Tuesday, February 15, 2011

Hypernatremia w/altered mental status

He actually wasn't conscious when he first came in--of this we were aware. He came in last night, but that morning we met him as a team. Mouth perpetually wide open, hands wrapped in giant mittens to protect himself and others around him.

"Mister Griswolllld!" Our senior resident would yell out each morning shaking him by the shoulders. That morning he responded with unintelligible moans.

My intern whispered in my ear, "Hey Griswold. Where do you think you're gonna put a tree that big? Bend over and I'll show you!"

"You ever seen National Lampoon's Christmas?" he asked me.
"Parts of it, but never the whole thing"
"Alright. Your assignment for today is to watch some you tube clips of that movie so we have something to laugh about together."

Over the next week, Mr. Griswold would recover some form of responsiveness. Demented as hell, each morning he would be greeted and shaken. Eventually, the mittens came off when he was aware enough to stop scratching himself and pulling out his IVs. Then we noticed his hands.

"Hey, check out his lobster claw!"

His left hand sprouted three long and sinewy fingers and nothing more. The thumb, the index, and the bird.

"Watch out. Once he gets a hold of your arm, we'll have to chop it off cause you ain't getting it back!"

Those first few days we couldn't understand a word he said. Then, one morning, I went in with my senior for our daily shaking. He was already awake by the time we got there. Eyes open, he stared at us. We paused, startled at his consciousness. His ever gaping mouth slowly curling upwards, eyes fixed on her.
And then he uttered.

"IIII LUUUUV YOUUUUUU!"

"Awwwww" the inflection in her voice crescendoing as we left the room. "He said he loved me! Mr. Griswold!"

The last day I saw him we were planning him for discharge. Several steps from his room we smelled it. Clostridium Dificile. Shit. Literally.

"How you can tell it's C. Diff?" I asked.
"Just lift up his sheets and smell it."

And so he and his lobster claw were discharged from our service likely to relapse as soon as he settled into the nursing facility to which he was going, We had all come to see Mr. Griswold in a certain light. From unconscious, dehydrated admit to helpless, feces-ridden geriatric to lobster claw freak show, it's startling how little we actually knew about him.

"I loved Mr. Griswold," our senior mused.
"That's because he told you he loved you!" one of the interns replied.
"I know..."
"But he never seemed like the sort of guy that would have a history of being arrested several times for robberies."
"Oh, Mr. Griswold."

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