i know he has AIDS. i know, for a fact, that he is dying.

i also know this sounds totally cold, but you know what, i just don’t care anymore. i treated him with respect. i looked past the truth that he got the virus out of abusing IV drugs. he was my patient, and he needed my help. he didn’t have a long time to live, but i was optimistic i can make a difference, even a tiny one.

well, me and my grand ideas!

for the past three weeks or so, every nurse who has taken care of him warned me about his attitude. they used every sort of word to prepare me. obnoxious, stubborn, hard headed, manipulative, condescending. hard as it was, i tried to erase all the images and started on a clean slate.

he has every right to be angry, i told myself. of course he hates life and everything in it. i mean, why wouldn’t he? he is only in his 30s. he is supposed to be at a point in his life when he is starting to enjoy it, but he’s not. instead, he is starting to lose it. it may have been because of some stupid mistakes with those infected needles, but still, who doesn’t make stupid mistakes?

when i went to meet him for the first time, i was planning on making his life less miserable. his last weeks or months shouldn’t be the worst time. i will try, and with my so called warmth, i will make him smile, or at least, i will make him more cooperative.

surprise, surprise! i failed. and i failed big time.
he refused or took meds depending on his moods. he changed his IVF rate, turned it off just because he knew better, and because he knew how to deactivate the lockout system. 
he argued about the time of his pain medication and denied i have given him any.
he called often, to remind me i was lying to him about his pain meds. he criticized me for not knowing how to do even the simplest things like taping his IV tubings.
he was not happy with this, he was dissatisfied with that. 
nothing was right. 

to him, everything i did was wrong. every nurse he met was either lazy or stupid. to him, all the doctors were against him and do not have any idea what they were doing. he is dying because we are not doing what we were supposed to do. on and on and on, it dragged for two nights, and yes, i admit, it unnerved me. it pushed me to the edge.

after three nights off, i went back to work expecting he was transferred, but he was still there. and as luck would have it, not only was he still there, he was my patient again. he just had a bronchoscopy and it was quite difficult to wake him up after they have given him some serious sedatives. i hoped the power of versed combined with dilaudid would last the whole night, but it didn’t.

after about two hours, he was half awake. when i got to his room, he was tyring to put his shoes on. with the calmest voice i can muster, i explained why he shouldn’t go off the unit. not only that he was being monitored, and was hypotensive, but he was obviously still very unsteady. “you are clueless about what i want to eat, so you can’t stop me from going to the cafeteria”, he said. it would have been easier if that was the truth, but the truth was, he wanted to sneak out to smoke, as he had been doing in the past, despite every imaginable reason why he shouldn’t be sneaking out.

“i know i can’t force you to stay, but i hope you realize that what you want to do is unsafe and i do not want you to go”, i told him.

“well, i am going anyway. watch me.”

he was a little wobbly with his first steps, but i didn’t help him, and i didn’t flinch. not only that i didn’t approve of him going off the unit, i was hoping he will listen when he found out he was not that ready to walk alone yet. he was determined, and smugly showed it. i could have repeated my explanations for the nth time, so he will stay, but i didn’t. instead, i walked away. then, i sort of washed my hands and told the charge nurse i’ve had enough. fortunately, she handled it very professionally, and ended up sending our very busy patient care assistant to go with him off the unit after negotiating that he go in a wheelchair.

after that, all my resolves to make a difference flew out of the window. for the next hours, and the night after that, i was so disgusted with him i offered him nothing. no empathy. not even sympathy. not even when he was crying.

i was helping him put his legs up the bed and he started crying about his swollen body being “full of toxins, and all the doctors doing nothing about it.” in between sobs, he was still bashing the doctors and the nurses, it was unbvelievable. without making eye contact i asked him if there was still something i can do to help him. he was a llittle short of breath, but it didn’t stop him from being opinionated. when he started again, he picked up from how the doctors are never doing what they were supposed to do, to how the AM RN didn’t pay any attention to him. apathetically, i left the room while he was still going on and on and on blaming everyone about his miserable life. well, everyone else except himself anyway.

i left him crying, and i offered him nothing. no little touch on the shoulder to let him know i feel his pain. no look of understanding to let him know someone was there for him. none of those. all i offered him was a meaningless stare, which i selfishly thought he fully deserved. i was so cold, i could have left him frozen.

i didn’t plan it, but it turned out, it was not that hard to act like a robot. you know, i was there giving him water, emptying his urinal, changing his sweaty gown, cleaning up his vomit. i was there, but was not really there. listening to him complain about everything made me realize it was impossible to make a difference in his life, and he made me sick. 

i know this may sound inhuman or something, but really, while i was taking care of him, i was in such a state of mind or emotion wherein if he dropped dead right there in front of me, i probably wouldn’t care. i lost even the slightest ability to care, and the whole thing just saddens me, that realizing it made me sick of myself.

why can’t i be more compassionate? what does it take to be more patient? what do i do to be more understanding?

should i just shrug my shoulders and say “well, he wants to be miserable, that’s his choice, not mine” and look away? is it justifiable to be cold and unfeeling towards a person who seemingly gloats in the idea of demeaning other people because they are helpless about their own situation?

i don’t know. i just know that’s what i did. at that time, nothing else felt more appropriate. i rationalized over and over that i was only giving him what he was asking for, and that it was right. yet, after everything has been left unsaid and undone, why does everything feel so wrong?

maybe because it is.
maybe because being coldhearted is always wrong.
and i was coldhearted, and i was wrong.