by Eva Catenaccio
“Have you had a bowel movement?” Ms. L smiled, shrugged, and pointed to her colostomy bag as if to say, “You tell me.” So began the first day of my internal medicine rotation as a third year medical student. My first patient was 83 years old and stuck in the hospital after a colon cancer surgery complicated by renal failure and pneumonia. I ended up following her for the next five weeks, spoon-feeding her lunch and bribing her for blood draws with ice chips I smuggled past the nurses. Muted by a tracheostomy tube in her throat, she still had an emotional and expressive face. She smiled in delight at the ice chips, but winced and looked away when I struggled to find a vein.
Taking care of her, I learned how to harvest a sputum culture from her throat, how to apply the sequential compression devices to her calves, how to check the ventilator settings every morning and trace the tides of each breath in little green lines on the glowing monitor. I sat for many minutes holding her hand and trying to read her lips. She had worked years ago on that very wing of the hospital. She had never learned to read or write. She had no family. One day she started to cry and could only mouth helplessly, “I’m afraid.”