The Story of the Mystery Patient

As I mentioned as January ended, this February has been challenging for me to keep up with this Project and it’s associated tasks. I still hope to have new pieces soon. In place of a new encounter and performance with a poem or other text, let me do one of those posts where I pretend this is a normal blog

I know nothing other than what I read in the news about the situation in Ukraine — and that news with Ukraine now is, in short, mostly about what is feared to be an imminent invasion. I’m sure this Internet is full of folks with takes and information and policy positions if you feel the need for that, but instead I’m going to tell you a little story from my youth.

Back in the 1970s I was working the overnight shift in an urban hospital’s Emergency Department. Overnight, those 11 PM to 7 AM shifts, are probably not good for one’s health or social life, but I rather liked them. Staffing is much lower, and there was in my day almost no administrative or support presence. No crowd of attending MDs looking for proper deference to their priorities, no administrators to set or enforce policy in between meetings. Therefore, hierarchies were radically flattened at night, and I got to see and participate in a lot of different medical things.

My ED then was staffed with myself, a registered nurse (RN), a clerk who typed in information to print up a chart and the handy labels that would be pasted on lab requests/samples, and a family practice resident*  Just down the hall from our suite of four treatment rooms was a door with a buzzer where anyone from the ambulance patients we’d expect after incoming radio calls, to those who’d called their doctor and clinic and were told to drive to the hospital for further evaluation that couldn’t wait until morning would appear. And then too, the walk in.**

I worked nearly 20 years in hospitals, most often in Emergency Rooms. This stock photo looks about the right vintage.

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On the night I remember, the buzzer rang and there was an older man at the door. He had apparently walked up alone, and I usually was the one who went to the door to see what was the matter. And that was the issue from the start: he was speaking some foreign language, and he seemed to have only a scattered understanding of English and almost no English words to reply with. He looked to be in his seventies, had no obvious injuries, no severe distress. He moved slowly, but was walking.

Our door had a big lit-up Emergency Room sign, we could only assume he’d come in for treatment, but for what? You might assume that any 1970s urban hospital would have multiple language interpreters on hand, but that was not the case in ours then. And frankly, we wouldn’t even know what interpreter to call because we couldn’t figure out what language the man was speaking. Some words sounded a bit like German to me, so we called up a nurse working that night who spoke some German to come down. The RN and I hooked our mystery man up to the cardiac monitor, and the resident MD did a quick exam to see if we could figure out why this man had come to us. I think I may have even done an EKG on him, with no obvious issues found.

We looked for an ID in his clothes once we’d put him in a hospital gown and on a stretcher. There was none.

The nurse who spoke some German arrived. She got to her first preliminary question, which might have been “What is your name?” “Or why are you here?” and the mystery man exploded. At least some of the reply was in German. And our volunteer nurse interpreter said his angry words were that Germans had killed his family. How much German did he know? Made no difference, he wasn’t going to answer questions when asked in German.

I next got a bright idea. One of that class of residents was a young doctor who had a great facility in European languages, speaking at least a half-a-dozen of them. He wasn’t on call, and it was 4 AM, but I thought we should call him in. Given the infamous hours that residents worked in those days (maybe still do) that was asking a substantial favor, but he agreed to come in early. I was busy with something when our multilingual resident MD arrived. At one point he thought maybe Russian, and tried that. Later, I heard that once again the mystery patient became angry. Our resident didn’t know the man’s native language, but he got back something that was similar to our German speaking nurse — Russian was not a welcome language to our mystery patient.

Our multilingual resident was a smart guy though. One of the old-guard attending doctors on the hospital’s staff was Ukrainian American and had written a book dealing with Ukrainian culture in Ukrainian, a copy of which was on the shelf in the hospital’s medical library. Our resident showed that book to our mystery patient he later told us, and there was a quick realization that that was his language. After the regular day got underway, the older Ukrainian American doctor found that the man was one of his patients who was somewhat confused and had wandered to the hospital thinking that his doctor might just be there in the middle of the night.

So, as I said at the start, I know nothing about Ukraine — but I do think of that man who appeared in the night at the door of my Emergency Department and demonstrated how little I knew of him and what his country had been through.

Long guns, a poetic example.

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What to bring forward for a musical piece today? How about this one about war and violence that combines a line or two of language expression from Afro-American singer Howlin’ Wolf with second generation Swedish immigrant Carl Sandburg’s poem about countries that pack those long guns. Player gadget below for some of you to play it, or you can use this highlighted link otherwise.

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*Family Practice was the improved modern evolution of the old school “General Practitioner,” and the program that our hospital had treated that generalism like any other specialist residency to give the doctors who went through it a great deal of practical experience in things they would encounter. Almost every one of the residents I worked with there and then were fine people, who would come in some degree of unsure in the Emergency Room and leave after three years as the kind of doctor that I would want for myself or my family. Doctors and regular medical educators ran that program, but experienced nurses were so important in that too. Each June brought in new residents who really needed the steady hand of nurses at night to guide them in practical medical logistics and solutions.

**There was an indoor hockey rink across the street that had a fairly full set of bookings that ran until midnight. Yes, we needed to keep a lot of suture kits in stock.

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