At least there are options

All I wanted to do was get his vitals.  Make sure I didn't have to grab any narcotics, or administer anything IV for a skyrocketing blood pressure.  Both were quite possible, considering the makeup of the typical clientele on this unit.  I really didn't expect to walk out with tears in my eyes.  I've gotten to the point now where it's hard to make time to care anymore. This man, however, had a different story.  Well, maybe not different, but he was honest about it.

They all start kind of the same.  Chronic Obstructive Pulmonary Disease.  Maybe he was a smoker.  Nausea and vomiting were the admitting diagnoses.  I made sure when I came in to introduce myself that he was not currently experiencing either.  He wasn't.

1.5 years of nursing experience on a lung transplant floor has taught me a few things.  For starters, don't encourage transplantation.  That holds true for most of the global population.  Secondly, if a patient's admitting diagnosis is nausea and vomiting, it's probably due to receiving, or not receiving, the very drugs that they need to stay alive.  In my patient's case, he had gone a period of time without taking a prophylactic pill that wards away aspergillosis, a potentially fatal organism to which the immunosuppressed are particularly susceptible.

How could this man do something so irresponsible?  Someone had to die in order for him to receive those lungs.  Well, we grow up and learn that money is the root of most of life's problems.  He and his wife just couldn't pay for the damned V-fend.  Now he is hospitalized in a step-down bed, at the cost of approximately $10,000 per day.  He's retired, but his wife remains employed.  She has insurance but it cannot possible cover all these transplant-associated costs.  He's exhausted Medicare Part B.  Lucky for him, there are other alternatives to explore. 

Divorce?  It's not ideal.  He's been married to his wife for 49 years.  They met with a lawyer last week.  Together, the income he shares with his wife surpasses any eligibility requirement that would allow him to receive assistance in affording the $850 per month medication (this pill, sans insurance coverage, is roughly $50 per each).  Eight hundred fifty dollars.  That's what Walmart charges him.  It considers the twice-a-day dosing that allow his body to maintain these purchased organs. 

So.  Divorce?  If it'll allow him the ability to remain transplant-disease free a little bit longer.  I was clearly upset about his predicament.  His response to the situation?  Acceptance.  "We would have made it 50 years next December.  I can't wait that long.  It's just a piece of paper, anyway."  Maybe the transplant consent form has an asterisk at the bottom stating that additional decrees are necessary.