And speaking of that, I had the weirdest dream last night. But let me set it up.
Took care of a man last week, brand new diagnosis of lymphoma. We ended up having the psychiatrist doing an eval on him, because he had the oddest affect and he seemed determined to refuse random parts of his treatment. Like, he agreed to the biopsies and CT scans and such and the high-dose chemotherapy, but he refused to have a central line placed, which means no chemotherapy.
The PICC nurses there to place the line came out of his room in a frustrated huff and told me "he needs a psych eval! He kicked us out!" When I went into his room, he was shaking his head and muttering and his father-in-law was talking to him in a low voice. Well, I sat with him for a long time. He said, "that damn bitch (his doctor, hee) never said nothing about no hose coming out of my arm." I said she'd probably told him, but she also told him 90 billion other things and it might have gotten lost. He shook his head some more.
Finally I just laid it out. "If you don't get this catheter in your arm, you can't have the chemo, and you'll die." He shrugged. "I've died before," he said. I took this as a spiritual statement of some kind. Told him, "this is your chance to choose. You don't have to die this way. This is a really hard death. This isn't the death for you." He started crying, but he kept saying no. I left him with his uncle talking to him in Navajo.
About twenty minutes later his uncle came to get me. "He'll do it," he said. So we got the PICC team, and there were a few minutes of tension at first, because he wouldn't sign the consent before he saw the size of the "hose," but it was wrapped up all sterile in the PICC kit. But I got a book from the nurse's station and found a picture and we satified him that it wasn't, in fact, a "hose" in any sense, and just like that everything was cool and I stayed with him while they placed the line because I had said I would, and he told me about his horse and his dogs and his cattle, and when they told him they were going to put the dressing on the site he told them "I like ranch!" and cackled like a fiend.
The psychiatrist told me he was from an extremely isolated community where people don't come into contact with Western medicine much, a group of Navajos living separate from the cities but also from the main Navajo tribes for historical reasons, so they're like their own little world but here he is, now, with strangers. Not crazy, but not like "us."
His father-in-law told me once, "he's afraid of you now" and they both laughed like this was the best joke ever. Dammit! Why didn't I just ask him why? I missed out.
Oh! So but anyway. Last night I dreamed that he and I were in a house together, hunting this huge bug like a big flat centipede, and he kept laughing at me and I was all, oh shush. Then we went to see the next Star Wars movie together, the one that hasn't been made yet.
Here's some North African/Indian electronica for ya.
Esperando Chuva, by Digital Bled
Love love love this stuff.