I was supervising the medical interpreters that day. It was
early in the morning, and the first call came from the Emergency Department –
they needed a Spanish Interpreter ASAP.
The interpreter and I ran to room 36, expecting to see it
full of clinical staff given the urgency of the requester. Instead, we found a Hispanic
man in his 30s, lying in bed, suffocating. He had difficulty breathing despite
the oxygen going thru his nose, and moved from side to side, desperately changing
positions, complaining about how exhausted and thirsty he felt. His lips were completely
white from dehydration, his skin pale, and his look confused and powerless: why
is no one trying to help me?
When we walked into the room, he was alone. By protocol, the
interpreter should not be alone with the patient, so we were supposed to leave.
But it was impossible, his eyes cried for help, or company at least. A few
seconds later, a nurse walked in very calmly and injected something in his IV
without saying a word.
“I am thirsty, I am so thirsty. Please give me some water”
the patient panted. The
interpreter relayed the message to the nurse, who responded: “The doctor said
you cannot have any water. You are very very sick, OK?” as if her condescending
baby talk would make the patient understand English. The interpreter relayed
the message to the patient, who continued his struggle to breathe.
The patient had dangerously high levels of blood glucose.
His diabetes was out of control and he was actually pretty close to dying. We
spent about three hours in that room, waiting for a space to open up in the ICU
so that Mr. Jesus could get the care he needed. The entire time, he pleaded for
water, but no one gave him a single drop…
Once in the ICU, he asked for water once again, and a kind
doctor ordered a nurse to wet a sponge and rub it on his lips. If he drank
water, he might vomit and make his already delicate state worse. His hydration
needed to be directly through the IV.
When Mr. Jesus felt the sponge on his lips, his eyes widened
and his lips almost smiled. His problem was solved! He impatiently bit the tiny
sponge and squeezed it with his lips, trying to suck out the minimal amount of
water in it. A profoundly sad scene, his joy for a few drops of water after hours
of begging for it.
This experience made me realize the huge discrepancy between
health care providers’ approach to illness, and the perception of the patient
experiencing it. Providers usually concern themselves with the biological
dictates of disease, a mechanic view of the broken human body that needs to be
fixed. Patients, on the other hand, experience the consequences of such
brokenness, which should be reduced with mechanical fixing, but may also
require another level of attention and care.
In Mr. Jesus’s case, yes, he was in a very critical
condition and needed his internal body to be fixed. Hence all the IV
medication, the oxygen, blood tests, etc. But what Mr. Jesus was complaining
about was not how much his blood glucose levels hurt – he could not feel that
directly. His primary concern was thirst, a thirst that was making him
delirious and could be appeased with a few drops of water in a sponge, with no
significant risk to his health.
I am not saying that the medical team should have stopped
everything taking place to give the man some water. But I do believe that
health care providers need to be aware of what patients experience and not
ignore those concerns. The three hours we spent in the Emergency Department
would have been entirely different for Jesus if only someone in that department
had listened to him, had some compassion, and given him a drop of water to
reduce his suffering.
Biologically speaking, the feeling of thirst and exhaustion
is connected with the high blood glucose level and blood pressure. If those
“bigger concerns” are addressed, technically the lesser ones (like the thirst)
should decrease eventually. But why not try to empathize with the patient and
do what is possible to make his experience of illness a little less terrible?
Professionals in the medical field need compassion, not just
knowledge. There is a big difference between fixing a patient and caring for
one.