As the world steps back, healthcare professionals from around the globe are going above and beyond to serve those in need during this COVID-19 crisis. Dr. Kristofer Smith, naviHealth’s President of Home-Based Medical Care, is one of these dedicated workers, tirelessly answering the call to volunteer for the cause despite not practicing acute care medicine in over a decade. These are his daily stories – uncut and untouched, as told from the front lines.
Day 7 – Syrup
Over and over again, we are receiving patients from other hospitals who are being described during sign out between teams as altered, delirious, demented, or just out of it. And when they arrive on the unit, they are indeed impaired. Their thoughts appear stuck in syrup, as if they are seeing the world through a semi-permeable veil.
Yet, strangely, when we call their loved ones, we hear about a totally different person. One patient performed at a jazz club three months ago, another holds a job often working six days a week picking up extra shifts and another runs a greeting card company. At the bedside, these same patients initially range from obtunded to, at best, fuzzy. We all think that their families and friends have missed slowly progressing Alzheimer’s or damage done by drugs or alcohol.
Despite our skepticism, we do our best to work with the patients to continue orienting them to person, place and time. We hand out clocks, give newspapers and arrange for phone calls with familiar voices. They watch familiar shows and movies on donated tablets. And slowly, the fog lifts.
Soon, they start to remember where they are. The next day, they remember a name of a loved one. The next day, they remember the phone number of their primary care doctor. And finally, humor returns.
When I was a trainee at a city hospital, there was a Dunkin’ in the basement. We all used to laugh that we knew a patient was ready for discharge when they had the “Dunkin’ sign”—they were well enough to leave the floor and get themselves a cup of coffee from Dunkin’. For our patients today, when they start telling jokes, we know that they are close to being themselves and safe to leave our care.
Catch up on the entire series of “Trials and Triumphs” featuring Dr. Kristofer Smith.