NPO

As much as we rely on it, the written word is often insufficient for true and accurate communication. It relies on both a competent scribe to narrow an idea into words, and a willing and curious reader to interpret those words correctly. No matter how clear and brief, writing requires the attention of the reader.

I reflect on this now from my hospital bed, and come to this conclusion: While the meal delivery staff here at Duke Hospital most surely embody many positive qualities, ‘willing and curious readers’ is not among them.

Are there written words to quickly communicate the concept that ‘the person in this room doesn’t get food’? In medicine as in military - When words are too wordy, make an acronym. So there is ‘NPO’. Stands for ‘nothing by mouth’, but in Latin or Greek. The whole of the hospital, including the meal delivery staff, knows the translation - From acronym, to ancient tongue, and to English.

Still, six times a day, the knocks come. Each mealtime, an echo – An initial attempt; A return to retrieve a delivery denied.

They’re almost always friendly, and I’m almost always so in return. Unless I was asleep, in which case I tend to be curt.

Events came to a head of sorts yesterday evening. Nearing 70 hours without a continuous hour of sleep, I took a walk and asked for a dry erase marker from the phone addled floor desk attendant. ‘NO FOOD NO TRAY’ in transparent blue ink onto my window. My nurse was not pleased, and erased it immediately, promising to do things properly.

I strode about the hall, pushing an IV tower arrayed with the pelts of 8 bags, silently vowing to fall down before yielding. At last, an 8½ x 11 sheet onto the window – ‘NPO (except for meds)’.

Yet again this morning, the knock comes – ‘You NPO?’

In any case, I did get 3 successive hours of sleep last night. My mood is much improved. I feel OK, and the infection (which is some gut bacteria, lost and running around in my blood) seems to be knocked back. It’s a Sunday, and no one really checks out of the hospital on a Sunday. At least not voluntarily. In that context, waiting seems preferable.

Next steps are to get a new PICC line (IV line that I get nutrition thru). Once the folks up at vascular access on the 9th floor see fit to do that, I’m halfway home. They’ve cultured my blood and figured out which antibiotic is working. That will let them move me from a Long Island iced tea of antibiotics down to a more reasonable shot of Stoli. If all goes right, home early this week with either oral or IV antibiotics.

Then it’s all about getting surgery rescheduled. The GI side of the surgical team stopped by today - some of them twice. They were optimistic about getting me back on the schedule and promoting me to favorite ex-patient. We’ll hopefully hear more from Plastics on Monday.

These health issues have proven difficult for me to put into a larger context. I often get the sense I’m not learning the lesson I’m supposed to. This latest episode is yet another bullet item on a long list.

Some look to philosophy for comfort, perhaps from the Stoics. Or religion - One of my caregivers shared his love for Paul’s letters in Ephesians. Not ashamed to say I find comfort in words from what are surely the fables of our present age – Season 2, episode 22.

Lisa: Perhaps there is no moral to this story.

Homer: Exactly! It’s just a bunch of stuff that happened.

https://www.youtube.com/watch?v=dtbkYCLFxYU

~Ed