Friday, May 29, 2015

Palliative medicine

One morning, my patient’s wife told me that he had decided against any more aggressive procedures...

I stared at the sign still hanging behind his bed, NPO (from the Latin “nil per os,” or “nothing by mouth”) in bold black letters warning his caregivers that he wasn’t allowed to eat or drink.
I told the medical student I was working with that we were going on a field trip — to the liquor store.
“Won’t we get in trouble?” he asked.
I hoped not. But I had promised my patient a beer when it was all done, and that was a promise I could keep. So that afternoon, we trooped to the liquor store across the street form the hospital and bought a cold bottle of Guinness Extra Stout, which the medical student tucked inside the pocket of his short white coat. We giggled about the bulge the smuggled beverage made in his coat as we rode the elevator back up to the patient’s room...
“I figured I’d get you that Guinness I promised,” I said. I held it up to the patient’s wife first, who nodded encouragingly, and then turned around and showed my patient. He smiled – a Guinness man after all. It was only after I struggled with the cap that I realized none of us had a bottle opener. My medical student saw me casting about, grabbed the beer and expertly flicked the bottle on the side of the table. We all laughed in surprise as drops of beer ran over the side of the bottle and onto his hands. The room smelled like a party.
“Is that O.K.?” I asked.
My patient gave me a thumbs-up. I wished that I had known him better. “Cheers,” he said.
“Bottoms up,” I replied.
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