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Lessons from the Judge

My co-worker in the intensive care unit said, “Hey, that looks like Burl Ives,” as we came out of the change-of-shift report.
The charge nurse replied, “No, that’s Mr. Jones, a federal judge. Everybody’s scared of him.”
I saw a beefy patient with reddish hair and a salt-pepper beard who did indeed resemble the 280-pound folk singer. He was my patient now–no pressure. He’d been admitted during the night with severe chest pain and shortness of breath. His EKG was positive for acute myocardial infarction (heart attack). His enzyme levels were rising, his heart muscle showed damage. His risk factors included a high-stress job, obesity, and hypertension. Despite his high level of education and his father’s sudden death at age 50, Mr. Jones loved to smoke his pipe.
Bet he asks a million questions, I thought. I squelched the butterflies in my stomach and entered his room. Newspapers were strewn across his hospital bed; the judge peered at me over his reading glasses and barked, “What are you here for, young lady? I’m catching up on my reading.”
Clutching the patient-education flip charts to my chest, I said, “To prepare you for your cardiac catheterization in the morning.”
He put down the New York Times. “You’re up. Proceed.”
His expanse notwithstanding, I sat half my derriere on the bed and launched into my preop teaching routine. He listened intently. I covered what would happen to him chronologically, head to toe. My presentation was flawless as I pointed to illustrations, referred to diagrams, explained the myriad of details in lay terms.
“So…any questions?”
“Clear as mud.”
OMG, what did I do wrong? I told him everything.  I was crushed, deflated.
Hoping to redeem myself I asked, “Well, are you anxious?”–thinking, I can knock you out with a sleeping pill.
“No, darlin’. I’m not anxious. I’m worried. This test tomorrow may be my death sentence. I’ll have to make huge decisions, whether to let them cut on me for heart surgery, if I’m even a candidate…”
It was one of those “aha!” moments that stuck with me for the next forty years.
Forever after, I added “Anything you’d like to talk about before I begin?” to my teaching repertoire. And I also deleted “anxious” from my conversations with patients. To Mr. Jones, “anxious” equated to fretting, being out of control. The more human term is “worry,” which means pondering one’s fate while being in control. If a super-smart patient like the judge couldn’t handle the term “anxious,” no one can.
Marilyn Barton
Hampton, Virginia 


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