Liquid Diets and Sippy Cups

Posted on Nov 17, 2012 in Life of a Medical Student | 0 comments

Every once in a while, I get to do something that reminds me why I’m training to be a doctor. Yesterday, I had a day like that. I was recruited by one of the doctors working with a 13-year-old boy who has a new diagnosis of Crohn’s Disease to visit him and instill some optimism about his condition. And 20 minutes of chatting and a gift of a plastic cup later, I think I can say I’ve made his hospital stay a little bit better.

Why me? It’s not something I’ve been terribly open about before, but I’ve recently been struggling with a Crohn’s flare of my own. It’s a painful and embarrassing disease and I’ve spent a long time playing the denial game.

So that’s not Starbucks in that cup. It’s Ensure. Yeah, that stuff that you feed to old people in  nursing homes. And what I’ve been living on for the past three weeks. The ensure diet is one of the treatment options that some doctors suggest to induce remission without using side-effect-plagued corticosteroids. My doctor suggested it when I wasn’t tolerating any solid foods and it’s worked wonders. The cups I drink it in hide the proteinaceous smell and make it look like I just have an addiction to iced lattes.

When I went to go and see this patient yesterday, I found that he was also subsisting on the ensure diet and it was not going well for him. He asked me how did I get it down? He was not impressed by the stuff and we spent a long time discussing where each flavor ranks in the spectrum of taste. I have strong feelings:

So today I went out and bought him a cup like mine (but not pink), filled it with ice and ensure, and brought it to him. When I got there, I found he’d had a feeding tube put in his nose last night because he was having so much trouble drinking the ensure. He looked at me skeptically and asked if he should hold his nose. I told him no, that’s what the lid was for! He hardly believed me when I told him it was just ensure with ice. As I was leaving, he had agreed to drink and was getting the feeding tube removed from his nose.

I remember from my experiences as a patient how much the small things matter and try my hardest to incorporate that into my own practices. One of those times was when I was a senior in college and I had to have a piece of my small intestine removed. The most painful thing after abdominal surgery? Coughing. I was coughing up all sorts of stuff after being intubated and was miserable for two days. Until a nurse came in, saw me coughing, stopped dead, and said “I’m going to give you a present.” She came back with a round, hard, blue pillow. A cough pillow, apparently. And sure, they give a lot of people those pillows, but the fact that no one had thought to give me one before made her special. Her name was Cathryn. She’s the only nurse whose name I remember.

I spend hours every day trying to figure out how to solve the medical problems of my patients, making decisions about medications and treatments and testings. But I think that when all is said and done, it’s the small gestures that make our patients feel like we see them as people rather than medical problems. I hope I never forget that.

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