My first job as an occupational therapist was in a skilled nursing facility. There I treated patients who were recovering from strokes, heart attacks and hip fractures, among other medical conditions. My documentation included a subjective section where I captured patient perspectives, such as “I brushed my teeth,” or “I put my shoes on by myself!” Unofficially, I also kept a log of funny or memorable quotes. Patients’ comments and insights often surprised me.
For instance, while working on standing balance with a woman who had dementia, I strung a laundry line in our clinic and asked her to clip socks to it. She obliged. However, as she affixed the second to last sock, she turned to me and asked, “Are you hanging these out here to dry?” When I nodded, she said, “They’re all dry.” I felt sheepish, as if Toto had pulled back the curtain on my Wizard of Oz act.
While treating D, who was recovering from cervical surgery, I carried my laptop to take notes. D described himself in the third person as ready-made dictation: “Deathly ill and in great pain and aggravated to boot.” Or, “Needs to go to bed. Is being kept up by irritable person who is only interested in the walker.” D’s physical therapist and I frequently reminded him to use his walker for safety. One day he told me that he had named his walker after me.
“Oh, I’m honored,” I said.
“Yes,” he said, “you should be, until I throw her into the river.”
H also noticed our documentation mandate. As she pedaled on a cycle machine, I sat beside her, typing on my laptop. “Are you writing a play or something?” she asked. Another day, greeting H in her room, I commented on her cheerful display of Christmas cards. “Ohhh,” she replied. “I mean, people I thought were dead were alive.”
The facility’s rehabilitation gym was a bustling place. At 11 a.m., the room could contain up to 40 people — therapists and patients bending, biking, lifting, balancing. Standing at the gym’s threshold, M commented, “I never saw so many people. . . . Where’d you get ’em all from?” A few days later: “It’s a mob down here. Do these people live here?” One man who was at risk for wandering wore an ankle monitor that triggered an alarm if he exited his unit without a staff member punching in a keypad code. As I sat with him in the gym one morning, he gestured toward his ankle band: “I got that at a party. Take that off.”
Short-stay rehab was a camp experience for begrudging campers. Patients were not 12-year-olds keen on sailing lessons but typically were 70- to 90-plus-year-olds in pain and paired with disruptive roommates. The food was a frequent topic of complaint.
“I don’t know how this place learned how to make eggs taste like a sponge,” said P.
“What are we having to eat today? Anything eatable? Or just the same old junk?” asked M.
I’d like to think that neither the discomforts nor the charms of my patients were entirely lost on me. Here’s one more exchange with a sweet, small woman with a stooped posture and a tremor that reminded me of a quivering bird. She perched in her wheelchair as if in a nest. One afternoon, as I gathered my items to depart from her room, she reflected, “I guess this is the first day we didn’t have a jolly.”
“A what?” I asked.
“A jolly.”
“A jolly?” I swelled, feeling seen.
“A chuckle.”
“You always make me laugh,” I said, peering down at her.
“But we’re not here to laugh,” she replied. “We’re here to learn how to take care of our feeble bodies.”
Laughter shot out of me as she continued, “Isn’t that right?”
Erin Buckley is an occupational therapist in Richmond, Virginia, where she now works in a hospital outpatient clinic. Patient details have been changed to respect privacy, but D’s walker’s name is accurate.