She was the classic definition of a frequent flyer. She lived alone in a ramshackle motel on the outskirts of town. She had kids but they didn’t like her and never came around. I can’t say that we blamed them. She was mean as hell.
Each time, she would stop taking her meds and her body would swell …legs like giant sausages, lungs frothing, drowning in the excess fluids. You could see on her face that she was suffering and it was hard to understand why she did this to herself time and again.
Just take your frickin’ meds already!
We would admit her, give her IV Lasix, make her pee liters and liters over 3-4 days, and then send her on her way knowing full well that she would be back again in two or three weeks.
One late night, it was my turn. She had a reputation for being an ugly, hateful woman and I did my best to walk in with a Code Red swagger, guns blazing. This tactic worked for a lot of difficult patients… but not for her. Before I had completed my interview for her history and physical she was spitting and cussing and screaming at me to get the f**k out of her ER room.
(In all fairness, that room had probably had been purchased for her by all of those previous visits so she was well within her rights…)
I decided to let her cool off and try again in a few hours before morning rounds.
When I went back I decided I would try the sweet, perky lady doctor routine. When I bounced into the room she cracked one eye open at my cheerful greeting and grunted.
“I remember you,” she growled, told me to go to hell, then rolled over in bed with a few more loud grunts so that her back was to me.
“Look, you know the routine. This isn’t your first rodeo. I have to do this, so let’s just get it over with shall we?”
I did a cursory exam as she riddled off expletives at me. She was a professional abuser and before it was over with, I was fuming.
I had let her get to me.
As we did rounds with the attending, she was sitting up with her bloated legs hanging over the edge of the hospital bed. She lit into me again, telling anyone who would listen that I had cussed at her (I might have) and had manhandled her (that part probably wasn’t true).
Finally, I had had enough. I let everyone go on ahead of me and I sat on the edge of the bed next to her.
“What do you want?” I asked her, struggling to keep the frustration out of my voice.
“Something you can’t give me.”
Was that a tear? My stony heart softened ever so slightly.
She stared warily at me for a minute, sizing me up. Finally, she spoke. “I want someone to love me.”
I swallowed my pride. I put my arm around that woman and I told her that I loved her. Then, I told her that she needed a shower in a bad, bad way.
She laughed. I laughed.
And that was the last we saw of her in the hospital.
I saw her in the clinic every few months. She took her meds faithfully. She was not hospitalized again until 18 months later when she died of something completely unrelated to the heart failure.
She became one of my favorite patients and I miss her even now. She taught me that love, not swagger, gets things done.