My Rocky Mountain Heart

I remember the moment like it was yesterday…

I was 23 years old, fresh out of OT school and working at my 2nd job out of school at Zale Lipshy Hospital in Dallas on the inpatient rehab floor.  The patient I am writing about was someone who’d had a stroke and was making a miraculous recovery in all of his therapies! All the therapists said he was like poster boy for stroke rehab – all his movement, function, memory, speech – everything was coming back at lightning speed. It was exciting and rewarding to work with him, knowing that he was truly coming back to LIFE! However, when patient’s progress SO quickly in therapy it’s easy as therapists to trust your patients too much, and my fellow OTs and PTs can understand what I mean when I say that.  I will be honest, I don’t remember the patient’s name – which honestly makes me feel slightly horrible, but after 12 years of doing this, there are only a handful of patient’s names that I have never forgotten.  For the sake of story-telling, let’s call him Mr. Anderson.

This particular morning at work, I was assisting Mr. Anderson to the restroom, a regular part of my job as an OT, when he sat down on the toilet and ask me for his privacy.  I always TRY to give my patients as much privacy as I can but when there are concerns about balance, safety awareness or impulsivity, I simply cannot – for the patient’s sake.  Trust me, it’s not a glamorous part of my job but it IS my job to keep my patients safe. Mr. Anderson said, “I think I need to have a bowel movement, can you give me a few minutes?” I helped him place his right arm (the weaker arm) up on the rail for safety and I shut the door – MOST of the way.  Something in my gut told me to leave that door cracked, just a couple inches. I could see into the mirror above the sink, which allowed me to keep a distant eye on Mr. Anderson, just in case.  A few minutes go by and he seems fine, so I turn my back for a second.  I start to get impatient so I turn back around to look in the mirror and check on him.  All I see I Mr. Anderson leaning backwards, spine extended, arms rigid and shaking…. “Oh shit,” I think, he is having a seizure.  I quickly pull the red cord and simultaneously SCREAM, “I need help in here! Get the crash cart! NOW!” Within a few seconds, there is a whole team of people there to assist me.  We have to transfer the patient, while seizing and rigid, to a wheelchair, wheel him out of the bathroom, transfer him down to a compression board on the ground, then lift him up to his bed on the board.  Somewhere during this process, the crash team took over, I think once we safely got him down to the ground to the compression board. I was told by the head nurse to go page the patient’s doctor with 911.  So I ran out of the room, I paged the doctor. I didn’t ever go back in because at that point compressions were started, medications were being administered and it was all out of my hands.

I remember sitting at the nurse’s station feeling like I was having an out of body experience.  Is this real? Is this really happening right now? It was my FIRST MONTH working in a hospital.  My very first month. 30 minutes later, Mr. Anderson was pronounced dead. What?!? No, this can’t be real.  This isn’t supposed to happen. Rehab patients are medically stable, right? They are supposed to be medically stable and ready for therapy, right?  Wrong. Mr. Anderson had a grand mal seizure on the toilet and continued seizing until he was gone. They were never able to get the seizures to stop.  I sat at that nurse’s station in shock. Literal shock. I stared at the computer screen for I don’t know how long. I didn’t know what to do. Do I go see my next patient?  Where is my boss? Suddenly, the nurse manager, Shelly, came up to me to tell me that I need to fill out an incident report in our documentation system and that I may have to attend the M&M conference on Mr. Anderson the following week. For those that don’t know, M&M (not the candy) stands for Morbidity and Mortality, where the doctors and nurses get together to analyze what happened when a patient dies.  What could have been done differently, if anything. Did the patient show any signs we could have caught sooner? How did the team work together? Could we have gotten a better outcome?…. I immediately started to panic. Did I do something wrong? Could I have reacted faster? What else could I have done? As these thoughts are racing through my mind, I hear his wife coming up to the floor and enter his room and just start wailing.  “Noooooo……Noooo…….” My heart shattered into a million pieces. Mr. Anderson was only in his 50s if my memory serves me correctly. Far too young to leave this earth and his wife and family. And there I was, 23 years old.  A baby. My first month working in a hospital and a patient of mine died – with me.

Somehow I walked to the elevator and went back up to the floor with our office.  I remember walking to our magnetic scheduling board to try to rearrange my schedule because I had obviously missed a few treatments by then.  I remember standing there in front of that board and wanting to burst into tears. My PT partner at the time, Chi Chi, came up to me and said, “Sondra, what are you still doing here?  Go home.” I replied, “I have patients to see.” She said, “No, we’ve already absorbed all the rest of your patients for the day. Go home. Decompress, take care of yourself.” And that was that.  I went home and cried. Cried on the way home. Cried when I got home. Cried all night I think. My husband didn’t understand. He questioned me about why I felt “so attached” to Mr. Anderson. I felt his question was heartless at the time, I got angry at him for not being more sympathetic.  But in retrospect, he didn’t get it. He works in an office in front of a computer most of his day. How could he possibly understand the bonds that are formed between a therapist and patient when most of his ‘interaction’ with people at his job occurs via email.

Looking back on this incident now, I realize that it wasn’t so much my attachment to Mr. Anderson specifically that crushed me.  It was the very sudden and painful realization that in just an instant, ONE instant, life can change forever.  A life can be taken away JUST that fast.  That’s a hard lesson for anyone, let alone a 23 year old with an “I’m gonna save the world” attitude in my first month working at a hospital as an OT.  That moment, that day at work, changed me forever. My mindset shifted from “I can do that later” and “I have all the time in the world” to “Do it now,” “Say ‘I love you’ now,” “Make time for the people who matter,” and always ALWAYS leave the door open just a crack to keep an eye on your patients.