I was taking care of the sweetest little lady. She had Alzheimer’s disease. She didn’t know who I was, who her daughter was, what her own name was.

But she beamed delightedly at everyone she saw. “Well hello!” she would exclaim joyously. “How very nice to meet you! How very nice of you to stop by! What a pleasure! Tea?”

She had been admitted to the hospital with constipation which had now resolved, as evidenced by the copious liquid stool that she was freely passing. She certainly hadn’t needed that stool softener I’d given her earlier that morning, I thought regretfully. Drat.

That afternoon, glancing in as I passed her door, I saw her standing uncertainly in the middle of the room. Uneasy, sensing something was amiss, I entered her room and cautiously looked around.

And I saw her hands were covered with stool.

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I was setting up a PCA (Patient Controlled Analgesia – a “pain pump”) for my new patient.

I didn’t really have time to be doing this. It was one of those busy days. Everyone was calling me. The pager in my pocket rang constantly: Pain meds! Anxiety meds! When will the doctor be here? I want to go home! Move my Kleenex box two inches to the right!

I would leave a room, and would get called right back in. I couldn’t make any forward progress.

My new patient had just had surgery, and was in pain. She called me every five minutes, telling me the pain medication wasn’t working. I was pouring morphine into her, and finally called the doctor for a PCA, so she could push a button and receive a dose of pain medication whenever she wanted.

Taking the time to set up a PCA would ultimately be better than being paged to her room every five minutes. I could get to my other patients, who were also calling constantly. And she’d have better pain control. Win-win! If I could just get it set up quickly!

Because I really didn’t have any time.

The pump already had batteries in it, located on its underside. As the pager rang in my pocket, I turned on the pump and programmed it with the settings given to me by the doctor. Hooked the tubing up to the patient. Explained that she could hit her button whenever she wanted, that the pump would prevent any overdoses. Stepped back to admire my handiwork, satisfied – Did it! Got it done! – ready to move on to the next room –

And pop went the battery door to the PCA.

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