The man with the fedora in the ICU

I visit him in the ICU day in and day out. It’s the man with the fedora. I see him every day because he is not going anywhere. The metastatic cancer has ravaged his colon, bones, liver, and lungs. His oncologist is willing to try more chemo — but not now — maybe someday “when he is stronger.” The man has already failed several other regimens. The oncologist hasn’t seen him in a while. He’ll see the patient in clinic when he is discharged. He thanks us for keeping him updated. Every day as I log on to the electronic health record in the top left corner, I see the man’s picture. Taken at an outpatient visit many months ago, he is smiling and wearing a charming brown fedora with a feather. It’s tilted just so and not by accident. He’s unrecognizable from the man in the bed. The smile is full of optimism. The twinkle in his eye. He took time to pick out the fedora that morning, perhaps with advice from his wife of fifty-plus years. He has several on his hat rack in his bedroom, but this was the right one that day. He wanted to look handsome for the doctor. He was pleased they took his picture that day. He sure looked suave in that fedora. Now the man with the fedora has pneumonia, sepsis, DVT and C. diff infection. He has aspirated, has a trach, a feeding tube, a PICC and an IJ line. The nurses gently turn him, preventing pressure ulcers. Dressings are changed with care. His catheter bag is emptied, ins and outs recorded. An ever-rotating list of antibioti...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Critical Care Hospital-Based Medicine Infectious Disease Source Type: blogs