“Be careful. He’s violent.” That was the way sign out began for Mr. T. The intern continued, “He has been in the hospital forever because he was kicked out of his nursing home. Good luck. And, oh yeah … he’s blind.” Puzzled, I looked at my list of patients and, not sure whether I should write “violent” by this patient’s name, I decided instead to write “blind.” I paused. The intern said, “Don’t worry, he hit someone with his cane. When you enter his room, just keep your eye on the cane.”
The next morning, as I approached the room, I was nervous and unsure of what to expect. When I knocked on the door, I was greeted sharply with a bit of a grunt, and a quick “Is that my breakfast tray?” I quickly responded ‘no’ and that I was the new doctor on the team. Knowing that a hungry patient can be tricky to warm up, I decided to sit down first. I found a very tall African American man sitting near the window, listening to the radio. Mr. T appeared much older than his stated age, and he wore a spirit of fatigue that was heavy and ominous. I could also sense his strong feelings of distrust, which I often see in African American patients, but his inability to see his surroundings presented an even higher barrier for me to climb.
During my first two days of taking care of Mr. T, I didn’t examine him. I just sat there with him. Shamefully telling my attending on both days that the patient was on his way to dialysis when asked why I was unable to examine him. I knew he felt violated and distrustful, so I wanted to wait for him to trust me. First, I started with asking about the music he enjoyed, since he was always listening to the radio. Through his love of music, I begin to learn about his life. I found out that he grew up in the foster care system, that he had been homeless for a year, and that, at the young age of 40, he lost his vision due to diabetes.
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