Personal and Professional

Disposable masks, disposable gowns, and disposable gloves are mounted on the door. The five feet betweeen the hallway door and my friend are called the Isolation Area. It's where I cover my breath and hands so that my presence, intended to bring comfort (to me? to her?), is denuded of its power to harm.

I hope.

"He's vent-dependent", I say at work, reviewing the paperwork of someone I don't know and clinically assessing that individual's need for attendant care and other services.

"She's on a ventilator", I say, with some level of amazement that this really happens to people who were walking around and breathing just fine last week. The respiratory therapist says he needs to clean out the vent tubing and "you can stay if you wish, but, well, some people faint." I have nothing to prove and literally turn my back on my friend. I don't like the symbolism of it, but I don't have great choices. Picking the least-bad of all choices has been rather the hallmark of this entire journey.

We, as a profession, are all about promoting and supporting independence. Driving is more independent than being driven. Being driven somewhere is more independent than being home-bound. Cooking is more independent than being cooked for and eating by mouth is more independent than a feeding tube.

And on a ventilator - Jesus, you can't even decide when to switch from "inhale" to "exhale." Of course, being heavily sedated, that's not an issue for her right now.

"She has a lower-level spinal injury so she has good use of her arms" I say at work, thinking this is really pretty good news.

"They can't say how much use she'll have of that arm," I hear in the hospital. And I wonder how she'll cook and if she'll play tennis again.

In the State Capitol, as I often am for work, I hear that X% (I wrote it down somewhere) of nursing home residents have no one to speak for their wishes in an emergency.

Twice this week I've walked past the bed of a man who has had no visitors that I'm aware of.

Isolation Area.