A piece of my day, renal rounds

Detroit, Michigan,2008

Attention Doctors, Nurses, Specialists, Visitors,
We ask you please,
Do not talk negative things in front of her or close to her;
Smile to her, be kind and positive;
Be compassionate, please!

I looked at those words on a white piece of paper posted at the door of the hospital bed where she had been admitted for over 2 weeks with failure of her lungs, liver and kidneys. I was called because her kidneys had shut down.

‘Who are you?’
‘Which service?’

Before I said a word her son pulled himself up close and looked at my name tag.

‘I can’t deal with that one,’ he said pointing at my long last name.

Her BP was so low that she was requiring medications to maintain it. She couldn’t breath on her own so had to be on a mechanical ventilator. I looked at the flow sheet first. All the 24 hour activities were neatly jotted down. The first page had her name, age, daily weight followed by her infusions, vital signs starting with blood pressure and followed by her pulse and temperature in degree Celsius. I focused on her urine output. She had had 325 cc of urine the previous 24 hours but the last few hours it had decreased to a bare 5 cc per hour. Then I looked at the flow sheet for the continuous slow dialysis which was initiated 2 days prior by another kidney specialist who was covering the weekend.

I washed my hands quickly and focused on her again starting with a physical exam. The melody that was coming from the African classic music in the room was heard over the squeaking of the mechanical ventilator and the dialysis machine. The wall inside the room was decorated by her pictures, some with her husband and her children; a smiling beautiful mother in her primes. Some of them may have been taken when she was young and still lived in Africa. Her husband was pacing the room. He would walk out and come back in holding his bible. He would stare at her for minutes continuously. He didn’t ask any questions. He knew what was left was beyond us. I left the room with the tranquility and peace hoping His miracles.

When I went back the next day to see her she had made some progress. She was able to support her own blood pressure; her kidneys had started to wake up, so to say; and she was making effort to breathe on her own. As I left the room, her husband showed up. Ignoring me, he continued pacing the room with his hands folded across his chest.
I updated him about her improvement. His face lighted up for a moment but almost instantly continued mumbling words I couldn’t comprehend.

She continued to improve over the next several days. She started breathing without the mechanical ventilator. Her kidneys fully recovered and she was taken off dialysis.

Thank God, she finally walked home with her family after an ordeal that lasted a little more than a month but the words her son posted in her room reverberate in me even today when I walk to any patient’s room.

Do not talk negative things in front of her or close to her;
Smile to her, be kind and positive;
Be compassionate, please!

What a caring family. What a lesson!

About Tenayistilign

I am a physician trained at Jimma Institute of Health Sciences ( now Jimma University, in Jimma, Ethiopia) and Wayne State University ( Detroit, MI, USA). I teach and practice General Nephrology/Hypertension and Kidney Transplantation in the USA.
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1 Response to A piece of my day, renal rounds

  1. Bisrat says:

    Miracles happen…

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