mardi 19 juin 2012

The one who drank caustic soda in order to forget.

Visceral Surgery rotation, 4th year.
Digestive surgery patient hosted in the high located E.N.T. service.

I quietly stare at her, waiting for any kind of answer.
It won't come.
Her blurred look insists on ignoring me, heading towards the window. We can't see anything else than the summer sky through this one. From her eighty-five years and her erratic medical follow-up, i am not convinced that she actually sees that sky.

I hold on to her file.
According to the nurses, the first thing she said to the psychiatrist was "I failed, but i'll do it again.".

I inform her that i am going to check up her scar.
She starts holding her lips and blouse tightly. With that strenght that can only be shown by the elderly while defending themselves against the White Coat Confraternity.
I instantly start reciting an endless flow of words in order to establish some kind of non-agression pact. Doing that, i brought back her record in my mind.

Eighty-five years old, social isolation, domestic violence lasting for more than half a century, eighth suicidal attempt recovered at the hospital.
Phlebotomy and defenestration didn't work out, neither the absorption of caustics. Unlike some others doing it again and again, it is not due to a lack of will.
This time, she drank two bowls of Destop(R).
As our Psychiatry professors say "When an elderly does a suicidal attempt, he or she usually succeeds."
She, indeed, stood close to self-dissolution.

She reluctantly accepts to show me her abdomen, rightfully hoping that it would make me leave quicker.
The scar is smaller than what I had expected. There is a  nearly clean draining pocket and a gastric tube for enteral nutrition. I follow the tube with my finger.
Indeed, compared to the other clinical cases I studied before entering her room, she "was lucky". I mean that the soda didn't have the time to nibble her stomach as it did for her now removed oesophagus.
The firemen, called by the family, came up pretty fast, which is of prime importance in the cases of chemical burning by strong bases.
She won't be able to swallow her saliva anymore. A little pocket on her neck is here to collect the limpid liquid.

I can't help thinking that she might be planning another suicidal scenario right now.

I step aside and let her button herself, ending the contact which was obviously painful for her.
I reach the door of the room and try a last glance. She is still huddled on her armchair, staring at the window.
"- The one who is always there to call the firemen, don't you think that he could prevent her from being beaten ?" would eventually spat my senior surgeon.

The occasional impotence of our caring system and the morbid grotesque of her situation still freeze me to the bones.

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