Almost everyone has made some sort of description of their work involving blood, sweat and tears. But in nursing, the reference is literal, and it barely scratches the weeping, edematous surface. Seriously, how many times have you pulled off an old patient’s sock when a cloud of foot dandruff invades your airspace? Ah, memories.

This very old man lay in bed, living in his own private little world. He had a brain hematoma and his mental status was alt-coherent. There wasn’t a need for continuous observation because the overall condition rendered him weak and sleepy, but running neuro checks every four hours was a pain in the ass. The reason for this wasn’t physical, such as forgetfulness or agitation. He simply hated me, and his insults damaged my fragile ego. This serves as a powerful reminder to all providers that you simply can’t please everyone, and this is a good thing, because if you get along with a jerky patient, what does that say about you? Every time I approached this guy for a neuro update, his eyelids would form into narrow slits, like a geriatric cobra sizing up his prey. I’m pretty sure he fought in WWII so I was intimidated. 

"Mr. Shwartzenhelmer, do you mind if I ask you a few questions?"

"Huh?" He was hard of hearing. "I’d like to ask you a few questions," I repeated. "Fine," he said.  "Can you tell me where you are right now?" His face wrinkled and sagged south. "I’m in... uh..." His frown deepened. I took a few steps closer and tried to clarify. "What place is this? Can you tell me, sir?" I pointed to my ID as a hint and tried desperately to ignore his dentures. They were old school uppers that looked like those fake teeth people wear for Halloween, plus they were really stained so the overall effect was part hunchback and part hillbilly. His breathing grew heavy so they puffed in and out with and I winced with every breath, waiting for them to pop out and smack in my face. I was about to ask him another question when his eyes darted toward the hallway and he lunged forward, like a very old Frankenstein monster.  "Uhhhrgghhh..." he moaned. Shit. Here we go again. He was getting up to wander unsteadily at least five times a shift and it was a real trial getting him back to bed, usually taking at least two guys to get the job done. I was way behind my rounds and tired, so I decided to let him have his way for a few steps. A sort of reverse psychology. Up he rose with a creak or two, moaning and groaning while I gripped the back of his gown for stability, and he took those steps perfectly. Then a few more. Before I knew it, we were walking down the hall. Who knew? My co-workers watched and smirked at the surreal image of a nurse taking his patient for a walk with a gown for a leash. I’m not sure what motivated his actions, because our dialogue was minimal. He just seemed determined to keep going, step by step, and I was impressed by his focus. He wasn’t agitated anymore for that matter, so I made a mental note to try this activity at least once a shift. I patted myself on the back for a successful trial run, and all was well. I heard a muffled voice yell my name. Was it the patient? No, it was one of the assistants. "Larry!" he yelled. "Watch out!" I spun my head to spot the danger and looked down just as I was about to step in a huge pile of poop the patient had just dropped. I was able to avoid it at the last minute, and glancing behind I saw a trail of crap, ranging in size from chihuahua to rottweiler, which my patient had been plopping with every step. No wonder he was so quiet. He needed relief. Who can blame him? We’ve all been there. The only problem was he was completely oblivious to it, even though the trail began on his thigh and snaked it’s away down his leg, piece by piece, and ten feet down the hall. He just wanted to keep on walking, and any attempt to stop him would only make him angry ("Uhhhrgghhh") so I grabbed an assistant and we took turns walking and cleaning, one of us staying with the patient while the other wiped his butt and legs and then ran back to a soapy water basin to wring it out and run back to the patient again. We threw down what had to be ten towels on the donations he had made as he walked, and with each wipe of his butt I could only wonder if this is what it was like to serve Egyptian loyalty centuries ago, timidly sprinting back and forth with poop-soiled rag in hand, ensuring the master would be pleased with our service spare us his mighty wrath. By the time everything was cleaned up and the patient was put back to bed, we must have ran a mile. The Brown Mile. But how can I complain? In this business, shit literally happens.