A long slow death. In the end dementia and violent behavior, then coma.She held his hand and with a few friends kept vigil as life left him. We've known each other for years, since before the diagnosis. I'm her advice nurse.

We talk today and I encourage the re-telling of every detail. I know this helps. I focus on 'her' now, her friends, her family, her life. I congratulate her on the courage she showed these last years and remind her to have the same strength to face her own grief, understand it, digest it, then move on. We both have lumps in our throat as we say good bye.

The automatic next call requires me to assume my "Tom Bodette Motel 6" persona telling of the experience of sigmoidoscopy. I know this approach moves the caller in an inevitable way toward the acceptance of these facts now more understandable less fearful. " We'll keep a light on for ya" With a chuckle and a thanks we end the call.


And it hits me, the huge chasm of emotion I've just jumped. Like when you survive a near miss accident. This tears me apart like a fault line tears the country. I'm giving a lot to this job. I feel it. I'm doing it as well as it can be done.
A few calls later an infected arm. It's been seen in emergency and treated but something is still wrong. Yes the arm needs a look, but the injury is the result of an assault. So mustering the courage to look inside another stranger I settle the physical issues then gently explain that much of the injury in assault is in your heart. The outrage of being a victim. The fear. And that although I'm sure she was referred in ER I want to know now if maybe a talk with someone in Psychiatry would help settle any outstanding pain , inside, deep inside. The sobbing on the other end of the line lets me know that I've opened the right can of worms. That I'm curing the person not just the wounds. We agree on the need and I demystify the process and assure her the person on the phone in behavioral medicine is really friendly, Tell her you talked with me. Use my name.

People heal people, not policy, not call processing, not statistics, not production and certainly not call centers. These ideas come from people afraid to look at the process. They focus on numbers Say good by to the advice service you used to know. These calls ruined my stats. And stats make my competency determination. Am I competent? Did these patients feel I was competent? These calls ruined my stats but they made my day. They made me feel human and I still have the courage to be human.

How is service improvement answering the issue that people treated like machines behave like machines. If your husband dies and you want to reach out to a friend in health care----someone you know------press six--------your grief will be processed by the next available android.

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