It was October and I was finally starting my first shift in the ICU, the week of our surgery rotation most students anticipate. That morning, all I could think about was how vastly underprepared I was to take care of essentially the sickest patients in our hospital. Upon arriving, the lead intern handed me a list of every patient on the unit for today’s morning report and pointed to the first one. While reading the patient’s long-winded hospital course and trying to absorb the details leading up to her most recent ED admission, I finally came across her diagnosis: neuromyelitis optica. Wonderful, I thought. In 10 minutes, I’ll be standing in front of the Department Chair and Critical Care attending to present a patient whose disease I had never even heard the name of.
Kari Benning was 41 years old, with more than half her life still ahead of her. She was diagnosed less than a year ago, but the inflammatory attack in her central nervous system had already wreaked havoc on her body. Her condition progressively deteriorated, requiring her to have a sigmoid colostomy, a nasogastric tube to evacuate bilious fluid from her obstructed gut, and a fenestrated tracheostomy collar to help her speak in whispers whenever she inhaled.
After introducing myself and entering the room to check her vitals, I asked Kari if there was anything she needed. Truthfully, I felt useless even asking. What’s the most I can really do, unkink her Foley catheter to prevent an incorrect read of her urine output? I could barely insert the peripheral line that delivered her loads of morphine to kick the pain. She was on her second day of NPO after scans came back showing dilated loops of closed bowel, but her heart’s poor ability to pump halted her from undergoing immediate surgery. She was desperate for a cup of water, but strict pre-op orders prohibited me from giving her the one thing she wanted most.
Kari’s distended belly grew balloon-like; I could see her PEG tube leaking from the stoma as it was starting to get pushed out from her abdomen. In my blue protective gown and latex gloves, I carefully spooned ice chips into her mouth and watched as she let them melt on her tongue with eyes closed. “You have no idea how good that feels,” she said. She was right. I stood at her bedside doing this for two full hours. What must it feel like to be that thirsty? Where is the rest of my team, and do they think I’ve disappeared somewhere to shrug off all responsibilities? Is there such thing as too many ice chips?
Together in room 603, Kari and I watched episodes of cake baking competitions on the Food Network because that was her favorite. We placed bets on the winners and joked about how terrible our own attempts at towering cakes would be. She showed me videos of her only daughter and told me the story of meeting her fiancé while dancing at the Mermaid Parade in Coney Island. However much it pained her to speak, Kari wanted someone to listen. She paused throughout intervals of the conversation to give her lungs a rest. At one point in our silence she said, “I’ll never take the taste of juice for granted again.”
Behind her hospital bed was a large window overlooking Fort Greene Park—couples walking around with locked hands, dogs tugging their owners behind leashes, and little kids prancing around in their Halloween costumes with pumpkin buckets full of candy. Turning back, I noticed that Kari’s legs were skinny like toothpicks, but her inability to walk left them feeling stiff and heavy. My next thought felt just as awkward as it was inevitable. If Kari could see what I was seeing, would she experience a sense of cruel punishment or would it make her grin?
After eventually getting cleared for surgery, she was downgraded to the floors for rehab. During lunch breaks, I’d knock on her door to say hello. She shared her plans of switching to a new nursing home with palpable excitement in her voice; this was a nicer place that offered afternoon tea time, morning bingo, music therapy, and extended visiting hours for her family. On days when studying gets rough, I think about Kari and her gratitude for the little things. More than anything, she taught me the powerful effect of giving someone your simple attention. Years from now, I’ll keep the image fresh in my mind—every time I passed her room and gave her a wave, she’d take a sip of fruit punch from her straw and then throw me a smile.
All names and identifying information in this article have been changed to ensure patient confidentiality and privacy. *
AUC FRONTLINE 