EMS: “80-year-old male. Altered coming from nursing home. Baseline unclear, possibly dementia”
“Reset the counter” I think to myself. Start going through the usual.
He was pleasant, smiling, cooperative, but clearly confused. He could answer some simple questions, but his responses were inconsistent and his attention wandered.
Go over the basics—order labs, imaging, review chart/history/meds, etc... We know this routine all too well.
Contact the facility. Turns out his children had been visiting him earlier that day and noticed he wasn’t acting the same. I called them to see what was going on. But instead of hearing about his symptoms, they told me about their dad.
For more than 40 years, he had been a doctor himself, a pediatrician. Much of that time was spent practicing at Big Academic Hospital, where I currently work.
They spoke about how much he loved medicine, how devoted he was to his patients, and how generations of children had grown up under his care.
Hearing all of that, my perception of the patient in front of me changed. He wasn’t just another “AMS with dementia” patient... he was a doctor. He had been on the other side of the stethoscope.
He had cared for babies, kids, teens, and their families. I might wonder, do some of them work here now as nurses, doctors, pharmacists and so on?
I returned to the room to ask him about being a doctor… and for a glimmer, his gaze focused. He said something to the effect of “I loved it. They were all my kids.” But just as quick… it was gone. Pleasant confusion returned.
In that moment I was saddened. He had, by all accounts, an illustrious career. The career so many of us endeavor to create. Now, years later, dementia had slowly taken it away from him. He no longer has the memories of the career that had defined so much of his life.
One day, that could be any of us...
Every time I walked back into the room, I addressed him as “Dr. ____.”
He may not have remembered the thousands of children he cared for over forty years.
But for at least that day, someone else did.