Hospital,
Dr Samuel Ebbs’ office
SAMUEL HAD A LARGE NUMBER OF PATIENTS UNDER his care, all of whom needed different things. Ellie Brady might have been considered one of the least optimistic cases at St Michael’s, but after meeting with her the previous day, hers was certainly one of the cases that intrigued him most.
He had reflected long and hard about their first encounter and was quite sure, irrespective of what his prior expectations had been, that he had been very much surprised by Ellie Brady. Sedatives used in institutional care were not uncommon – the majority of his patients were on benzodiazepines, and night sedation ran to about 65 per cent of the patients at the hospital. But he sensed a spark about Ellie yesterday, bubbling just below the surface, a kind of feistiness that gave him hope. He was glad he had made the decision to tweak her medication. The alteration would have gone unnoticed, other than by those in the hospital pharmacy. He had not mentioned it to Ellie purposely. It wasn’t always a good thing to advise a patient of such a change, especially a long-term patient who might fret, impacting on any benefit there might be.
Although at first glance Ellie’s appearance had been drab, as was the case with most of the inmates of the institution, and she undoubtedly looked every bit her forty-seven years when she walked into the room, the remnants of her youthful beauty were still apparent to him within moments of meeting her. It was one of the first things that had struck him about the old photograph in her file – how attractive she was,and how alive and vibrant she seemed. He had been taken aback by her remarkable bone structure, both in the photograph and then in real life. But there was something else. It was in the way she looked at him, how she seemed to lock onto his face, unusual for someone of her condition, leaving the distinct impression that when she stared at him, she did so with the knowledge that she had seen a great many things which he had not.
Re-examining the case notes, he went to the last entry written by his predecessor, Dr Norris.
Ellie Brady (née Thompson, born 20/10/1963) Patient displays no change in condition since last review.
Based on her prolonged period at St Michael’s, it would seem unlikely that any improvement in her mental state is envisaged in the short or medium term.
Memory of events leading up to and after the fire are still sporadic.
Patient still seems capable of only minimal recall.
Continues to demonstrate behaviour of withdrawal and a reluctance to engage in any activity other than the basic interaction with others.
As symptoms and behaviour show no signs of alteration, for the short term, I recommend continuance on existing medication and set review date for six months from today.
Signed: Dr G Norris
His predecessor’s assessment confirmed Samuel’s suspicions about the entire file: many of the reviews of the past few years had achieved little more than repeating the same things that had been stated previously.If anything, the assessments were nothing more than a recording of what seems to have been accepted as the status quo when it came to handling Ellie’s case.
The only reviews of any difference were those recorded when Ellie was first admitted to St Michael’s. She was undoubtedly a very sick woman from the outset, willing to take her own life by whatever means had been open to her. Once the initial danger Ellie posed to herself had passed, it seemed that what had been adopted was little more than a desire to keep her condition stable.
Samuel had been struck by something else during his encounter with Ellie, apart from her feistiness. There was no denying that she had made direct eye contact with him, in fact she had no problem on numerous occasions attempting to outstare him. This was unusual for someone who supposedly had withdrawn inside themselves, even given the slight adjustment to her medication. More importantly, it
Dr Samuel Ebbs’ office
SAMUEL HAD A LARGE NUMBER OF PATIENTS UNDER his care, all of whom needed different things. Ellie Brady might have been considered one of the least optimistic cases at St Michael’s, but after meeting with her the previous day, hers was certainly one of the cases that intrigued him most.
He had reflected long and hard about their first encounter and was quite sure, irrespective of what his prior expectations had been, that he had been very much surprised by Ellie Brady. Sedatives used in institutional care were not uncommon – the majority of his patients were on benzodiazepines, and night sedation ran to about 65 per cent of the patients at the hospital. But he sensed a spark about Ellie yesterday, bubbling just below the surface, a kind of feistiness that gave him hope. He was glad he had made the decision to tweak her medication. The alteration would have gone unnoticed, other than by those in the hospital pharmacy. He had not mentioned it to Ellie purposely. It wasn’t always a good thing to advise a patient of such a change, especially a long-term patient who might fret, impacting on any benefit there might be.
Although at first glance Ellie’s appearance had been drab, as was the case with most of the inmates of the institution, and she undoubtedly looked every bit her forty-seven years when she walked into the room, the remnants of her youthful beauty were still apparent to him within moments of meeting her. It was one of the first things that had struck him about the old photograph in her file – how attractive she was,and how alive and vibrant she seemed. He had been taken aback by her remarkable bone structure, both in the photograph and then in real life. But there was something else. It was in the way she looked at him, how she seemed to lock onto his face, unusual for someone of her condition, leaving the distinct impression that when she stared at him, she did so with the knowledge that she had seen a great many things which he had not.
Re-examining the case notes, he went to the last entry written by his predecessor, Dr Norris.
Ellie Brady (née Thompson, born 20/10/1963) Patient displays no change in condition since last review.
Based on her prolonged period at St Michael’s, it would seem unlikely that any improvement in her mental state is envisaged in the short or medium term.
Memory of events leading up to and after the fire are still sporadic.
Patient still seems capable of only minimal recall.
Continues to demonstrate behaviour of withdrawal and a reluctance to engage in any activity other than the basic interaction with others.
As symptoms and behaviour show no signs of alteration, for the short term, I recommend continuance on existing medication and set review date for six months from today.
Signed: Dr G Norris
His predecessor’s assessment confirmed Samuel’s suspicions about the entire file: many of the reviews of the past few years had achieved little more than repeating the same things that had been stated previously.If anything, the assessments were nothing more than a recording of what seems to have been accepted as the status quo when it came to handling Ellie’s case.
The only reviews of any difference were those recorded when Ellie was first admitted to St Michael’s. She was undoubtedly a very sick woman from the outset, willing to take her own life by whatever means had been open to her. Once the initial danger Ellie posed to herself had passed, it seemed that what had been adopted was little more than a desire to keep her condition stable.
Samuel had been struck by something else during his encounter with Ellie, apart from her feistiness. There was no denying that she had made direct eye contact with him, in fact she had no problem on numerous occasions attempting to outstare him. This was unusual for someone who supposedly had withdrawn inside themselves, even given the slight adjustment to her medication. More importantly, it
Similar Books
