Meet Carrie Ann AKA The Neglected Angel
I was told all about Carrie Ann before I met her.
“Good luck getting her to do anything. She’s sweet but she doesn’t want to do therapy, she just wants to talk.”
Carrie was weak from cancer and the regular chemotherapy and dialysis that accompanied it, but you would never know it from the way she spoke. Set up like a queen in her bed, Carrie Ann commanded the room. In a sassy, almost crazed tone Carrie Ann dictated how things were going to go. She was not unkind however, and even as she gave orders she cackled good naturedly to herself, her eyes bulging with every laugh. In short, Carrie Ann was a hoot.
Despite being highly skeptical of exercises, I convinced Carrie to do them daily. Granted the only reason she agreed to do them seemed to be to keep me there as a captive audience.
I would arrive with theraband and peppermints (a treat Carrie begged me to buy for her). She would pop a peppermint in her mouth, giggling as if she were doing something naughty, begin obediently stretching the theraband, and her stories began.
Carrie Ann talked and talked, telling me all about herself. She talked about her family and introduced me to those family members that came to visit. The more we talked, the closer we became. Carrie was so full of love and life. “Honey, one of these days you and I are going to go to lunch. And I’m going to buy us the full spread. Oh and we’ll have everything!” Carrie chirped cheerfully.
But as the days passed, I observed what no clinician wants to see in their patient. Carrie was making no progress. I begged her to let me sit her up at the edge of the bed, which she permitted on days that her sacral wound didn’t hurt as much.
Once while sitting up she lamented, “Well you know me honey, I don’t like to complain but I feel so mistreated.”
“Why is that, Carrie?” I asked.
“Well I go out for my chemo and dialysis and they forget to give me meals when I come back, and whenever something does finally come it’s so cold I can hardly eat it. And sometimes they just drop it off so fast they forget to give me a fork and I hit the call light, but they don’t come.”
I started monitoring the delivery of Carrie Ann’s meals and realized with horror that she was in no way exaggerating. Carrie would return and be promised a meal, but hours would pass and nothing had been brought to her. What finally was sent up to her room was a sad excuse for a meal. I intervened as much as I could and reminded staff of Carrie’s calls, but somehow because Carrie had been labeled “a needy patient”, that seemed to be an excuse to most staff to not attend to any requests, reasonable or otherwise, in a timely manner. Somehow, I ended up answering a good number of her call lights throughout the day.
One night I was about to leave but I caught something out of the corner of my eye as I passed Carrie’s room. I found Carrie Ann returned from a dialysis treatment, still sitting in her wheelchair though she wanted to get back to bed.
“How long have you been sitting here like this Carrie?” I asked her, thinking of her wound, especially as she sat in the chair without any cushion beneath her.
“Oh a couple hours I expect,” she sighed. “But you’re here now! Can you help me get back to bed? OH and actually honey- I want to be able to go to the toilet soooo bad,” she told me mournfully. “They never let me go to the actual toilet and that bedpan just bites my butt! Can’t you take me?”
Carrie looked up at me with wide, pleading eyes. I knew that Carrie was typically a max assist x 2 to transfer (she was probably twice my size) but I also knew that Carly needed to get up. I went out into the hall to check to see if any CNA’s were available to help me. No one was there.
“I really need to go soon!” hollered Carrie from inside the room.
In my head little clinical alarm bells were going off that this was not a good idea, but I just couldn’t say no.
“Ok Carrie, it’s just you and me. Let’s get to the bathroom.” In my mind I was rationalizing this to myself- ‘It’s ok, the only reason the CNA’s need 2 of them is because they refuse to use a gait belt- you can do this.’ Or so my delusional thinking went.
I pulled Carrie Ann into the bathroom and set everything up. I literally do not know how I managed it but with all my and Carrie’s strength and likely a few guardian angels, Carrie and I made it to the toilet. Shaking and sweating I sat on the floor of the bathroom, while Carrie did her thing.
Never did I ever think I would have a heart to heart with anyone while they had a bm, but life is always surprising you.
“I’m sorry sweetie,” Carrie said. “But it does feel so good to sit on this toilet.”
“No no Carrie- you did good! We just need to practice this more often, that’s all.”
Carrie laughed and shook her head. Then she looked down at me with love. “You’re the only one in this place that has heart,” she told me. “Heart is everything.”
“Well Carrie, I’m learning from the best,” I said softly, gesturing to her.
Carrie’s eyes teared up, but she gruffly snuffed them back and snapped, “Alright enough of this chit chat, let’s get me off this toilet!”
Several weeks later, I came into work in a bright mood. It was my birthday and I was looking forward to being taken out by my coworkers that day.
“Ashley, I have some bad news…” My supervisor told me in a hushed voice, taking me aside. “Carrie Ann died this morning. Well, at least that’s when another patient found her. No one checked on her overnight. And it seems that no one tried to revive her when they did find her. She’s gone.”
At first I was outraged and I spoke my mind to my supervisor. Then I sat stupidly, silently until everyone had left the room for the morning. I didn’t know what to do with myself. Eventually I stood up and before I knew it I found myself standing in the hall outside her room. There was Carrie Ann, or at least her remains, in a body bag on a stretcher, forgotten again.
I stood there for the longest time, overwhelmed by the injustice of it. How had no one checked on her? Why had no one tried to revive her? Carrie deserved so much better than this.
That’s the tricky part about being close to your patients. They are ill, and that means that some may not make it. People say to keep a distance between you and your patients so as not to burn out and become emotionally drained. I cannot fully agree with this- as therapists we meet people at the most vulnerable moments of their lives- to detach and prevent emotion from seeping into your time with them is, to me, unnatural. I would rather err on the side of caring too much than not enough.
And, as I learned with Carrie Ann, people did not care enough. I often wonder whether or not I did enough to help her. If I had advocated more for her, maybe she would not have died the way she did.
I will never know for certain. All I do know is that now every time I am tempted to rush through things with a patient, I think of Carrie Ann and can practically hear her saying “Have heart.”
