Written and shared with permission by David Abelson, MD, Former Park Nicollet CEO and Health Partners’ Senior Executive
My daughter recently acted in The Hour We Knew Nothing of Each Other, a one act play by Peter Handke. The play depicts a town square with hundreds of characters including old ladies, lovers, children, joggers, mothers, fathers, brides, musicians, clowns, workmen all wordlessly crossing the stage. We glimpse moments in their lives leaving us to wonder about their past and future stories.
The play reminded me of a hospital. Consider the story told to me by a colleague about the patient in room 372. Some people may perceive “bed 372” as a cranky lady who complains excessively about not getting a warm blanket on demand. After all, why should she make such a “big deal” about not immediately getting a warm blanket?
Her name is Shirley. She is 74 years old, a “warrior” who has survived two open heart surgeries, a stroke and several cardioversions for atrial fibrillation. Following each setback or surgery, she fought her way back. She worked hard in rehab five days per week to stay in shape and subsequently befriended the other phase-three rehab patients and staff.
In March, 2007, her husband died, and one month later, so did her son. Caring for her husband toward the end of his life challenged her as she felt powerless and demoralized. One day while talking with her physician, she broke down and cried, recalling a terrifying incident when she was about 10 years old. She and her family were living on a farm in southern Minnesota. Her grandfather was very ill, and staying with the family. The rest of the family left to work the fields, leaving Shirley alone in the house to care for her grandfather. Her grandfather took a rapid turn for the worse, dying while she was alone with him. She felt helpless about getting the help needed to save him.
After her husband and son died, Shirley fought serious loneliness and depression for a year. About six months ago she met John. A couple of weeks ago she and John were about to go out to dinner, when she collapsed in cardiac arrest. John called 911 and performed CPR. The ambulance brought her to Methodist Hospital where she underwent acute reopening of a blocked circumflex coronary artery. She was placed on the hypothermia protocol (chilled, sedated, and paralyzed) for the first 24 hours to minimize damage to vital organs. Imagine her with suboptimal sedation, unable to move, feeling powerless, and absolutely freezing.
After being in the ICU on a ventilator for two weeks she graduated to room 372. She lost some of her short term memory as a result of the arrest and appears more impatient than before. She finds swallowing difficult and dislikes the soft diet. She’s slowly increased her capability to exercise, but struggles with the amount of muscle strength she’s lost. Some days she gets kind of “cranky.”
And she sometimes gets cold. When she gets chilly, she becomes terrified by an ill-defined recollection of feeling absolutely freezing, unable to move, and powerless to do anything. She feels desperate for a caring person to bring her a warm blanket, to comfort her, ease the cold, and eradicate her sense of powerlessness. Sometimes she must wait for over an hour and gets really “cranky.”
The hospital, viewed as a set in the play, The Hour We Knew Nothing of Each Other, presents a stage on which people cross in an average of 4 days. As a snapshot, we see only a “cranky” lady in room 372, unreasonably demanding blankets. Alternatively, consider the intricate back story preceding the snapshot and our privileged position to create a memorable hospital stay adding to the life narrative of the patient and family.