Having a Bad Day
Posted on February 4, 2011
Carl, Dad’s physical therapist, motioned to me just outside the elevator door. He was bringing Dad to his room after his morning session and he wanted to talk to me.
I sat down in the activity room across the hall and waited for Carl. (By the way, Carl is a made-up name; the rest of the names in this piece are aliases, too.)
“He’s just not himself today,” Carl said. “He likes to work out hard, but today I had to sit him down. He just couldn’t do it.”
“Do you mean today he didn’t want to do it?” I asked.
“No,” Carl said. “He felt dizzy and sick. I had to sit him down to rest. And after a while, I said, ‘Mr. Blair, let’s go to your room’ and he didn’t even hear me. I got down on my knee in front of him and said, ‘Ernie, Ernie, let’s get you back to your room.’ Then he turned his head and looked at me and said, ‘What? What? Oh! Yes!’ and I got him up and we just came back.”
“How is he now?” I asked.
“I think he’s okay, but he’s just not himself.”
“Carl, my dad has had unexplained fainting episodes for years. That’s not on his chart, is it?”
“No, I haven’t seen anything like that. What do they think causes it?”
“Well, he’s been diagnosed two or three times with possible epilepsy. In fact, he took Dilantin for several years a long time ago, and that made him sick. Last time he saw a neurologist, he put him on some new anti-seizure medication, but he just couldn’t tolerate it. Diagnosis was ‘unexplained fainting.’”
“Now, he didn’t faint…And I took his blood pressure. It was low, but not real low. It could be all sorts of things, maybe low blood sugar. Could be something he ate. Or maybe he’s just having a bad day. Or… maybe he was having a near-fainting episode.”
“I’ll talk to his nurse. If that thing isn’t on his chart, it should be,” I said.
“Yeah, I think so, too. Don’t get too alarmed, though. It may be just a bad day. We see that a lot.”
Carl is Dad’s favorite therapist. He’s a Nazarene youth director; he and his wife moved here from Wyoming. Carl seems to like Dad, too. I like Carl.
“Hey, Dad,” I said, “What’s going on?”
“Oh, I’m just having a bad day,” he answered. He didn’t look good, either. He was too white. He needed a haircut, a beard trim, a bath. I had the barber shears and clippers in my bag, but this was Tuesday; the bath was scheduled for Wednesday after dinner.
“Maybe we should wait until tomorrow for your haircut,” I said.
“Ohhhhh, no,” he said. “I’m getting that haircut today. It will make me feel better.”
“Your shower is tomorrow, though. You’re going to have hair all over.”
“No, I’ve talked to my nurse and she says I can get a bath after supper today since I’m getting my hair cut.”
“Okay, but what happened down there?” I asked.
“Oh, I tried to pass out. Had to cut it short,” he answered.
“Do you still feel faint?” I asked.
“No, I’m better. I just needed to rest for a while. You’re going to have to get a towel.”
“I brought a sheet to put around you. Now where are we going to do this?”
The wing nurse swept into the room; she disappeared behind a dividing curtain to check on Dad’s roommate, Kenneth. Jean looks rough; squatty, blonde, a smoker. She’s always been friendly to me.
“I’m going to cut his hair,” I said. “Where shall I do this? They just cleaned his room. Is there a better place?”
“Oh, don’t worry about that.” Jean pulled the curtain back. “Just call housekeeping and they’ll clean up afterwards. I think I’d do it in the bathroom.”
“If I can just get a broom, I’ll clean up,” I said.
“There’s no need for you to do that,” she said as she left the room.
“Cut it pretty short, Sis,” Dad said after we got all set up. “And then you can put my extra blanket over the bed so that I don’t get hair all over it until I can get my shower.” He’d thought this through.
“Did that wear you out?” I asked after I helped him back to bed.
He laughed. “Yes, it did, but I’m sure glad to get it done.”
I cleaned up the bathroom floor with wet paper towels.
“Dad, you go ahead and get a nap. I’m going to see if I can talk to the nurse.” If there was no information on these “unexplained fainting episodes” on his chart, someone needed to know.
There was no one in scrubs in the hall. I walked on down to the nurses’ station.
“Can I help you?” a young clerk asked.
“Yes, I need to talk to Dad’s nurse.”
“I’m not sure where she is right now, but I’ll tell her.”
Forty-five minutes later, I returned to the nurses’ station.
“I was trying to talk to Dad’s nurse,” I said.
“Okay,” a different clerk said. “I’ll leave her a note.”
“Do you know what time she’ll be on the floor?”
“She’s working now, but she’s just with another patient.”
Dad was awake and sitting up on the side of the bed. He had good color and said he felt good.
“Except…I need you to look at this place under my arm,” he said.
Once, at the hospital the week before, he had complained that there was a little place under his left arm, “toward the back,” that felt as if it had a small cut. It burned, it hurt, it felt “like somebody stuck me with a knife.”
“Okay. That place is still bothering you?” I asked.
“Yeah. It is painful. Feels like somebody stuck me with a knife,” he said, pulling his arm out of his grey waffle-weave shirt.
I poked and felt around until he flinched.
“That’s it, right there! What does it look like?”
“Doesn’t look like anything much, but I think I can feel a little rise of sorts,” I answered.
“I’m going to get somebody to look at it. The nurse is supposed to talk to me anyway.”
“Sometime this afternoon,” I added, to myself.
I stuck my head out into the hall. No one there, but I did see the nurse practitioner at the nurses’ station. NP, I call her. I can never remember her name, but I know that NP is the highest medical person on staff; the Medical Director, a physician, makes rounds but is not onsite. I rounded the nurses’ station to place myself in front of her.
“Hi,” I said. “You’re the Nurse Practitioner, aren’t you?”
“I am,” she answered.
“May I have just a word with you regarding my father, Ernest Blair?”
“Yes. Have you talked to his nurse?”
“I have asked to speak with her but that’s been about three hours ago and I haven’t seen her. I’m going to have to leave soon,” I answered, with my voice trailing off.
“Okay, what is it concerning?” she asked.
NP is much taller than I am and she was looking over my head, down the hall. Sometimes she leaned her upper body to one side and then the other to look around me. I shifted and then turned to look down the hall myself.
I continued, “Well, there are two things. The first one is, he had a near-fainting episode in physical therapy this morning and I wanted to make sure that you all know that he has a history of unexplained fainting.”
She countered. “That’s what he came in for.”
“No,” I said. “You mean, from the hospital?”
“Yeah, that’s the diagnosis he came in here for,” she said.
“No, actually it was an internal bleeding thing that sent him to the hospital.”
I was going to continue but she interrupted me.
“Same thing. He fainted from the internal bleeding,” she said, still bobbing around me to look down the hall and then in back of her toward another wing.
“Yes, several times,” I said, “but they sent him here for therapy, to get back on his feet and also to treat a sore shoulder.”
I stopped. “I’m sorry, do you need to attend to something else right now?” I asked.
“Oh. Well, I’m trying to get this family’s attention. They’ve been trying to teach their mother to use the wheelchair and she’s down this other hall making wheelies and everything. They need to see this,” she said.
“Okay.” I didn’t know what else to say.
NP called over my head, “She’s down this hall, flipping wheelies and going all over the place!”
The family proceeded past the nurses’ station, toward the other hall.
“I’m sorry,” NP said. “Now, tell me that again.”
So I did.
“Same thing,” she said again.
“No, not exactly,” I said. “He’s here for therapy, to be able to get around again, and also for his shoulder.”
“Oh. Okay. What was the second thing?” she asked.
“He has this little place under his arm that is extremely painful, and I am able to find it. I want to show it to somebody,” I said.
“Have you talked to his nurse?” she asked. “Because you really need to talk to his nurse.”
“No. I’ve been waiting to talk to her but I haven’t seen her,” I answered.
“She’s right down the hall there in front of his room,” she said, motioning with the clipboard in her right hand.
And she was—in the hall—not in front of Dad’s room, but in his hall. She was distributing medications.
“Thank you,” I told NP. “I’ll just run down there and talk to her.”
By the time I got to the medication cart, Jean had ducked into a room. I stood by the cart to wait for her.
“I just need to tell you a couple of things,” I said.
“Okay,” Jean said. She looked at me, my signal to start.
“The first is that Dad had an episode of near-fainting in physical therapy this morning and I don’t think there is anything in his chart to say that this is his history. He has a history of unexplained fainting episodes,” I said.
“Oh, great,” Jean said. Was the tone sarcasm? “That’s good to know.”
“Well, yes,” I said. “And the second thing is that there is this place under his arm that I think you should look at.”
“Let me run in here and give this medicine,” she said, as she disappeared into Mrs. Taylor’s room.
I waited beside the cart. Jean and Mrs. Taylor talked about the weather, the kids, the floral bedspread.
When Jean came out of the room, she said, “Physical therapy never called me this morning.”
“Well, I know that the therapist took his blood pressure, and it was low, but it wasn’t that low…”
“Physical therapy is not nursing. They are not medical people. They cannot make medical decisions,” she said.
“I think they were just trying to make some immediate response. He said he had to sit Dad down, and they didn’t get to finish the therapy session.”
“They’re supposed to let us know, immediately, if something medical happens. I’m going to be calling physical therapy to have a word with them,” she said.
“Oh, you don’t have to do that,” I started.
“Yes, I do,” she said. “They are supposed to call us.”
“I was just trying to let you know, you know, in case Dad got woozy…You know, he took a fall the other day.”
“I know he did,” she said. “Let me give this medicine.”
She ducked into another room and came back out.
“The second thing is that there is this place under his arm, actually on the side of his armpit, that is painful, and he says it feels like somebody stuck a knife in it. I think someone ought to look at it. I can actually show you the exact spot,” I said.
“Okay, I’ll be down there in a minute,” she said.
That meant I should go to the room and wait. Jean passed me as she entered the activity room where Mrs. Smith and her daughter were visiting.
“How you doing?” Jean said to the daughter.
“Good. Good. Hey, I think Mom needs a change. She’s been out today for a long time and I’m sure she needs to be changed.”
“I’ll get you somebody,” Jean said. “How did the curtains turn out?”
“I think they look really good.”
I stopped listening. Jean handed the pills to the daughter along with a glass of water. The daughter handed the pills to her mother, one at a time, and her mother swallowed each one with a sip of water while the conversation continued.
Jean hurried by me into the room.
“Where is he?” she asked, just as we heard Dad click the paper towel dispenser twice.
“He’s just drying his hands,” I said.
“Then I’ll come back,” she answered, and she was gone.
Dad sat down on the side of the bed and we continued a conversation about Egypt’s upheaval.
“I think they’re just in for bad trouble,” he said.
“Yeah,” I answered.
“Sis, you need to get started home. It’s going to be dark pretty soon. I don’t like you girls being out after dark.”
I smiled back at him. “I know. I was waiting to see the nurse,” I said.
“Maybe you should start getting ready to go,” he said. “She’ll probably be in here in a few minutes.”
“Okay,” I said. I began to gather up Dad’s laundry, some cards he wanted me to take home, and the magazines on the table that I had brought to read while he napped.
As I passed the window, I saw Jean crossing the parking lot, pulling the hood of her jacket over her head in the rain. As soon as she crossed the street, she lit her cigarette and called out to the other woman joining her.
“Dad, I think I’ll go on. I’ll talk to the nurse tomorrow.”
“Okay, Darlin’. You have a good evening. Give Mom a kiss for me,” he said.