29 April 2022
Dana the RN came today to do Joyce's wet-to-dry dressing but while she was doing it, I got a call from Dr. Tong. For me.
She wanted to talk to me about what to do next. She had discussed it with Joyce in the hospital but she hadn't talked to me about it. I appreciated that.
She thinks it's time to retrench.
She doesn't think more surgery will do any good. It's been enough cutting. They'll monitor the wound for slough but not as frequently. Twice a month, once every six months, whatever is required.
She thinks its important Joyce get back to enjoying life rather than keeping appointments. She thinks the oxygen treatments have been a huge imposition of time and resources. And they just haven't made much of a difference.
No more Wound VAC. It was too painful. And annoying. Even the wet-to-dry dressing changes can be reduced to once a day rather than twice. Play it by ear, she said.
Which is funny because today Byram delivered 100 Mediplex pads, of which we use four a day, making a 25 day supply for the month. I've complained about that before. Wounds aren't Monday-to-Friday things, taking the weekends off.
But if we only do one dressing change a day, I can open a stand on the corner and sell the extra Mediplex pads for $5 each.
Let's just let things settle down, she suggested, and see what happens.
My own inclination by nature is just the opposite, I told her. Head things off at the pass. Ambush the bastards. But I yield to her wisdom.
It has the faint whiff of those there's-no-more-we-can-do-for-her speeches but she made it clear she isn't abandoning us. Just retrenching.
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WE WENT TO ST. FRANCIS after Dana left and about an hour earlier than usual at their request.
They knew Dr. Tong had not approved another 20 sessions. Monday will be our last. There was a certain sadness in the air.
"We like to tell patients we hope we never see them again," Kathy the LVN said. "But there are some we do miss."
I could have hugged her.
She was born in 1989, about the cutoff for our DVD movie collection. It has been a running joke to see if she knows the movies we bring in for Joyce to watch during her two-hour session. And if not, maybe the actors? Never.
Joyce watched Il Postino, which none of them had ever heard of. Not Thurman the Program Director or Hawkeye the nurse filling in for Jessica who is vacationing in Oregon.
Joyce gave me a thumbs up from the chamber near the end of the movie and talked about it all the way home.
It's the story of a young unhappy fisherman who gets a temporary job delivering mail to the only house on the route, the home in exile of the Chilean poet Pablo Neruda. The mailman, who is not well educated, is in love with a girl who works at the cafe in town and wants to impress her with a little poetry so he imposes on the poet and they become friends. He marries the girl but he dies before their child is born.
What you don't know when you watch the movie is that the actor who stars as the postman was a famous Italian comedian who had bought the rights to the story and hired a director. But he also had heart disease and died before filming was complete, recording his dialog in advance for dubbing.
Life imitates art.
And doubly so. There is also a little poetry in Joyce's situation and the story of the actor who didn't get to see the end of his own movie.
But keep watching. Stories with happy endings all have their sad sequences but even stories with sad endings often have their happy moments.