The Menu

Ahmad Abdullah
University of British Columbia
Class of 2015

the menu image

IakovKalinin.iStock/Thinkstock

I woke up today after a fourteen-hour, guilt-free slumber. I had stayed awake for a total of 34 hours, running on a total of three hours of rather choppy sleep while on my first CTU call shift. I knew it was probably going to be busy but I didn’t know that I would find myself so pressed for time every moment of the shift.

I must have been in REM sleep when I woke up because I remembered I was dreaming about my trip to Paris last summer. Ah, Paris! I missed strolling around at a leisurely pace through the long underground walkways of the Paris metro, enjoying the upbeat accordion music played by street musicians while Parisian crowds whizzed through tunnels trying to catch their next train to work. I also missed the little cafés I would sneak into to enjoy my café gourmand. And then there were the non-touristy, well-hidden authentic French restaurants! Anyone who has been to France can understand what I speak of.

The best meal of my life was in a restaurant called L’Instant Fraicheur in Versailles. I vividly remember the waiter hastily dragging the humungous blackboard menu from outside the restaurant to my table and trying his best to explain the menu, written neatly in chalk, in English. He introduced himself as Laurent. As he explained the items on the list one by one, I couldn’t help but marvel at how nice and friendly he was. I could not believe how much effort he was putting in to please me, how adamant he was on creating a positive impression. Perhaps that was because I was clean, healthy, and had some cash in my pocket?

Back to the shift. We are in the hospital. I am the waiter. But instead of wearing the meticulously pressed, spotless white shirt with the radiant black bow-tie, I am wearing plain, boring scrubs like most of the people around me. And the client is a very unclean, sick, old woman with fragile, infected-looking skin and a nasty-looking break on her forehead coloured with congealed blood. She lies asleep with her legs swollen by peripheral edema and her skin raw-looking from extensive stasis dermatitis. There is angry-looking cellulitis on one of her legs. Her nurse had caught a worm crawling out from beneath her body earlier.

She does not have any money to offer me; I know that very well. And I must admit I am not there to please her or impress her with my service because, quite frankly, I don’t have the patience or energy left for it. I am already on my thirtieth hour of work and am staying past the time I was supposed to go home. One of the obstacles between me and my comfortable bed at home is getting a DNR on this patient. I feel disgusted with myself while waking her up for “the talk,” but that’s how it works in busy services like the CTU. She had probably had a miserable night since there is rarely, if ever, a quiet moment in a busy emergency department. I feel guilty robbing her of her few moments of calm, but I wake her up.

And then I present her with the menu: “Would you like us to try to restart your heart if it were to stop? Would you like a tube down your throat if you were unable to breathe for yourself? Would you like this and that as part of your medical management?” She seems dazed and confused from the hassle of being in the hospital. She takes a brief look at me, ignores me, and falls back to sleep. I think I deserve that.

After this encounter, I am surprised to find myself reflecting back to my time in Paris and my meal with Laurent. This patient was from a nursing home with no social supports or contacts. She had no blood-relatives to share her suffering and pain, no one to provide a moment or two of empathy. But she must have once been someone’s brand-new baby girl. Her skin must have once been smooth and shiny. Just perfect. Someone may have once held her in their arms, loved her and caressed her. But in her last moments she had no one, and I feel guilty that I did not have the time to show her some empathy. People on the streets of Paris seem to always be on the go. People in the hospital always seem to be on the go. I do not believe it is our fault entirely; we cannot all be Laurent. But if there is one thing I learned from this shift, it is that a healthy life is too precious to waste. When you are healthy, you have the privilege to pick the things you love from the menu of life —and your options are not limited.

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