The nicest patient I’ve ever met was Mr. Harris. I first met him in the ED with his son and daughter by his side, noticing a foley bag filled with bright red blood. He was an elderly gentleman with ALS and was brought by his children for hematuria and blood clots overnight. Never happened before, and we were all unsure of the cause. Urinalysis soon showed likely UTI, so we started antibiotics. I called urology, and his nurse initiated continuous bladder irrigation for the next three days. Because of Mr. Harris’ ALS, he cannot speak but does everything else. He always smiled at me when I visited him in the morning and afternoon and would use his whiteboard to write down his thoughts and questions for me. He was bald like Bruce Willis and wore these silver round eyeglasses that reminded me of Harry Potter. Oh, he was attentive to everything being done for him. His gestures were meaningful, either a thumbs up that he was doing ok. Or he was pointing at the foley bag so I could look at how his urine is today. Most of the time, all I saw was his bright, big smile. Towards the end of Mr. Harris’ hospital stay, I had some downtime in the afternoon and came over to speak with him and his daughter, Sarah. “It looks like your urine is almost clear now, very little blood now,” I told Mr. Harris with a smile. He smiled at me and wrote on his board, “Good!” “Do we know what caused the hematuria?” asked Sarah. “I’m not exactly sure. We are treating your dad for a UTI, which is likely the cause. The urologist wants your dad to follow up with him as an outpatient after he goes home.” “But… what if the hematuria comes right back? Back to square one? It is challenging for us to transport my dad because of his ALS and incontinence …” “Let me speak with the urologist about getting the cystoscopy done here, especially since the hematuria is almost gone.” On reviewing outside hospital records, he had a similar hematuria episode a few months ago before his daughter and son took over his care from another family member. When I mentioned to them this past episode, they were unaware and shocked that now is the second time. After speaking with the urologist, he decided to do the cystoscopy in-house. Thankfully, he didn’t see anything that would be the cause of Mr. Harris’ hematuria. It was indeed a bad UTI that has now resolved. On his last day with us, I told Mr. Harris that he was good to go. He smiled ear to ear and gave me a thumbs up. I learned that you could express so much your emotions, wants, and needs through gestures alone. Not everything has to be spoken to convey how you are feeling. And Mr. Harris again showed me the importance of advocating for your patients. The importance of finding out what’s going on and that extra step for them. We all love our patients but never want to see them again in the hospital. That means we did our work the right way. Source
