Dr. Evelyn Reid, MD
Affiliation: Department of Internal Medicine, MercyOne Des Moines Medical Center
Language was the first loss she experienced after her stroke, but it was not completely lost. Though she could still provide fragmented answers to questions and nod in response to whether she was in pain, the experience of effortless conversations would elude her from that point forward. She’d reach out for a word only to be met with silence.
The hospital room adjusted accordingly to the newly-established silence. The monitors around her would still beep about every three or four seconds. The medical staff would pop in and out of the room providing care at the same rapid pace as any of the residents. As her time in the hospital progressed and she became more and more silent, her chart became thicker and thicker.
I was lingering in her room during rounds one day and someone brought up that she used to be a piano player. I read this almost casually in her chart under the social history section as:
Music Teacher; Played Classical Piano for 40 Years
This statement hung with me long after the team completed their rounds. After signing off on my notes that evening, I returned to her room with my phone and a feeling of uncertainty that I couldn’t put my finger on. I searched for Debussy, the type of music that seems to be more of a memory than something that is composed. I turned on the music and placed my phone on the bedside table. Initially nothing changed. Eventually, though, her fingers began to move.
There was no big movement, only a little movement against the blanket, her hand traced invisible keys into its surface. Her eyes, which were always so far away, got sharp watching the sound. The room felt like it was coming apart. The monitors, fluorescent lights, and smell of antiseptic were lost behind the music for about five minutes. The next day, I brought watercolor paper. I had been thinking about how impulsive and unprofessional this was. Hospitals are built to count things; lab values, imaging data, survival curves, oxygen titration protocols; there is no protocol for what to do when a patient starts to disappear.
She looked at the blank paper for quite a while before using the paintbrush. Her painting was very simple, uneven washes of blue and grey, but she was able to steady her breathing while painting. The nurses gathered at the door to watch, and a respiratory therapist stood silently next to the IV pole, watching the colour spread on the paper. For the first time since her admission to the hospital, the room no longer felt like a place just waiting for this patient to die.
It felt like a place where someone belonged.
Weeks later, although her speech was still broken she began speaking more during therapy. She started with single words, then made sentences, and moved on to telling stories. She shared with us information regarding her students, her upright piano, and how much music means to her home.
This image is a fictional representation and does not include any real patient information or HIPAA-protected data.