i told you so

In my office looking at the computer screen, I saw her name on the schedule for clinic that day and wondered how she was doing since the last time I saw her when I could hear the crackling sounds of fluid beginning to collect in her left lung. It was the second time I had seen her and my words still sounded like a stranger’s advice. Though I hoped her kidney function was stable and that she was still feeling relatively OK,  I hoped even more that she would be willing to allow me to make the phone calls to get her started on dialysis without having to be admitted to the hospital. On my way to clinic, I stopped by the dialysis unit to write an order in one of my patient’s charts. There I saw her name on the spine of a neighboring chart. Her name was still hand-written—the clerk had yet to find the time to print it out from the computer onto paper color-coded to signify who was her nephrologist. In that moment I knew how she had been doing. I’d seen it happen time and time again.

Still, after clinic I stopped back by the dialysis unit to find out how she went from “You should get ready for dialysis” to “If you don’t start dialysis now you will be dead within hours.”

She sat in the recliner with the leg rest extended. Her skin was ashen. She appeared to have aged a lot since I saw her just a month prior. She was watching a movie on a DVD player. She looked up as I approached and the look on her face changed from contentment to embarrassment, like she knew a well-deserved “I told you so” was coming her way. Instead, I asked her how she was doing and what happened.

“I tried to lay back in bed and I felt like someone was trying to kill me,” she said.

She was describing a sensation of drowning just like others with fluid building up in their lungs described.

“I told my boyfriend to call 911 and he freaked out.”

“And can you believe they kept me in the ER for more than 12 hours before I got a room?” Her tone was higher pitched with a twinge of anger now.

“Yes, I can,” I nodded knowingly. “I was trying to spare you from that,” I said.

Guess I said “I told you so” after all.