Health Care: “Patient” is a Dirty Word

Posted on October 18, 2012

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At age 89, congestive heart failure finally caught up to Dad.  We spent that last night with him in the hospital.  Then my brother went home to get the paperwork for the crematorium to pick up his body.  Dad had always been the consummate planner, and this was no exception.

I didn’t want to leave his body unattended, so I sat in the hospital room and waited.  He had the blanket pulled up to his chin and almost looked like he might be sleeping.  Almost.  I didn’t want to cover his face as if he were dead, even though he was.

Then Nurse came in.  One of them.  This one had given my brother some grief over medications and questions.  She was one of those take-charge types, seeming to think she knew best and therefore took some kind of precedence or had some kind of authority over patients and families.  Now here she was again, though there was no more nursing to be done.

She saw me sitting there, put on a sympathetic expression, and moved as if to hug me.  I said, “Don’t touch me.  It’ll make it worse.”  I had to maintain control, at least long enough to get the paperwork done and make sure I knew when and where to get the death certificate and the cremains.  Who to notify.  Other details.  I could mourn later.  I didn’t want to start just yet, not there.  I was keeping a lid on it, with difficulty.  Don’t touch the lid.  It might blow off.

She stepped back and tried to console me with this:

“He was a good patient.”

I snorted.  “He was a terrible patient.”  It was true.  He did not tolerate pain or prodding or uncertainty.  He feared helplessness and dependence, even as it crept over him in his final months.  “I’ve lived too long,” he once said.

“Well, sometimes we just have to be firm with them,” said Nurse.  “But he was a good patient.”

I just looked at her and said nothing.  She left.

Sometimes we just have to be firm with them?  He was a good patient?   I had just lost my only parent and the last of my mental energies were consumed trying to take care of the aftermath in a dignified, organized way.  I wish I had had more presence of mind, because I should have told Nurse this:

My Dad was not a patient.  He was a survivor of the Depression, he was an Eagle Scout, he was a medic in World War II, serving in North Africa and Italy.  He was at Salerno and Monte Cassino.  God, the things he witnessed.  After the war, he graduated Phi Beta Kappa from Lehigh University and got a Master’s from Harvard.  He served in the CIA for 26 years.  He helped establish the West German Intelligence Service.  He survived some dangerous situations in South America.  He spoke three languages.  He was a young widower who raised two small children alone and sometimes overseas, with no help or support.  He never forgot his wife and taught his kids to remember her.   He taught us about independence and responsibility and how to manage our own finances.  He was an expert with firearms, and taught me to shoot.  He was a protector of animals and taught us to respect and care for our pets.  He went back to teaching tradecraft as a contractor after retirement.

Dad was a whole person, an accomplished person, and one who had seen and done and endured things that Nurse could not dream of.  He never wanted to be a patient.  Who does?

I hate that word:  patient.  It smacks of weakness, infirmity, illness, dependence, need.  It subordinates people to their health-care providers.   It lumps them into a mass of broken, ailing flesh petitioning the almighty doctor for their attention.  How different from, say, the word customer, which carries power rather than helplessness.  Customers are people to be respected, courted, attracted, catered to.   They are equals, or perhaps even more than equals.  They have something the businessman wants.

So you see, language matters.  Labels convey ideas and attitudes.  And I have decided that patient is a dirty word.  Patients are on the wrong end of the power continuum.  Patient is what gives Nurse the idea that my Dad was something over which to exercise her misguided “authority,” rather than a person whom she was hired to serve.

So, Nurse, remember this:  the hospital may strip away all physical vestiges of personality from the people who come through its doors, but all of those nearly-faceless patients in their identical hospital-issue gowns, under identical hospital-issue blankets, in identical hospital beds, are not identical.  They are all vibrant, individual people with real histories, real experiences, real talents and strengths.  They don’t need your “firm hand.”  They need a compassionate, respectful one.

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