Coffee and Cigarrettes

"Alright Ted, do you remember what you have to look for when you're crossing the street?"

I looked ahead as my resident asked our patient, who was happily puffing away on a cigarette, if he remembered to look for the walk sign before crossing the street.

My last rotation of the year was psych, so I spent my final four weeks as a third year medical student in a state-run inpatient psychiatric facility. And while the first few days, so drastically different from the pristine order and efficiency of the OR, made me long to be back on surgery, that morning I discovered a new found appreciation for psychiatry.

Our patient, Ted, was diagnosed with schizoaffective disorder, and had been at the psych center for a few months. My resident, who had been noticing improvement in his behavior, wanted to take him on a field trip to the Dunkin Donuts a block away as a kind of reward. So that morning, we picked Ted up from the ward, and walked with him to Dunkin Donuts, making a pit stop at the gas station on the way so Ted could get his nicotine fix.

It became clear pretty early on that Ted would not pay attention to street signals and oncoming traffic, and I seriously began to doubt whether our little adventure was a good idea at all. When we finally got to Dunkin, Ted ordered a cup of black coffee and an old-fashioned donut. After myself and the resident ordered our drinks and snacks of choice, the three of us sat there, happily munching away on sugary treats and sipping hot coffee. I looked over at Ted, who smiled and offered me a bite of his donut, and I finally saw the person, not the patient. I was able to see past the diagnosis and disheveled hair and saggy sweater and simply see Ted. I saw the person he was before he was diagnosed, and the person he was trying so hard to become again. The person who was happy because today, for a few brief normal moments, he actually felt like a person again, sitting there sipping coffee and eating his donut, like everyone else.

Everyone who comes into the hospital has a story, granted some stories are harder to see than others. As medical personnel we can get bogged down by diagnoses, especially if that diagnosis is a psychiatric one. But I'm thankful for my time spent with Ted, and all the other patients I had the privilege of working with, for the lessons they taught me. Lessons about compassion, and understanding, and meeting people where they're at. And, the power of a really good cup of coffee.