Lessons from the Judge

My co-worker in the intensive care exclaims, “Hey, that looks like Burl Ives” as we come out of shift-change report.

The charge nurse shrugs, “No, he’s Mr. Evan, chief federal judge, downtown. Everybody’s scared of him.”

I see a beefy patient with reddish hair and a salt-pepper beard who does indeed resemble the 280-pound folk singer. He’s my patient today–no pressure. Admitted during the night with severe chest pain and shortness of breath.  EKG positive for acute myocardial infarction (heart attack). Enzymes rising show heart muscle damage.  Risk factors include a high stress job, obesity, and hypertension. Despite his high level of education and father’s sudden death at age 50, Mr. Evan loves to smoke his pipe.

Bet he’ll ask a million questions.  I squelch the butterflies in my stomach and enter his room. Newspapers are strewn across his hospital bed, and the judge barks at me over his reading glasses,

“What are you here for, young lady? I’m catching up on my reading.”

Clutching patient education flip charts to my chest, “To prepare you for your cardiac catheterization in the morning.”

He puts The New York Times down, “You’re up. Proceed.”

His expanse notwithstanding, I sit half my derriere on his bed and launch into my pre-op teaching routine.  He’s listening intently.  I cover what’s going to happen to him chronologically, head to toe. My presentation’s flawless as I point to illustrations, refer to diagrams, and explain the myriad of details in layman’s terms.

“So, . . . any questions?

“Clear as MUD.”

OMG, what did I do wrong? I told him everything. I’m crushed, deflated.

Hoping to redeem myself, “Well, are you anxious?” I can knock you out with a sleeping pill.

“No, darlin’. I’m not anxious, I’m worried. This test tomorrow may be my death sentence. I’ll have to make huge decisions, whether to let them cut on me for heart surgery, don’t know if I’m even a candidate . . . “

One of those “Aha!” moments which sticks with me for the next thirty years.

First, add “Anything you’d like to talk about before I begin?” to my teaching repertoire.  Secondly, delete “anxious” from my conversations with patients.   To Mr. Evan, “anxious” equates to fretting and being out of control.  The more human term is “worried,” which means to ponder one’s fate while being in control.  If a super-smart patient like the judge can’t handle the term “anxious” no one can.

16 May 2018 


Debbie Roth 2018-05-17 11:03  Great job Marilyn, well done!

Jean Midyette 2018-05-16 22:31
Thank you so much, Marilyn for sharing your experience. Great writing!