The Night Crawler

It’s 3 am in my CCU. Lady with dig toxicity and 1 vein and the prior two bleeders went upstairs today while I was passed out at home. By Upstairs I don’t mean the Big Unit in the Sky (BUS=Heaven), I just mean to the medicine floor. Still no CCU patients hitting the BUS on my watch. One should code any minute since I just wrote this. At least my overwhelming paranoia thinks so. The two new admissions are mysteries in and of themselves. “Dah..my heart is ballooning” guy and “paranoia delux” chick.
The first to check in was “paranoia delux”. A relatively young lady in her late 50’s who had the unfortunate circumstances of having her second MI (Myocardial Infarction= Heart attack) in as many decades. She also had a long history of paranoid schizophrenia, let’s concentrate on this. To those who have not had the privilege to talk with these patients then let me describe the experience. It’s kind of like talking to a wall, except, the wall could probably hold up a better conversation. It’s quite painful, kind of like, running into that same wall over and over, at high speed, head first, no padding, steel wall.
The following is an excerpt from our conversation:
Me: So tell me what brought you to the hospital today Ms. P? (notice the open ended question form)
Ms. P: The ambulance. (me: aha….)
Me: Well, why did you call the ambulance?
Ms. P: I didn’t, my husband did.
Me: Why did your husband call the ambulance, were you having pain or anything else? (open ended #3)
Ms. P: yes.

This went on for a long time. An agonizing looonnngggg time.

Then came “dah, my heart is ballooning” guy (From here on, just plain “duh”). “duh” was here before, approximately a few months before this admission. During that time, someone happened to do an Echo and mention to him that his heart had ballooned to the size of a watermelon and that it may…just may…could possibly…cause him to have horrible heart failure and die real soon!
You’d think this would maybe make an impression, possibly scratch the surface, maybe even it would be something that you would like to follow up on. Therein lies how “dah” earned his title. Now with full blown CHF and a spec of hope for a possible transplant “dah” is back in full force. Updates to follow.

Topic of Title: It’s 3 am in my CCU and I am wide awake, unable to sleep but maybe because I switched my biological clock to nighttime now. So, technically, what is this called? It’s not insomnia because I intentionally did this. Rules. Well I’m climbing the walls, as I like to say, so for tonight I am the night crawler.