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A Piece of My Mind
May 2, 2007

Rounds

Author Affiliations
 

A Piece of My Mind Section Editor: Roxanne K. Young, Associate Editor.

JAMA. 2007;297(17):1859-1860. doi:10.1001/jama.297.17.1859

She was admitted to a four-bed ward that had been converted into a temporary intensive care unit. Although she suffered from scleroderma, she was there because she had experienced 22 minutes of ventricular tachycardia interspersed with bradycardia, her heart obviously suffused with the debris of connective tissue disease. Her bed stood by the entrance to the lone bathroom, an unfortunate location for anyone hoping to rest—the nurses came and went, emptying urinals and other containers of alien waste, repeatedly flushing the toilet that served as an irreverent alarm clock that prohibited repose from the constant torment of disease. A pulse oximeter hung from her earlobe because her fingers were sore and ulcerated from Raynaud’s, the digital blood flow reduced to a blue-pale coloration reminiscent of fresh death. It was a noisy room contaminated with the continuous beeps and blips emanating from the various monitors as well as the chatter of the nurses as they tended to the ill. It was early morning, and I was standing by the right side of her bed, my sister-in-law seated to her left.

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