Every day Mrs. M has the same set of complaints, only in various forms. I know that the minute I enter room 563, the same script will run - where I yell into her 96 year old ears at the top of my lungs, asking her how she's doing, whereupon she informs me in which direction her bowels are misfunctioning on that particular day. Diarrhea prevented her discharge last Thursday. "What if she has C. Diff?" (says her octogenerian idiot attending, totally ignoring that her diarrhea has been idiopathic, recurring, and in large self-limiting in the past month we've kept her.) "We can't send someone out who's sick." These past few days it's been constipation. I honestly can't remember if I have her ON the senakot or off. Always is this nausea, and this weakness. In the beginning I have tried to placate her by setting up her meals, bringing her to the bathroom, cleaning her bedside table. But now all I want to do is get out of the room.

The cynical part of me has begun to think of patients as perpetual complaint-manufacturing machines. Ask for complaints and you shall receive. Some complaints you will fix, only to generate a new set. And some complaints you can't fix at all. I'm tired, I'm weak, I'm bored, I'm dizzy, I hate blood draws, my neighbor is noisy. As if they expect a pill for everything, and are suspicious you are purposely depriving them of it. I have stopped thinking of my hour of rounding in the morning as a valid clinical experience. I have become a wastebucket for complaints. Like a concierge, a hostess, a pin-cushion. (How was your night madam? How can I make your stay more comfortable") By the eight O'clock hour I am already worn out. It is like as my precepting attending says. Some patients take a long, thick swirly straw, drill it into your head, and suck all your brain matter out, slowly and painfully. This is the life of in-patient medicine.

I would like to think of myself as still-compassionate. But what good is compassion if you cannot relieve suffering? The revelation I have come into is that so often, their suffering is inevitable, incurable, and self-perpetuating. It will drown you if you continuously seek to dowse it - if you take your failures to the heart. Far easier to turn a blinded eye, fix what you humanly can, and send them to rehab. (I have become so callous).