The VA elevators are quick, but the air is sticky. The chillers are still out, and the head of the hospital sends another email about them. Yesterday he said they would be up and running today; today he promises tomorrow. The interns are new, uncertainty still in their voices as they present plans on rounds, but they have worked enough for the beginnings of fatigue to set in. And we all sit there in our sweaty scrubs, baking in the July heat.
The patients feel it, too. One wrestles to maintain his cheeriness, telling me about being on tour in the desert, where it reached 120 degrees. “This is nothing,” he says, laughing. But the next day, a fan is plugged in at bedside, and his smile seems less strained. Another patient yells about something new every day, and every day he ends with a comment about the temperature. Late one afternoon, an industrial-size fan has appeared in his hallway, sending what feel like gale-force gusts down the whole ward. When we check on him, I can’t tell if his complaints are calmer, or simply drowned out. The team lingers for a minute outside his room, though, soaking in the cool.
And then the chillers are fixed, and the whole hospital breathes a sigh of relief. I spend my last days at the VA focused on notes and physical exams and causes of acute kidney injuries, grateful to be thinking about anything other than the heat.
***
Bellevue’s air conditioning feels like a dream, but the elevators are slow. I’ll take this any day, I think to myself as I wait with a crowd. Outside, the heat wave continues, and orange advisories flash across patient TVs. I joke about it with bravado born out of a childhood in Texas’ sweltering summers, but I’m glad my commute is short.
The hospital is full, and my team is busy. One patient is a middle-aged man, just transferred from the ICU. We go to see him, a cachectic man with a kind smile, who tells us he’s feeling better and just wants to get home to his daughter. We ask if there is anything we can do for him, and he says no, unless we can make the room cooler. “It’s so hot in here,” he tells us. I hadn’t noticed, but he sighs in relief when we pour him ice water.
The whole team goes to see him on rounds. The intern presents his history of metastatic cancer, bilateral amputations, and the wound that brought him from hospice to the hospital. “We’ll try to get you headed home,” the attending tells him. He gives a thumbs up and a half-smile. Then the attending asks him to raise his legs, and his expression changes as the legs don’t lift. “Why can’t I move my legs?” he asks. We test sensation; he can’t feel anything below his belly button. And he is lying in his own incontinence. My heart sinks as I process what this means. We tell him we have to talk to neurosurgery, and then we head to lunch.
Later, at teaching with other medical students, I suggest visiting my patient, but he doesn’t want to talk. I’m initially surprised by the change in his demeanor. “Are you in any pain?” I ask. He shakes his head but gestures sharply at his legs. My short-sightedness hits me. I am thinking about physical pain, but he’s dealing with much more than that: the loss of control over his legs, already half-gone, and yet another delay in getting home. And I can tell he’s still hot. He’s afebrile, but he lies listless, gown down to his waist. This time, I feel the stifling air too, the air conditioners overpowered by the violence of the afternoon sun.
I return with the intern, passing the neurosurgery residents on their way out. The patient is upset, and he says he doesn’t want any more pokes or procedures. I offer an ice pack as a peace offering; it’s moderately cold at best, and he doesn’t want it. His anger breaks into sadness as he asks if I have children. “I don’t,” I say. “Then you can’t know how I feel,” he replies. A phlebotomist comes in to draw blood, and he grimaces while she tries one vein, and then another. I leave with a pit in my stomach.
I relay all this to the mentor for my small group of medical students. She asks me if I’m okay, and I realize that my voice has a shake to it. I tell her I’m alright, but I wish I could do anything, at least to make him more comfortable. I can’t imagine the pain of what he is going through, the pain of a whole family’s heartbreak. I only know what it feels like to be hot.
“I have an extra fan,” she says. “You can bring it to him, if you want.” I hesitate. But then I think of the fan roaring in the VA hallway and how it felt to stand before it. I take it, carrying it self-consciously through the halls. “I brought a fan,” I tell the patient. His eyes close, and for a second, I think he doesn’t want to talk to me. But then he smiles and nods. “Thank you” he says, opening his eyes as I plug it in. On the way up, I had been worried that I would get in trouble or he would get too cold. But then I hear him laugh, and I’m not worried anymore. “That’s so much better,” he sighs, his eyes closed again.
And then I leave for the weekend, but the pit in my stomach is gone. Maybe he’ll be there when I return, and maybe he won’t be. He’s a dying man. I can’t change the cancer in his spine, the loss of his legs or his dwindling time. I can offer no cure, only the simple solace of a borrowed fan.