory comprehension is great but when she talks it’s utter gibberish. Every once in a while there’s a real word, but mostly it’s linguistic white noise. G was surprised to see me so late; I usually do therapy with her at lunch. She looks up, concerned and says in perfect prosodic nonsense, “Well you sure here are light”.