No victory

At coffee

At coffee 

my team lead asks after

a patient my colleague is looking after

now PPS 10% apparently

being terminally sedated.

It feels like a victory

one small step in the right direction

how I used to wish

I had the orders

the tools

that the doctors out there had the education 

and the confidence 

to manage the terminally restless, agitated 

end stage demented patient like that….

how my pleas

to cloak

the moral distress,

the emotional wreckage

the demented brain

falling apart

could no longer hold

as they were were haunted

tortured by their worst memories,

deepest fears,

PTSD…

and it all fell on deaf ears

and the violence persisted

patients who 

punched us, kicked out, threw chairs, bit, spat,

called us every vile name they could think of.

The years of abuse

physical and verbal

we endured.

I am grieving today

and there is no victory

only a sadness

that creeps in

late in the afternoon

when I want to cry

sitting in front of the computer

before walking off

to do yet another IAR

on yet another cognitively impaired patient

this one drank

fell, found down with bloody attends laying around…

attempting to drink her demons away I suppose

estranged children

one who has a caregiver as he has FAS

no doubt

brought on by all she couldn’t control

long standing numbing agent of choice

against the emotional and mental pain

and I wonder later

what the demons are

but then

everyone is fighting something

trying hide

trying to work so damn hard

filling time

so they don’t have to think

about the burdens they carry.

I am well aware

I grieve

for so much abuse endured

it wasn’t my fault

and yet the anger simmers just below the surface,

spilling over 

when something more tips the balance 

of all I hold

and my mind wanders tonight in yoga

that pysch patient years back you saw

who said out loud she was a cum dumpster and the easiest lay

that you missed it

you missed asking

when and how she was raped

you missed all she hid still

cracked as she was.

Everyone has their burdens

everyone has their demons

and we all carry them differently 

we all act out

we all work hard just to cover 

and the cracks show eventually 

at repeating points

when life’s additional stressors 

push us

to the breaking point

and we shatter.

So today

was the glaring affirmation

that it does exist

the terminal sedating of the hellish wreckage

that military patient who was so damn violent

a threat to all when in LTC

I remember crying 

after i lost it in STR, saying I couldn’t face it

after taking razors off him

all the times he stole packs of cigarettes off other LTC patients 

bullied them

threatened them

threatening to harm his LTC care girlfriend’s best friend

another Frail COPD smoker

when she tried to stand up to him

all the care aides he nearly punched

all the times he swore

vicious and threatening 

and I am betting all the anger

That came out

the lid he could no longer keep on the powder keg

i’d put money on that he was probably sexually abused

either a French Canadian priest out there

in the big family he grew up with – overwhelmed parents inattentive

Or somewhere up the ranks training in the military or was it airforce? Can’t recall, makes no difference anyway

probably joined up 

to get out of the poor growing up…

and there is no victory here tonight

only sadness

and a slow, far too late

gratitude that someone on the hospital team

reached out and actually was granted a palliative consult

when I used to beg for them 

and was never granted them for patients when I needed them most

so tonight

I am so very tired

and filled with sadness