Chief Complaint: Not Always What You Assume
- Jessica Rehrig
If I did not ask, I would have assumed regaining muscle control was the "chief complaint" of the young man I was caring for during my brain injury elective. He was an active college student up until a few months ago when a tragic accident left him wheelchair-bound and dependent on nursing staff for even the smallest of tasks.
The first time we met, he introduced himself to me through a laminated copy of the alphabet. Spelling out his name took some time, due to the severe spasticity that still engulfed his musculoskeletal system, but it was his only means of communication due to the loss of control of his vocal cords.
"I am here to join your care team," I had told him. "I want to help you work on facing your biggest problem right now. Can you tell me what that is?"
And, to my surprise, he spelled C-O-N-N-E-C-T-I-O-N. The word board was useful in communicating needs like "hunger" and "sleep" and "pain," but it took away his connection with others. He could no longer share his feelings to a depth he had once been able to, and this loss of expression came at a time where he needed it most.
I was reminded, at that moment, the importance of avoiding assumptions when caring for others. The physician treats the patient, not the disease. One hundred cases of the same condition may present, but they stem from one hundred different people. The inherent uniqueness of each patient is a reminder of how humbling it is to play a role in their lives, and the importance of not assuming what is valuable to them.