Saturday, August 8, 2009

Very demented old man in the hospital: "Your beauty took my pain away."

Earlier this week I was assigned a patient in the hospital with very severe dementia. When he first came in he was pretty sick and could only give one word answers to questions. However, as he started feeling better he also started speaking in more complete sentences and the extent of his dementia became more apparent. He would point to objects not present, etc. A few days ago I went in to check on this patient before rounding with my team. I started asking him about the various kinds of pain he had been complaining about the day before and whether or not the pain was any better. He responded by saying that before I had come into the room he had been in some pain, but that I was so beautiful that his pain went away as soon as he saw me. It was quite the humorous comment, particularly since this patient was older than my grandfather. I decided to focus on trying get information from him about his symptoms, but he kept insisting that he had no pain and seemed to be making attempts to ask me out on a date which I politely ignored. Frustrated, I went to look up some lab values before rounds. During rounds, I gave my presentation and informed the team that the patient seemed to be feeling better this morning. However, after my presentation the patient started going on and on about all the pain he was experiencing, including a new pain that had not been present the day before. I thought about sending the patient a nasty look - I would much rather have been called ugly and been able to present my team with accurate information, but it was clear that my patient no longer remembered our previous conversation. Apparently my stunning looks only function as a temporary analgesic!

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