Patient is Now Unable at Multiple Levels (Notes)

Patient is a person who experienced sudden onset consistent with

evidence. History has been severe — very severe — the present is what

it seems, and the future, as always, is unknown, undetermined: this

situation — and perhaps others to come — notwithstanding.

Some function, little function, waning function, absence of function

(incomplete may become complete or remain)

After long days of nothing who can say.

How to communicate this: You will now

live in the small space between.

How to explain?

First there was bled out fluid — it trickled, gushed, reabsorbed, trickled

again — through the slow flow of malformations in barely visible caverns.

Imagine a vessel traveling through the tangle of bloody networks down

expanding paths among lost soft lesions in such spacious places, in immense

dark depths, only to find it abandoned, hollowed out, in rapid decline.

Consider a come and go violent injury without violence, a cavernous

complex formation followed quickly by degeneration. A complicated

incomplete yet complete non-injury injury. Hemorrhagic and sporadic.

You are in need of acute awareness: the divide in understanding is,

quite clearly, deep and wide.

Extensive evaluation then prepped with no clear reason

(difficulty obtaining clearance). Struck down by slowness,

out of the bare minimum of luck. Patient introduced to the useless

universe, the long reach

of time. Did time forget what to do, how to move?

Patient is now unable at multiple levels.

Remember the old adage: A pumped stomach always reveals its contents.

Ask Patient: how do you feel?

Ask Patient: how do you hurt?

Ask Patient: who are you now?

Evidence is extensive, so extensive, but still

we ask: Same, worse, or better? Same, worse, or better?

For more significant revelations ask

specific questions!

But in the end, we rely on summary again and again:

Delicate surgery begets no surgery;

difficult clearance begets no clearance.

Evaluate and evaluate and evaluate,

but do not encourage.

Reassess, reassess, reassess,

then do not bother.

Patient is

unable.

Unable to seek

care

Unable to facilitate

care

Unable to know

who will

care,

do the

caring,

how to

care.

Do Not Share:

Perhaps you have arrived at the last place. Do not think

about other possibilities. You wondered where or when

or how it would come: the time is now. Do not consent:

it shouldn’t have happened this way, but you borrowed

time. Hijacked, ransacked, plundered time until the moment,

the very last moment, before unexpected event. Do not

consult: what more could anyone say. What can and

cannot, will and will not, happen next is never known.

Do not consider: none of us can enhance or assess or

reason with chance. Did you listen for the ringing, the

warning shot: you are out of time. This is it. Now. This

is what will take you down.