The Graceview Patient By Caitlin Starling - 1

New nurse tonight.

She’s about my age. Gentle. When Nurse Lauren did her shift change report, the new girl’s fingers twitched like she wanted to be taking notes, but she’d had no paper, no pencil. No tablet. Her gloves squeaked with the movement.

Margaret Culpepper is twenty-six years old, and was admitted to Graceview Memorial seven weeks ago for inpatient management of Fayette-Gehret syndrome under the SWAIL protocol. She had an infusion this morning, and another scheduled tomorrow.

Everybody still wears full PPE around me. Face shield, gloves, N95—the works. It wasn’t supposed to last this long, was it? I’m not sure what that means, except that it’s bad. Of course it’s bad.

Margaret, can you give your full name and date of birth?

I’m so tired of everything. I just want to go home. But—

Margaret initially tolerated treatment well, but has experienced several setbacks.

Setbacks. That’s a nice way of describing it.

This room isn’t as nice as the one I started out in. My body is more broken than it has ever been. The overhead PA is intermittent but loud, echoing day and night with codes, with messages, with requests I can’t always understand. I’m not sure what day it is anymore, or if the whiteboard across from my bed is still accurate. My eyes blur when I try to read the clock. When my brain cooperates, I can mark the march of days by the light through the window and the coming and going of my nurses.

When my brain doesn’t cooperate, I drift. Most of the time drifting is easier.

Four weeks ago, Margaret began exhibiting symptoms of tuberculosis. She is currently being treated with isoniazid INH in combination with rifampin, pyrazinamide, and ethambutol. She has been experiencing nausea, joint pain, and intermittent confusion and paranoia, as well as occasional seizures, currently understood to be caused by the interaction of her medications, the SWAIL infusions, and her underlying condition. We have been treating side effects as they emerge.

Report, twice a day, is one of my last anchors. Seven a.m., seven p.m., again and again and again. A litany of my suffering and my sins, a little different each time, but always sanitized and organized. Margaret Culpepper, burnt-out and burned down. They don’t mention my stolen phone, or the nightmares, or what happened to Isobel.

They never mention Isobel at all.

All medication is being administered via a port-a-cath placed ten days ago on her left side chest, replacing a previous port-a-cath that was removed due to self-inflicted trauma.

Ten days ago? I can’t remember …

Margaret, how is your pain right now?

I never know what number to tell them. Quantifying is something for the hospital to do; I only experience everything qualitatively. My gums are bleeding again. My breath rattles in my chest. My head swims, but I’ve lost track of if it hurts, or only wanders. My skin is pocked and blistering, and my stomach is the same; and yet they’ve both been worse many times before. I’m on the mend. I am being reorganized.

A six? That’s what’s circled on the board, so I must have said it. A six. Does this feel like a six? Did it earlier, however much earlier, when the new nurse first arrived?

(What’s her name again? That isn’t on the board. She forgot to update it. Maybe I was a six this morning, instead.)

She is voiding fine, but has not had a BM today.

I’m supposed to contribute, but it’s so much easier to let them discuss me as if I’m just an object. Mostly, I’ve stopped caring. But it always gets me, the quick aside about the waste I produce. That’s quantified, too. They need to make sure I’m giving as much as I’m taking in.

They go through a recitation of letters and numbers: my CBC, CMP, ESR, CRP. Once, I tried to sort out what it all meant. But that knowledge can’t help me now, if it ever could.

My windows are dark, but the clock says …

No, I can’t see that far today. But maybe it’s still early. Ten?

Margaret is on a mechanical soft diet due to oral discomfort. Meals have been preselected and will be delivered at 2030. She is often able to feed herself, but please assess when dropping off her tray.

Dinner was mashed potatoes and chicken stewed until it was slime. I can still taste it. It can’t be that late.

And bedside report still rings in my ears, infiltrating, reminding me of where I am. Who I am. How they see me.

She is a high fall risk, see her yellow wristband. Her bed alarm is on at all hours. She generally uses her call light appropriately and gets up well with an assist, but should not be left unattended in the bathroom. Although Margaret isn’t currently requiring one-to-one supervision, she is considered a high elopement risk and remains on a medical hold. Notify Charge immediately if soft restraints become necessary at any point, and ensure you have a physician order within fifteen minutes.

But neither Margaret nor I anticipate that being necessary; we’ve had a run of good days, haven’t we?

Haven’t we?