Refeeding Syndrome

It was the second time they went to go see him. It was the wing of the hospital furthest from the main building, the Forest, they liked to call it. He had a lot of problems. Cancer, fungus in his blood, cystic fibrosis, and probably a multitude of other opportunistic infections. The attending followed by the intern followed by the medical student. They were the infectious disease team consulted by the primary service to manage something.

"You look a little tired today," the attending said, dressed in the yellow isolation gown.

No response. He was known for not always being particularly responsive.

"Are you having trouble breathing?" He clearly was, but was still capable of speaking. He looked at them blankly and annoyed. The physician looked at him concerned.

The intern coming up along the bedside took a brief glance at the patient. With a quizzical look on his face he turned to his attending and remarked, " I think he might have refeeding syndrome. Sometimes after people haven't eaten for a while, their body has a hard time readjusting to oral intake creating increased carbon diox--"

"Listen to me," the emaciated 25 year had spoken. His hoarse, weak voice conveying the severity of his condition.

"The reason why I'm tired is because I can't sleep. Every night I have nurses that come in a readjust this and readjust that. I'm in pain. When I finally do fall asleep, I'm woken up again at 4:30 am so they can draw blood. Then for some reason, when the nurse comes in to get my blood, the other nurses think it's a good time to come in and take my blood pressure, take my temperature. Next thing I know some doctor is coming in at 6:00 am to ask me questions. Now it's bright out. Then when everyone finally leaves me alone you guys come along and ask me even more questions, see me tired, and think I have some refeeding syndrome. Now I don't claim to know as much as you doctors with all your knowledge and training, but what I do know is that if I could actually get some sleep here, I might not be so tired when you guys come around. What I do know is that I don't have no refeeding syndrome"

Silence blanketed the room. The attending turned to the intern, "I don't know why they have to draw blood at 4:30 in the morning. We'll try to stop by earlier in the morning so that he won't be interrupted as much."

And wishing the patient well, they turned around and left the room leaving the sick man to attempt sleep once more.