Gallows Humor: this week’s theme post for rarasaur’s Prompt for the promptless series.
The medical community is notorious for “ill humors”, both of the “germ kind” and the “sick humor” kind. And it is rife with episodes full of what has been dubbed “gallows humor”. Gallows humor was the term applied to the last words’ condemned prisoners would say right before they were hung. It was the blackest of black humor. And in today’s world, sometimes black humor is the only humor to be found.
In the old days, illness and disease were thought to come from “ill humors”. “Humor” was a term for body fluids, so “ill-humor” was sick body fluid. Hence the practice of “bleeding” the patient. Remove the “ill humors” and the patient would improve. Unfortunately, while they had the right idea in some cases (like septic patients–who have an infection in their bloodstream), “bleeding” generally hastened death in most cases.
In the dialysis world we still use the term “ill-humor” as an “ill-humored” joke. Dialysis removes body fluid and waste products, and when the patient is deathly ill, sometimes we just don’t know what the heck we are trying to remove, all we know is our patient is dying and, by golly, we got the machine and the technology and it sure would feel better to try to plug something in the drain that the poor patient is rapidly circling.
“Circling the drain” is medical humor for Get the Body Bag Ready. Dialysis is all about drains, as waste products produced from the treatment are dumped into drains’ behind the machine, so plugging something in the drain to prevent a patient from circling the drain by using a machine that drains is just one of our many “plays on words”.
One of our sayings is that we can “dialyze a grape into a raison”. Dialysis removes fluid from a patient’s blood, and if the operator is not careful, the patient can literally die from shock related to acute dehydration. Another saying is that “we can dialyze anything, even an orange”. While I have not dialyzed an orange, I have dialyzed a one kilo infant, not much larger, but technically oh-so-much harder.
But my gallows humor story for the day is the day we discovered we could dialyze dead people. We had worked night and day on a 3-year-old patient who received a kidney transplant who began “circling the drain”. The docs thought the child was ill right before transplant and got septic (infection in the blood) from the infection due to the medicine that must be given after the transplant to stop the immune system from rejecting the kidney. It was the weekend, and two of us were in the hospital overloaded with patient’s needing dialysis and this poor child who we had known and loved since birth. That’s the hard thing about pediatric dialysis. These kids stay with us often for years before getting a transplant, and we know them and their families inside and out. So when they fall ill, we all fall ill in our own way. Vicki and I were standing in our unit making our “hit and run” plan for the day, and we got a call from the ICU.
ICU RN: I’m sorry to tell you but “A” passed away about forty-five minutes ago.
ICU RN: I’m so sorry, I know you all have been up here so much.
Me: How is mom?
ICU RN: Really bad, can you come up?
Me: We will be right there.
ICU RN: Oh, and do you mind taking her off the CRRT machine as well?
ICU RN: It’s still running
Me: But she’s dead!
ICU RN: I know but it is still running.
Me: You mean you didn’t stop it? You are dialyzing a dead person?
ICU RN: Ah, well, I guess we are.
Me (choking): Be-right-there
I hung up and busted out laughing. I couldn’t stop. I was hysterical. I needed to be slapped, like they did in old black and white movies. Oh, God, now I knew that we could add dead people to our list of fruit and baby dolls. It was a sick moment of defeat. I sputtered out the story to Vicky. She said, “Oh honey”, and opened her arms. I went to my “mom” and we laughed and cried and hugged each other and then just sobbed.
And then we went to hold mom’s hand.