But one of the CT scanners was broken, so there was a long line for the other one. Worse, trauma cases kept rolling in that night. This woman had been in the ER for seven hours, and she was still awaiting her scan. She threatened to leave. The attending talked to her and came back. The nurse returned twenty minutes later. "She says she's gonna go," the nurse said. Her (perfectly acceptable) facial expression said, "And I'm resigned about it."
"I'll talk to her," I said. Talking to upset people is one of my favorite things to do, ever since I deescalated a potential emotional explosion in the psych ER waiting room and someone told me I was good at it. My theory is: it can't get any worse, and you can only make it better!
The attending was busy, so he let me. I went in and sat down, preparing for a long haul. My intention was to sit with that woman and talk with her until a radiology tech came to take her to the CT scanner. It was something I was uniquely poised to do, because I didn't have true clinical responsibility and I could be functionally absent for whole hours, if necessary. It would be good for this patient and our ER if she stayed--she'd know more about her colon (cancer?) and the ER wouldn't have her back in two months with inoperable disease. So the attending let me go, and I plopped down at her bedside, hoping to distract her.
It worked beautifully.
After a few minutes of expressing her displeasure about the wait, I got her talking about all kinds of things. TV shows, her day, traffic, weather, her old jobs, her family. Her favorite topic was her grandchildren. Her voice changed from unpleasant to soft and full of fondness. When she started talking about when she first became a mother, something peculiar happened.
|Alfred Gilbert: Mother Teaching Child|
Our roles suddenly reversed. I was no longer in power, pinning her down as one who knew better. She was instantly a queen, telling a little girl about magic.
"Really?" I asked.
"People say it's painful. I say 'ha!' Pain is nothin' compared to what you have. Your baby growin' inside you, then your baby in your hands. Just you wait, you're gonna be a good one. Now," she said, pragmatically, "how long I gotta wait for this CT?"
I grinned enormously. She'd taken me off my guard and my silver-tongued attempts to keep her in bed were suddenly exposed. I have a feeling she knew what I was up to the entire time, and was letting me win.
"I'm being honest," she said. "I still want to go."
"I'll ask," I said. I found out she was third in line and went back to her. "Number three!" I said, like we'd both won the lottery.
"Three?" she said, smiling. "Guess I'll stay, then."
I have no idea what the results of the CT were (it was read after my shift was over), but I got her to stay until she was in the scanner. She stands out in my mind as someone who values motherhood; even if she knew what I was up to, she was serious when she described how marvelous it is. I think of her frequently now and I try to have that esteem for motherhood, too.