I take call about 5-6 days per month which means that I take care of patients that come into the hospital with fractures. A few weeks ago I treated a woman who had a hip fracture (I treat a lot of hip, ankle and wrist fractures when on call).
The ER staff who gave me her initial story told me that they thought she was a bit incoherent when she came to the hospital. In fact she admitted to drinking a “glass of bourbon” on the night that she fell and injured her hip.
I can tell you from experience that when a patient comes into the hospital drunk usually colors the way that the ER doctor communicates the story to you. Instead of the “pleasant 70 year old woman who fell and broke her hip.” It’s the “70 year old incoherent alcoholic who doesn’t take care of herself, etc etc.”
And sometimes that’s a correct assessment. But what always blows me away about medicine is how it can give you such a surprising window into humanity.
My patient was definitely was a bit “out of it” when she came into the hospital. The ED tested her blood alcohol level and it was not very high, so I suspect that she was just just struggling with the pain and dehydration.
She sailed through her surgery easily. And the day after her surgery I came to visit with her while she ate breakfast. She was like a new woman: sitting upright, conversing fluently. She threw me slightly when she started using medical lingo. Turns out she had gone to nursing school (per her parents’ wishes) but did not finish because she had difficulties due to dyslexia. She went into television production and art instead- which she always wanted to do- and told me how she loved photographing nature scenes. In fact she works at the local TV station.
I was a little stunned. She seemed a far cry from the “incoherent” lady that I saw the night before. She had a genuinely touching story and an artistic sensibility about how she portrayed some of her struggles with dyslexia. And I was very happy that I was able to intervene to help get her back on her feet.
The whole interaction just reminded me that there is often a wonderful, surprising story inside the patients that you see in those trying circumstances. And sometimes you can’t imagine what the real story is when you first see them in their most vulnerable and compromised state.
That surprise is part of what brings me joy in what I do and why medicine will never be boring.