Licensed to

In James Bond terms, it’s a license to kill.

In philosophical terms, it’s a license to heal or to help live.

In pragmatic terms, it’s a DEA number and a way to bill and get reimbursed by insurance.

In French, license means bachelor's degree, and permis means license. Unspoken, assumed permission. Allowed.

Person to person

I got a patient’s blood on me the other day.

(not unusual)

A patient’s blood splashed in my face the other day.

(unusual)

A patient’s blood spattered over my face, little drops over my neck, cheeks, forehead, and one on the inside of my lip. That I felt – one. None in my eyes.

A patient’s blood spattered on me and her eyes were closed and she was concentrating so hard on her breathing that she didn’t notice I stopped, stopped the procedure. I stopped for a minute, maybe two, at most. More like 90 seconds.

Paused.

We are holding you here

Danger to self, Danger to others, Grave disability

For the past month, my patients have either been dying or seriously troubled. Or both.

These might be different sorts of dying.

This may be an introduction for stories to follow. There were more patient moments of transcendence, on palliative care. That’s next – what it means to be able to imagine a life for someone when you’ve never really met them before almost-death. There are the hours and hours and hours of stories, now. The Mental Status Exam – there’s another piece. Will be. But for now, by way of segue, and because the writing for the evening is meant to be five closely hand-written pages on my patient’s background, the factors that have contributed to her current situation, and an assessment and plan of what, in the hospital, we can do.

Cameroun, primate reserve/rehab near Yaounde