“I ain’t stayin’!”
Mr. R scowled at us with all the ferocity of a grizzly Vietnam War veteran; he had made up his mind to go home, and we clearly weren’t cooperating. Never mind that he had arrived in the ICU today for a nasty bout of pneumonia. Never mind that he needed 5 liters of O2 to breathe, had IVs and lines stuck everywhere, and couldn’t even drink water on his own. He needed to go home today to take care of his wife, who recently had a stroke.
Holding a sponge to his mouth, so he could suck some water, I told him, “Hold on sir, you first need to get well and out of the ICU yourself.”
He tried sit up in protest, but was too exhausted to move more than his head. Grudgingly, he growled, “Fine, but I’m going home tomorrow then!”
Well, tomorrow came and went, and we told him he wasn’t strong enough either. Trying to keep his spirits up, the team said, “Well, maybe Friday … IF you have help at home.” It was highly doubtful, but that kept him going for the week, and he managed to move from the ICU to the floor unit. Friday rolled around; after calling all his family members and every social work option the VA offered, we learned there wasn’t going to be anyone available to take of him 24/7, so he would have to stay the weekend. I knew Friday morning’s rounds with him was going to fun.
“What the hell do you mean I have to stay?! I need to go home to my wife now! Today is Friday!” His wrinkled hands wrung the bed sheets in frustration.
“I’m sorry Mr. R, we want to watch you a little longer. It’s for safety reasons – you might fall, and there wouldn’t be anyone to help you. How would you be able to go to the bathroom?” The upper level said. “It’s a risk we can’t take. Don’t worry, we’ll get you taken care of after the weekend.”
That wasn’t what Mr. R wanted. He argued with us another ten minutes, then, dejectedly, he slumped in his bed, refusing to respond to any more questions or making eye contact. My heart really felt for him, and I wondered if his wife knew how much he was fighting to go home.
My kind attending tried to cheer him up, “Hey, Mr. R, do you want stat McDonald’s?” He was under palliative care, so diet wasn’t an issue; happiness was. “Stat fried chicken? Stat pizza? We’ll order anything you want stat.” No response. But when she offered the “amazing” brownies I baked for the team that morning, his eyes perked up just a little bit. A subtle clinical sign, but the astute attending knew “brownies” had potential. “Alright,” the doctor ordered, “stat brownies and milk for Mr. R!”
Being good medical students, my partner and I knew when the attending requested stat anything (stat blood draw! Stat CT scan!) it meant absolutely right now. We jogged the 0.5 miles across the VA hallways to get back to the team room for emergency brownies and a little milk carton.
The rest of the team continued rounding while I knocked on his door and found him staring at the wall. “Hey Mr. R,” I said, “I’m, um, sorry about you having to stay the weekend. Anyways, I baked these brownies myself … and I hope you like them. They’ve got Nestle Cocoa.”
Slowly, he took a bite and muttered, “It’s good. Very good.” He proceeded to eat/inhale them so quickly that we had to hold them back, lest he choke (“Sir, I’m not responsible for any aspirations if these brownies are too tasty”). I cut up the rest of the brownies and saved them for him for later. He looked down at the brownie in his hand, and mumbled, “Thank you.”
I’ve baked for too many people and clients over the years to count. But somehow, this old man’s thank you remains the most poignant. I was touched, knowing these brownies were good enough for a devoted veteran and husband. And I learned a good little trick from my attending that day. Recipe adapted from Inspired Taste.
All American Brownies
10 tablespoons unsalted butter
3/4 cup granulated sugar (1 cup if you like it sweeter – I like dark chocolate personally)
3/4 cup unsweetened cocoa powder (I used Nestle)
1/4 teaspoon salt
1 teaspoon vanilla extract
2 large eggs
1/2 cup all-purpose flour