A Patient without Hope
by Lynn Beasley, RN, CCM

I met her during her first onsite visit. She had an impressive background, worked as an attorney, was well-educated, etc. Clearly, however, at the time of our initial meeting, she was tired. Tired of being in pain, tired of living with respiratory distress, and tired of physicians who had determined she was clinically depressed or a “chronic-fatigue” type patient.

She had given up hope. She exhibited signs of depression and hopelessness and doubted her self-worth as an intelligent, middle-aged woman. She broke my heart. I couldn’t give up on her.

I completed the initial assessment after obtaining her signed consent, and on my three-hour return trip home kept going over and over in my mind how I could possibly help her.

I learned of an upcoming local Charlotte Chapter Case Management Society of America meeting in the weeks ahead. The speaker was a prominent physician at the National Jewish Respiratory Hospital in Colorado. I knew immediately I had to attend; this could be an answer for my new patient.

I attended the meeting, arriving late due to work responsibilities, but with still enough time to sit with the speaker and tell him of my patient’s unusual diagnosis of BOOP (bronchiolitis obliterans organizing pneumonia). He was very familiar with the diagnosis and provided me with a brochure and his card, strongly encouraging the patient to contact his office.

I provided her with the information during our next telephone conversation, reiterating it was her choice whether or not to pursue it, and recommended she contact her insurance company to verify benefits available for the out-of-state consult.

She ended up contacting the National Jewish Respiratory Hospital and going there for a complete evaluation. Afterward, she sent me two letters to say thanks for “believing in me, for going the extra mile to find this resource for me, and for providing me with the information.”

She wrote again, noting that her physician from the National Jewish Respiratory Hospital maintained contact with her and her local physicians via email, and continued to direct her treatment plan. Turns out she had been misdiagnosed locally and wrote to me saying, “Thanks to you I have a new diagnosis, and a new treatment plan.” She was on the road back to life with renewed hope.

I had to close my case; my job was done. I had accomplished what I’d set out to do — to give her back her life, her hope and her self-esteem.

In her final card to me she wrote that she would never forget me and all that I had done for her. It was rewarding for me, too, and I will never forget her either. She validated my years of experience, skills and compassion, which is so often overlooked in today’s world of medicine.