What the...? Where am I?

Today was just a bizarre day. By the end of it, I felt exhausted and abused. First of all, I felt as though I were some sort of U.N. Ambassador. Working in a Rochester hospital, I'm surrounded every day by nurses from Ukraine, Poland, and Russia, as well as doctors and residents from all over the world, but most notably India, Pakistan, and the Middle East. But on top of that, on my caseload for today were patients who spoke French and Spanish (which I can at least speak), as well as Italian, Greek, and Ukrainian. And none of these people spoke English. Or so I thought.

The other thing that made my day stressful was that I ended up getting yelled at by all my patients. Most of them are confused little old people. One woman was yelling at me for stretching out the contractures in her calves and hamstrings, asking me "God dammit what's wrong with you!?!" The woman in the room next to her, the French-speaking patient, started out polite, and then ended up screaming at her nurse and me when I tried to translate to her that the nurse wanted to give her medicine. We found out that she spoke decent English. "You don't know nothing! Medicine! Medicine!?! Ha! You don't know nothing about my medicine! You don't know nothing!" She then punched the nurse in the stomach, so we left her to fold her sheets as she'd been doing. The guy across the hall from the French-speaking patient has a 40 year history of IV-heroin use, and becomes delusional and agitated at times. I found him wandering the hall, very unsteadily, so I tried to help him back to his chair. He ended up yelling at me to not be ashamed of my Latino heritage (I'm not the least bit Latino, but have been mistaken for it before).

The toughest, though, was a new patient I picked up today. He'd just been diagnosed 2 days ago with metastatic cancer of unknown origin, and was told by one doctor that he would probably only live 3 more months. Understandably so, he became a bit depressed and withdrawn. They ordered a physical therapy consult on him just to keep him moving so that he could safely go home and not have to spend any unnecessary time in the hospital. I read that he is a Vietnam veteran, and also that he has a history of post-traumatic stress disorder, but didn't exactly put the two together. Well as I got him up to walk for the first time, I stayed slightly behind him and kept a hand on his back to make sure he was steady on his feet, as I do with all my patients for the first time. He quickly turned and yelled over his shoulder "Hey, I'm not some old cripple. You don't have to hold on to me! And I really don't like you being behind me!" I explained to him that I wanted to make sure that he was stable and that I wanted to be safe. Two steps farther and he whipped around again. "Take your damn hands off me." So I did. He was pretty steady, so I walked beside him down the hall. As we got toward the end of the hall, he was getting close to the wall so I walked quickly behind him to the other side, so as not to run into the doorway. As soon as he'd realized that I'd switched sides, he immediately freaked out and came after me. He brought his hands up toward my neck and came quickly at me shouting something...I can't even remember exactly what...about being a Vietnam vet and not liking it when people move around behind him. I managed to hold his wrists and keep him from choking me long enough for him to settle down, then did my best to explain that I was sorry and just didn't want to run into the wall. Thankfully I stay calm in situations like this. I actually remember thinking, as he was trying to choke me, "Okay, just stay calm and let him get out whatever pent-up frustration he's got stored, then take back control of the situation." It worked, he settled down, and we continued on to the waiting area around the corner. We sat for a few minutes and talked. He apologized, then apologized again twice more when we got back to his room. I just made a concerted effort to stay in front of him. But tomorrow he's coming up to the PT gym, so we'll see how that goes. Wish us luck...