You & I: An Introduction

My new job at the hospital has provided me with plenty of material, and plenty of time in which to write. I have begun to compose vignettes based on my experiences with my patients which I hope will become a longer collection. For now, here is an excerpt from what I have been working on. I am not sure how it fits in with the rest of the pieces since it is not specifically about one patient, but I am thinking it could serve as a prologue by introducing my role and filling in the general details of my days since, as you can imagine, a lot of them are very similar and have me performing the same few tasks over and over.

Because this is (I hope) a longer endeavor, I am trying not to get too bogged down in editing, etc. and just allowing myself to write. Thus, I consider this a first draft. In other words, comments are encouraged.

(Excerpted from as yet untitled project John refers to as 'Inpatients')


Even though I spend twelve consecutive hours feeding you, cleaning you, and talking to you, you are probably not going to remember me. I am what is known as a sitter, and the reason I am here is because you need more help than is typically available to a hospital patient. I have been called here, literally, to sit at your bedside for my entire shift. I am not allowed to leave you unattended for any reason, even if the reason is that you don’t want me here. If I need to use the bathroom or make a phone call, I must wait for someone to relieve me. I can read, or watch television with you. I can converse with you (unless you have been placed on suicide watch, in which case we must both silently suffer, pretending everything is all right and that you didn’t try to end your own life). If you are awake and alert I usually end up speaking to you. I record your vital signs at regular intervals. I pay attention to what is being said to and by you when you interact with other medical staff so that I can provide correct information later, if needed.


The reason you need a sitter is that you likely have impaired cerebral function, or you are just too incapacitated to do anything. More often than not your report says you have dementia, which is too general a term to be helpful. Sometimes you cannot remember your own birthday; sometimes you don’t appear to have anything wrong with your memory at all.

My main task is to ensure your comfort and safety, but this can be tricky because I am not permitted to physically restrain you. If you attempt to get out of bed or rip the tubes from your body I can only use diversionary tactics. Usually you are confused and need to be reoriented. I try to distract you by asking a series of simple questions like Do you know where you are? or Can you tell me what year it is? Sometimes I ask you these things over and over, each time you wake up.


Often you are considered a fall risk. You can’t really stand on your own but continually try to get out of bed. (Unfortunately, this determination is often made after you have already fallen.) A lot of times you are detoxing. You came to the hospital with injuries, such as broken bones from a car accident, and during the course of your stay you began to exhibit symptoms of withdrawal from drugs or alcohol. When this happens you become delirious, and it is far worse than your initial injuries. You sweat and yell and believe you are being held prisoner by scientists who are performing experiments on you. You are kept at the hospital until this subsides. You leave clean but, despite what I tell you, and what you tell me, a lot of times you go right back to using.


Sometimes you threaten me, or try to harm me, and I have to pretend not to be afraid. I still have to make sure that you are safe. I have learned to control my face and my voice. I have taught myself to seem brave.


If you continue to pose a threat, to yourself or me, I am allowed to call security and have you restrained. I can, under the supervision of a nurse, place foam cuffs at your wrists and ankles and tether you to your bed. We also have to call your family to tell them you have been restrained. So far I have never wielded this power, but sometimes you are already restrained when I arrive. If you are calm I ask the nurse if I may untie you because I cannot imagine how this must feel. If you are not calm I have to sit here and pretend I can’t hear you pleading.


I am the lowest rung on the patient care ladder. I am not allowed to give you medicine or, in some cases, help you out of bed, even though you need to have a bowel movement and you just cannot bring yourself to go in the bedpan. Unless you already have a cup in the room I am even not allowed to bring you water; I have to ask a tech to do it for me. I understand that you will see me as useless and this will make me feel like I’m failing you.


I will almost never know the answers to your questions. They don’t tell me anything beyond what I need to know to take care of you. I don’t know your husband, or where he is, or if he is even still alive. I don’t know when you will get to go home. I try to be positive, but I am constantly worried I will give you false hope.


We both say things we don’t mean. I speak to you with more patience and understanding than I feel or am able to muster with my wife and dogs. You would probably feel ashamed if you knew how you were acting, at least part of the time.


You do not understand puns or sarcasm or any of the other elusive ways of speaking I employ with great frequency, so I don’t use them. I am direct and attentive. I try not to deceive you, but sometimes, for instance if you have failed a psych evaluation and were deemed unfit to decide your own treatment, I am not allowed to tell you everything I know.


You won’t always know what I am doing here. If you even know you’re in a hospital, you won’t necessarily understand that I work here. You won’t know why I am washing you or spoon-feeding you. You won’t understand why I am asking you to pee into a container or why I then measure it. Sometimes you think I’ve just wandered into your room and decided to spend the whole day with you, in which case you think I’m very strange, or a pervert, or just terribly lonely. Sometimes this doesn’t seem to bother you and you are happy for the company. Sometimes you offer me part of your meal and my heart sort of breaks at your kindness. I don’t know how to make you understand just what the hell is going on.


I have been trained in CPR, so if your heart stops beating I can manually supply oxygen to your brain in an attempt to stave off brain death. Other than that I am kind of making this up as I go. I was not provided with a manual on how to be a good sitter. I was given two weeks of training in which I worked with another sitter, observing when I didn’t know what to do, and performing under their supervision when I did. Beyond that I just try to be the kind of good person that no one really is.


I try not to laugh at you, but sometimes the things you say are genuinely funny. I also try not to cry in front of you, and so far I never have, but if your family visits and you no longer recognize them it is far sadder than any book or movie. I am given the impossible twin tasks of preserving your dignity and changing your soiled pants for you. I swear to you that I do not enjoy touching your private parts, but I understand why you look so uncomfortable when I do. I try not to talk to you as though you are a child, even if you are a child. I will tell you my name or where you are as many times as you ask.


I try not to pity you, but occasionally I feel really sorry for you, or me, or both of us. You make me mad, and hurt my feelings sometimes. Despite my best intentions, you call me terrible things. You telephone your family and make accusations that I can only pray they don’t believe, lest I should be thrown in prison. I feel anger at your petulance, but I say nothing. I don’t always want to sit here with you, but I feel guilty when I think like this. I try to remember that as hard as my day might seem, yours is worse.


At the end of my shift I go out in to the hall and give my report to the next sitter. If you were kind or confused, I tell them that. If you were hungry or had diarrhea I tell them that. If you swore at me or lied to me, I tell them that too. And then I say goodbye to you. Sometimes you say thank you. Sometimes you don’t even notice. Sometimes you seem genuinely sad to see me go, and on these days I am glad to come back to work the following day. But usually you just say farewell with the same measured hesitation you’ve used throughout the day. I leave you with the next sitter as a new wave of confusion washes across your face. You have already forgotten about me, but it will be a long time before I forget about you.