Although I more or less like all little old ladies, there's a certain subset of the genre that I love. The ones who are over 80 with the skinny bodies and the voices creaky like rocking chairs-they completely do me in.
When I go into their hospital rooms early in the mornings, I watch them for a moment before I wake them. I love their little heads drooping to the side like heavy blossoms while they sleep. I love the curls their skinny hands make around the covers. I love their little bellies, soft and round like puppies'. God help me, if it's wrong to love an old lady's belly, I don't want to be right.
I love these little old ladies, but I hate waking them up. They're always a little confused at first, then sweetly tired like children, snoring when I ask them if they had any trouble overnight. They usually don't remember it, and I am grateful for that.
I just discharged one of these patients today, a little confection of an eighty-six year old named Shirley (well, of course she's named Shirley). She's absolutely beautiful, with clear eyes and bright skin, and she wore a pair of diamond stud earrings the entire week she was in the hospital. She is incredibly funny and, despite her failing health, incredibly independent, and wanted more than anything to go back home to her cute apartment and just be by herself. She sucked up hours of my time just with joking and fretting, and I didn't mind a bit.
When I went in to see her this morning, she was sleeping the way old ladies do, and I watched her for a moment, the way I do. I woke her up the way my friend Val taught me to, by putting my hands on her legs and saying her name softly. She opened her eyes.
"It's so early," she said. "How early is it?"
"It's six-thirty," I said. Then, cringing, "I'm sorry to wake you."
"No, it's alright," she said. "I just don't like for people I like to have to be awake so early."
I don't like being awake so early, either. But if I have no other choice, at least I get to spend a few of those early morning minutes with the belly belonging to the nicest patient ever.
Signout is hospital slang for the transfer of information between patient care teams. It is also the name of this blog, which represents one of the less dysfunctional ways in which Dr. Signout copes with her participation in a U.S. medical residency program.









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