Sally had been a patient on the step-down unit all winter. After her open heart surgery, she developed an infection in her chest. The infection required another surgery and four more weeks of ventilator support as her open chest healed. Because she was not moving enough, she developed clots in her legs. Because of the DVTs, she had activity restrictions, which led to another bout of pneumonia. One complication led to another, with more medications that had to be carefully balanced. We tried not to do anything that would create a new problem while curing an existing one.
Now she was finally getting better, but her energy lagged behind. Did she still have the will to heal? I worried about that; I had seen too many patients slide from lassitude into the grave. I wasn't sure if she could recoup her energy and will to live; but her daughter Trudy knew exactly what would strengthen her spirit.
I should have suspected something was afoot when Trudy walked directly to her mother's room without stopping as she usually did at the nurses' station. The large, stiff red bag she carried did not seem her style, but I put it out of my mind as I gathered the afternoon medications.
When I went into the room, Sally was sitting in the recliner chair, just as I had left her after helping her with lunch. I pretended I did not see the two small Chihuahuas snuggling together on her lap.
"Quick, hide the boys," ordered Trudy, trying to block my view of her mother. She hurriedly laid the red bag on top of the dogs.
"Oh, don't worry about her," said Sally. She was smiling for the first time since her admission to the hospital almost three months before. "She's a dog person-she knows I've missed Pablo and Pedro as much as they've missed me."
Indeed, I did. She had talked about them often enough.
It wasn't long before Pablo and Pedro were a subject of debate among the whole staff. Several people were upset that I hadn't told Trudy to get the dogs out of here, STAT! Someone even suggested calling security to evict both dogs and owner. Dogs didn't belong in a hospital, ran the argument, they were dirty (as if the shoes of our human visitors were clean?). They carried germs, and our unit had more than enough germs already. I suspected the antibiotic-resistant bugs some our patients harbored posed more danger to the Chihuahuas than any danger we or our patients faced from them.
Luckily, I wasn't the only dog lover on the unit. Fred pointed out that dogs are as much a part of a family as children are. If we were willing to tolerate Mr. Taylor's runny-nosed grandchildren, he said, we should be tolerant of Sally's dogs, the ones she'd been referring to as her babies ever since she came off the ventilator two weeks ago.
Helen chimed in that dogs are "pure enthusiasm and love." We're supposed to provide our patients with emotional support, she observed, but who has time for that in our fast-paced unit? The puppies had probably given Sally more emotional support in the previous half hour than all of us together had given her the rest of the week.
Some of the conversation must have drifted down the hall. When I went back into the room for my last rounds, Trudy was putting Pablo back in the red bag. She smiled at me and shook her head. "I won't do this again."
I looked at Sally. There was a sparkle in her eyes I hadn't seen before.
I turned to Trudy. "It might be better if, next time, you come up the back stairs-the ones from the tower end of the garage."
She looked at me a moment, and then nodded.
And Sally? Two weeks later she went home to her beloved dogs. The infectious disease specialist took credit for finally finding the right antibiotic.
Fred looked at me and winked. "Yes," he said, "Chihuahuacillin."