A few years ago I worked at a hospital as a constant observer.  It was a transitional job as I tried to figure out the next step of my life. What exactly is a constant observer?  one might reasonably ask.  A constant observer is basically a nurse’s aide who stays in one room to be with patients who might be a harm to themselves or others. Hospitals try very hard not to tie people down on their beds anymore.  There are a lot of reasons I might be assigned to a patient: dementia, adverse reaction to medication, brain injury, detoxing, or suicide watch, to name some.  I saw people at their most vulnerable state.  This is the seventh in a series of vignettes on my experiences in the hospital.  I did this one a little differently in honor of Native American Day.

Despite only having one leg, he had ripped down a television from the wall the day before.  He was a Native American, older, maybe in his 60s or 70s, and he had had his leg amputated.  Many of the patients on the Renal floor are diabetic and have dialysis once or twice a day if they have chronic renal failure (damaged kidneys).  Some patients have to have feet or legs amputated because of a combination of numbness/insensitivity and vascular damage which can lead to skin ulcers and infection and ultimately necrosis and gangrene.  They had replaced the TV in his room but wanted someone in the room with him now—just in case, I guess.  In the morning he needed to be bathed, but couldn’t take a shower with his sutures and bandages, so that meant a towel bath.  The nurse helped me wash him for which I was grateful.  His scrotum was extremely swollen—he was in a lot of pain as she washed his genitals.  It was probable that he hadn’t been washed properly before, but she insisted that he allow her to clean him thoroughly.  I doubt I could have done it by myself.  I washed other men in my job, but it was generally rather quick and they were cooperative.  This man intimidated me.  He rarely spoke.  When he did it was usually in a quiet voice.  Except later when I followed him to occupational therapy and he pointed his finger at me and nearly yelled, “Quit following me!”  I tried to explain why I was with him but he repeated “Go.”  The therapist told me to go ahead and take a break.  After the break he was okay with my presence in his room.  He spent most of his time looking out the window in silence.

***

She wanted to be released immediately.  I think the woman, a Native American, was given a room in critical care because she had been difficult on a regular floor.  There they could keep a closer eye on her.  And I was there at all times for the rest of the night.  She was so angry that they wouldn’t let her leave the hospital.  She was tired of people sticking her for IVs.  So a nurse specialist put in a more permanent tube in the crook of her elbow.  It had to be completely sterile.  Early in the evening, she didn’t want me in the room when she peed in the commode, but after a while she stopped complaining.  I assured her that I wouldn’t look.  I’m not sure if that made any difference or if she simply resigned herself to my presence.  Sometimes I ignored her when she tried to get a rise out of me.  Sometimes I couldn’t help responding with pointless objections and explanations.  She dozed during programs on Lifetime.  In the morning, when my shift was nearly over and I thought she had warmed up to me a bit, she started demanding to see the doctor.  He was making his rounds, but not fast enough for her.  She threw the TV remote at the wall, smashing it to bits.

***

Both of these patients had a moment of rage.  They were probably hours away from home—Sioux Falls has two major hospitals so patients from all over the state end up here.  What was at the root of their anger?  Something personal?  The weight of generations?  Their treatment at the hospital?  Their treatment every day?  I didn’t know, and couldn’t.  I felt bewildered and awkward.  The barriers between their lives and mine felt insurmountable.  They had no reason to trust me.

One of the things we learned in training was that we shouldn’t look Native American patients in the eye because it showed a lack of respect in their culture.  It was hard to fight against my own cultural norms.  Did I do anything to make their hospital stay worse?  Patients in the hospital are usually at low points in their lives—sick, injured, possibly dying.  Here they were in the hospital, surrounded by white walls and white people.

Before moving to South Dakota, I read Dee Brown’s Bury My Heart at Wounded Knee because I wanted to have an idea what had happened on the plains in the clash of cultures.  I wanted to know the damage that had been caused: the treaties made and broken, the massacres perpetrated in the name of destiny.  There are many things that white South Dakotans don’t do right regarding the Native Americans in their midst, but changing Columbus Day to Native American Day twenty five years ago is a notable exception.  It’s a nice recognition, but it’s only a start.