My patient woke up

For the past three weeks, I have been following an elderly male patient. First in the ICU, where he was delirious, in and out of consciousness and often nonresponsive. I spoke to his daughter, who told me that before his 75-day-and-counting hospitalization, he had been an independent man who used to come to her house daily to walk and watch TV with her dog. She was concerned that with so many transfers between and within the hospital, his providers had lost sight of his baseline, and only knew him as the extremely ill, nonverbal, mildly disheveled patient before them. In fact he suffered quite a loss of independence and dignity.

Today I met him on the floor (out of the ICU, in a regular surgery ward), and I introduced myself. I often feel the need to be careful when revealing to a new patient just how much I know about them from reading the chart and speaking to others; I don't want to appear to be a stalker. In this case, the patient was lonely, and soon the encounter became intimate. He asked which daughter I'd talked to. We talked briefly about how long he'd been in the hospital. Without prompting, he burst out, "I feel depressed" and "I'm scared," a phrase he kept repeating. When asked why, if perhaps he is afraid that he won't get well, he said, "I don't know." I was scared knowing he was scared.