10 November 2008

Broken People

I live in a fairly small town in a smallish rural area of a small state on the East Coast. I work in health care, directly with patients, on an intimate level. I watch people sleep. But before I do that, I connect them head to toe with EEG's, EKG's, EMG's, respiratory belts, pulse oximeters, and nasal canulas. I touch people heads, I scrubs spots on their scalps. The whole set up of a sleep study takes 35 minutes to an hour.

That's plenty of time to get to know someone. Few people barely say anything to me. I pissed one patient off because I insisted he wear a shirt, and he punished me with silence. He was the only patient I was glad not to speak to. He came there looking for a fight. He got a hippie in a lab coat and nitrile gloves who didn't budge. Most people, at the very least, tell me about their sleeping habits and/or health issues. Many people tell me that, plus they tell me about their families, lives, jobs, etc. In turn, I tell people somewhat scripted, but sincere stories about my kids, how much I love my job, role playing games, my cats, my educational background, etc. I'm there for them, and they don't really need to know about me. I need to know about them, and I need to maintain an empathetic but professional distance.

I have patients who request me for their second sleep study with CPAP titration. I see former patients everywhere, all the time. It's a joy to hear about how well their home treatment is going, how getting a good night's sleep has changed their lives, etc. Being requested and being recognized make me happy. I love the feeling of making a positive difference.

Several of my patients have physical and mental health issues, which might be exacerbated by their sleep problems. In the past few weeks I've had a few broken people. A few more than usual? Not sure. Some get broken by circumstances, lack of access to adequate or preventative health care, bad cards, bad choices, etc.

Recently I had a patient who was broken by someone else. Someone close to her, and the abuse touched everything and everyone around her. It became her defining moment. I won't go into details, it's not my story to tell. What she told me had nothing to do with sleep problems. It explained a little why she was on so many medications, maybe why she was so nervous. I had her again for a CPAP trial a few weeks later. The first thing she told me was that she had not been doing well lately, that she had changed some of her medications, she wound up in a mental hospital for a few weeks, and even though she had the same room for the sleep study, the same tech (me, and she had requested me), and the same set up other than the added CPAP, she was even more afraid. Without her telling me any of this, it was clear she had to make an effort to keep it together.

And as before, she was hopeful that something would change with her. A new treatment, the constant of her support network (luckily she has a good one, too), she plans to cut her hair, and start fresh.

I'm not really going anywhere with this. I'm a little haunted by my patient and her story.The defining moment for this person was quite heinous and while she tries to rise above the trauma, it still haunts and trips her. After a week of celebration of national and global hope and change, I encountered someone desperate for a little of that light on the local level. At the very least, I hope she'll be able to sleep a little better.

Photo credit: Chris Anthony (remember him from the joy of Paintalicious? Man, he rocks!)

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