Friday, April 1, 2011

At Home in the Hospital - NYTimes.com

Some patients cope with long hospital stays by bringing in a few books and a favorite pair of slippers. For others, an incandescent lamp can offer light that looks more like home. A favorite Steelers blanket may adorn a bed. The mother of one young woman brought in a sewing machine and worked happily and busily during her daughter's monthlong hospitalization.

But some patients go even further, transforming their hospital rooms and their hospital lives into as much a version of home as they can.

One patient, in her 20s and struggling with a very bad diagnosis, turned her room into an oasis from the clinical feeling of the hospital. Pictures and cards were taped up everywhere. Her sister stuck paper flowers to the walls, making a swirl of color and warmth amid the bland hospital white. She used oils, with diffusing sticks, to perfume the air, so her room actually smelled good. Even the IV pole got decorated with ornaments, including ceramic angels there to wish her well.

And of course she had her own clothes, her own pajamas, her own blanket. Her charming boyfriend slept over. Family and friends came often, bringing not just comfort and support but a flavor of the outside world — of the full life that was waiting for her.

Her room was small, but all the personal touches made it feel less like the hospital and more like home. It was a pleasure to take care of her because it meant going into her wonderfully transformed room.

Beyond the room, though, she lived her hospital life like a person, not just a patient. She and her boyfriend went for walks, holding hands. Her family brought in food she liked. She would stay up late, refuse to have vital signs taken during the night, and then sleep late the next day, confidently defiant of our structured, early-to-rise practices in the hospital.

Her dog was the one thing from her life outside the hospital that could not cross that rigid hospital barrier. Many of the pictures taped to her walls were pictures of her beloved pet, a tiny dog with floppy fur that fell over its eyes. She really, really wanted to see her dog.

Lydia, our amazingly kind patient relations representative, decided to bring the dog to the hospital.

The first hurdle in pulling this off was the doctor. Would the patient's attending physician agree to a visit with the dog? The answer turned out to be yes, so the next question was where to hold the meeting.

Because many of our patients have suppressed immune systems, bringing the dog onto the oncology floor was not allowed. Lydia arranged to use a meeting room one floor below ours. She had the walls and floor wiped down with bleach and thoroughly scrubbed as a precaution to protect the young woman, whose immune system was also suppressed.

Her mother was bringing the dog, and when the time came, I went with the patient down to the meeting room. Because of her vulnerability to infection, she was not allowed to hold her dog. But she sat in a chair, wearing a yellow isolation gown and latex gloves, and watched while I held out toys for the dog to chew on, shake about and growl at.

The dog seemed content just to play. And even though the patient couldn't hold her dog, she also looked happy, the way I imagined she probably looked away from the hospital.

Soon, it became clear that having time with her beloved pet wasn't really just about the dog. We had been sitting in a windowless hospital room in the middle of winter, yet it felt like someone had opened a window on spring, letting the light and the smells of wet earth and budding flowers come flowing in. Somehow, that little floppy dog had brought the outside world into the hospital.

In the book "The Cancer Journals," the poet and activist Audre Lorde reflects on her experience coping with breast cancer, writing that each woman responds to the crisis that cancer brings to her life "out of a whole pattern, which is the design of who she is and how her life has been lived. The weave of her everyday existence is the training ground for how she handles crisis."

That certainly seemed to be true for my patient, who coped with cancer treatment by weaving her everyday existence into her life at the hospital, whether it was pictures from home or time with her dog. Now that patient is out in the world. She isn't completely well, but she is back to living her life.

http://well.blogs.nytimes.com/2011/04/01/bringing-home-to-the-hospital/