Please, Just Give Me Some Water...

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.