Medicine Reflections

PRN: short for “pro re nata.” Latin for “as needed.”  

Long, long ago in a hospital far away there resided a patient, a patient you could never identify, whose dementia was slowly overcoming him. This dementia left him with little memory of his past, his loved ones, his successes and even his reasons for being in the hospital in the first place. Luckily he still did have some aspects of his personality and preferences things that made him uniquely him. He knew the hospital staff that he liked, he knew the food that he enjoyed and he was happy when it came, and he even knew his favorite chocolate treat- the oddly shaped chewy caramel milk chocolate Rolo. Though this man had forgotten even how to feed himself, his fierce love for Rolos had yet to bid him adieu.

From a medical standpoint, this patient was tucked in. He was on an optimal medication regimen for his age and meeting all the goals of his hospital stay therapy. His diet was optimal for his comorbidities. He was cleared by psychiatry to be in the common area with other residents and not endanger himself or others. He had a great bed on a high floor with an even better view. In fact, his view made some of the medicine team members that would round on him in the morning jealous, because if you made it to his room and caught the sunrise at just the right time- though you were there in the hospital and minutes away from any exit, it felt like you were almost outside and breathing that fresh cool morning air seconds behind that dawning sun.

Maybe it was the view, or maybe it could have been the patient as well. He too was almost like a breath of fresh air. His problems were minimal and he was stable, he wasn’t one you were afraid of running a code on in the middle of the night. In addition to all this he was pleasant; pleasantly demented if there ever were such a thing. Rounds typically consisted of asking him how his day was, how his breakfast was, or even how he was, and every answer he gave to those questions was better than the last. He would even sometimes ask how you were as if his own mother were there reminding him when someone asks you how you are doing it is only right to reciprocate the favor back to them. Indeed, both he and his view were breaths of fresh air.

And without fail on most occasions, the strangest thing would happen after the almost ritualistic exchange of courtesies. A pause would come… then maybe a gesture… one slight gesture made for the door, if not a gesture then maybe the mere thought of one, and like clockwork, he would look up in anticipation and say those five famous words: “Do you have my Rolos?” It was the strangest thing to experience. Convincing him you didn’t was beside the point and altogether a lost cause; an argument you weren’t going to win. Nothing from my medical training would prepare me for the conundrum I then faced. This pleasantly demented man, my patient, wanted his favorite snack- the caramel milk chocolate Rolo.

The candy itself had altogether long ago left the shallow recesses of my mind along with the likes of Sunday morning cartoons, super soaker fights, and Pogs… that’s right the overly priced cardboard coined cutouts called Pogs- you remember them if you’re an old enough millennial. What was funny about this man’s inquiry was as a child I loved Rolos too. I REALLY LOVED THEM- like, my favorite candy type of love.

Initially, when he brought up the question I flashed back to a time when all I wanted was Rolos too. Hardly tall enough to reach for the tabloids, knee-high to a grasshopper, and though wet behind the ears, I knew at a young age that every trip to the store held the potential to net me some Rolos. And just like this man- as the ritual of shopping came to an end and gestures were made towards the checkouts, I would pipe up with 5 similar words: “can I have my Rolos?” We shared a similar love and a similar want; and though it felt like I was regressing to a younger me, the message was clearly received. As his provider it was my medical duty to procure my patient his Rolos.

I hope by now you have gathered my playfulness around the subject. I do it for good reason. So much of medicine is hard- people die, sick people have to make horrible choices between bad and worse situations. Worse yet, families sometimes have to make these choices for their loved ones. Grey hairs have worked so hard their whole lives to retire and weeks later discover terminal cancer. A lot of medicine is not good news and things get missed all the time in diagnosis and treatment of disease, it is just the nature of this unperfected beast.

But, I don’t say these things with you because I am jaded to the system. Not at all, on the contrary, I say these things to you because so much of medicine is also wonderfully beautiful. Beautifully flawed. It is one career out of millions, I feel, that is fully able to encompass our whole and sometimes gratuitous humanity- and deal with it on a daily basis. What a privilege it is to experience this- to experience another person’s own humanity and to offer assistance. In every sense, it is awe-inspiring.

I write all this tonight for sheer enjoyment and as a prayer of thanksgiving. I thank God for giving me the opportunity to take part in this patient’s care and teaching me a lesson through it, one that can’t be learned anywhere but at the bedside. That man who stirred up a bit of my own humanity over the simple topic of Rolos might not remember me tomorrow, but man was he happy when I brought him Rolos today. We shared a brief bond over candy and I learned a lengthy lesson on humanity, one I will carry with me as I continue a long, beautiful, gratifying, and unperfected march through my medical training.

Thanks for the read 🙂