Study for a Head, Francis Bacon 1952

“I WANT YOU TO CALL MY WIFE. I AM NOT STAYING HERE ANOTHER NIGHT. I AM NOT STAYING. BRING ME THE PHONE SO I CAN CALL MY WIFE.”

Most days on the CCU pass quietly, with some semblence of routine. I’m awakened by the phlebotomist, usually around 5:00. I’ve been able to work remotely from the hospital, so that keeps me busy until my COVID mandated one daily visitor arrives, usually around 12:00. My vistor leaves at 3:00 and I work for a few more hours. Dinner arrives roughly at 5:30. The routine makes it feel like I’m in a nursing home.

Today was different though. A new patient arrived in the room across the hall. I call him Screaming Guy. From the moment he arrived, he ranted non-stop. I started to wonder what sparked that energy. He was ranting when I went to sleep at 11:30, and was ranting when the phlebotomist woke me up at 5:00 the next morning.

I felt bad for him when he first came in to the CCU. The shouts — long, anguished moans punctuated by high-pitched yelps — reflected real agony. I could hear the nursing staff trying to ease his pain, but no matter what they did, he just kept screaming. He was trying to pull out his IV. “NO. NO. TAKE IT OUT. I DID NOT SAY YOU COULD PUT THAT IN ME. IT HURTS. TAKE IT OUT.”

After a while, I mostly wanted him to just shut up. The moaning stopped and the shouted attacks on the nurses began. His yelling wasn’t incoherent; he was very specific. He told them they were terrible people out to hurt him. He yelled about food. He yelled about poop. He yelled about piss. First, it was “HEY YOU” as a nurse walked by his room. Then it was “GET ME MY POTTY, I HAVE TO SHIT.” Then, “WHAT IS WRONG WITH YOU? ARE YOU HURTING ME ON PURPOSE? YOU’RE HURTING ME ON PURPOSE.”

He bellowed, and I could hear him from across the floor, with my door closed and my headphones on. I’ve been here two weeks and have been cared for by many of the people he yelled at. I can say without reservation that they are not terrible. In fact, their patience has been remarkable to witness, even as it waned. I began to sense frustration creeping into their responses, but they went right on and did their jobs. What was shocking to me, seemed to be just another day to them.

The night nurse, a guy named Steven, takes care of both me and Screaming Guy. Steven is Chinese-American, NY born and raised. He wears round, Harry Potter type glasses that make him look very young, despite his receding hairline and slight paunch. I didn’t ask him his age, but the slight edge of weariness in his voice suggests that he’s older than he looks.

When he was in my room, I probed a bit about Screaming Guy. “Rough night for you?” I asked him. “Eh. Not that bad, it happens a lot. You get these people, they’re knocked out from surgery or whatever. They wake up here, have no idea where they are. They’ve got no family with them. It’s disorienting.” I was shocked at how blasé he was about something I’m not sure I could tolerate. Screaming Guy had been heaping abuse on him since his shift started.

Maybe I shouldn’t be surprised at his non-reaction. He seems like a guy fully in control of the things he can control, but unflustered by the things he can’t control; like Screaming Guy. Steven is very knowledgeable and indulges all my dumb questions, not just about Screaming Guy, but about all kinds of other stuff: my blood pressure, COVID, whether or not he has a union (he does), and whatever else comes to mind.

I wondered for a minute if he wished I would shut up, the way I wished Screaming Guy would shut up. But only for a minute, because Steven is not just smart, he’s very funny. I’m far more independent than most of the patients on the floor. I can get up and walk around. I can feed myself. I can wipe my own ass. According to Steven, I’m “the kind of patient us nurses love to get. Low maintenance. Easy peasy.”

Earlier in the day, my daughter visited and brought Chinese food. The day nurse put the leftovers in the nurses’ fridge, and when I asked Steven if he could get it for my dinner, he wanted to know what it was. I told him it was stir-fried pork with bok choy. “That’s ‘My People’ food” he said laughing. When I said something about the salty food breaking the heart healthy diet rules, he had a quick reply. “Yeah,” he said, with an exaggerated eye-roll, “but they’re gonna give you a new one and put the one you have in the trash, so might as well.” Our hilarious laughing brought another nurse into the room to find out what was so funny.

Maybe having the ability to deal with a rude patient like Screaming Guy, while also knowing how far you can push your jokes with another patient, is part of what makes one nurse better than another. The nurses at NYP Columbia have generally been very good since I arrived, but some are definitely better than others. All of them can do the basic stuff, but the ones I’ll remember after all this, are the ones like Steven.

The morning of the second Screaming Guy day, Steven was in my room taking my vitals. I wake up early in the hospital, and I’m usually quite groggy, but I’d managed to sleep a bit. He had about an hour left on his shift and was remarkably calm, per usual. He seemed to glide through his shift. Screaming Guy was still screaming. “I WANT MY BREAKFAST. WHERE IS MY BREAKFAST?”

“It doesn’t come for two more hours, asshole” I said to no one but myself. I felt something beyond irritation by that point. It was something I recognized as anger. I’m starting to hate this guy, I thought. I created an elaborate scenario in my head; I get up, walk across the hall, and tell the screamer to shut his stupid mouth. “Shut up, shut up, shut up!!! You think you’re the only person on this floor?” I asked him, in my imagination. I’m embarrassed by my insensitivity to Screaming Guy’s obvious problems.

Later, on my daily walk around the ward, I snuck a peak into Screaming Guy’s room. He’d been quiet for a while, having finally run out of steam and fallen asleep. He was completely drained and his skin was the color of bile. Filthy hair matted onto his head, but, he actually looked kind of peaceful while sleeping. Earlier in the day he had what sounded like a difficult conversation with his son, at least as far as I could tell from one side. Now, lying there all hooked up, he just looked exhausted and defeated.

I felt bad all over again for my reaction to his ranting. He was in the CCU. No one had come to visit him in nearly two days. He was in pain and scared. But like all things in life — indeed, like life itself — the feeling was temporary. By the time I got back from my walk, he was back at it. “WHERE DID YOU PUT MY PHONE. THAT BLACK NURSE TOOK MY PHONE. STEVEN? STEVEN, COME HERE.”

I asked Steven “do they teach you how deal with this kind of thing in nursing school?” He laughed a little. “Yeah, I guess. Its sort of common sense, you know? Like, arguing with them will just make it worse. You’ve gotta make them feel like they’ve been heard. The most important thing is that you can’t take it personal. Like I said, sometimes they don’t even know they’re doing it.” A review of nursing literature reveals a dozen different versions of these basic principles. Maybe it truly is common sense, but I just can’t imagine how I would deal with it without punching Screaming Guy in the face.

“I suppose,” I said, “but this guy just seems like a dick. That must make it hard to be empathetic.” I felt another twinge of shame at my irritation. Its hard to tell if Screaming Guy really is just a dick, or if he’s had some kind of psychotic break and can’t control himself. Steven, whose laugh is equal parts warm and wry, chuckled. “I didn’t say it was easy. It just happens pretty often. So its better to learn how to deal with it than let it grind you down.” Then, from across the hall, came the call of Screaming Guy: “STEVEN. STEVEN. I HAVE TO SHIT. STEVEN, BRING ME MY POTTY.”

I don’t know how much they’re paying Steven, but whatever it is, its not enough.

I’m a lawyer with a brand new heart. My old one was busted.