Remember this guy?

He later disappeared from our floor for 9 hours.  With a PICC line.  In that time we went ahead and filed elopement and police were notified.  He returned late that afternoon, upset to find that his room had been given away.  His explanation for his absence?  He was in the parking garage.  Meditating.  Right.  The PICC line was removed and he was informed that he would have to return through the ER.

The next day he was back in the hospital, though on a neighboring unit.  Still pulling the same shit.  Told again and again that he would certainly die if he didn’t comply with treatment.

In a not-so-surprising turn of events, he was found face down in his bathroom.  Blue and purple.  Lying nearby were syringes (not hospital issue) and his own personal stash of Dilaudid pills.

It’s sad to see someone have so little regard for his own life.  What’s sadder is to see it over and over again.

I experienced deja-vu when I was assigned another patient with 8mg Dilaudid po scheduled 5xday.  With an additional 2mg Dilaudid IV q2h.  Who tried to tell me that she was supposed to get the pill and IV at the same time.  Who told me that her pressure was low when she was in pain, and that it would rise after she got the medicine.  Who tried to tell me the druggy behavior I was observing was from anything but the 40 mg of Dilaudid she took everyday.  Who complained how she was tired and sluggish all the time and that the damn doctors couldn’t figure out what was causing that.  Who told me there were some good veins here on her legs if I couldn’t  find  any good ones on her arms.

So, I told her about a patient I once had.  Who also took an enormous amount of Dilaudid every day.  Also for chronic back pain.  Who was told that he was going to kill himself if he didn’t stop.  Who’s now fighting to live.  No.  Scratch that.  Who we’re now fighting to save.  And I asked her.  Should we be trying so hard to save someone who was trying so hard to kill himself every single day?

I realize that wasn’t really appropriate, but I knew she’d heard it all before.  And even as I spoke, I could see that she was thinking of nothing but her next dose.