Friday we were to see our first patient, and take a social and family history. We were given a list of patients that had been suggested as good possible first-interviewees, and had obviously consented to talk to first-year medical students in pairs. And everyone seemed to have a great experience. Except Celine and I.
We nervous enough as it is, but as we entered the patient’s room, she was talking to herself, eyes closed, on her side. We initially talked to her nurse and she explained that she was awake and slightly demented, but came to fairly quickly. We introduced ourselves and tried to just get to know her–not even work on the histories–but didn’t get far. Her voice and mouth were weak with age, and her slight accent made it even more difficult. We tried to ask her some questions about her life, but she kept returning to the notion that she needed stitches to repair a gash which was gauzed and already healing, according to the nurse. It was an incredibly tense situation–neither of us sure how to respond–but we kept probing. I can still feel the buckets of sweat dripping down my back, feeling completely helpless. She started telling us that “if we really wanted to help people,” and really wanted to help her, we would call a doctor to stitch her up. She then told us that “no one listens to you when you get old,” and made me start to feel absolutely terrible.
As we were talking to her–or, in my case, just nodding and saying “mmm-hmm”–I caught this weird glimpse of her. I was looking in her eyes, staring right into them, and I had this momentary flash, like I was able to see her as a younger woman. Before the dementia. Maybe it’s just that she resembled someone I knew, but I walked away with this completely pierced feeling, like I saw some part of her–just for an instant–that she was trying to desperately reveal. Or maybe it was just my anxiety and nervousness coloring my view. I’m not sure either way, but I can still picture her face and eyes, and that flash of recognition. Or acknowledgment. I don’t know which.
Note: I added a bit to the disclaimer page about privacy and confidentiality. All names and features of patients are changed, and always have been–just wanted to make sure it’s clear.