Thirst

There are many uncomfortable things about being a surgical patient. We put big IVs, and tubes, and drains into nearly orifice of your body as we try to get you better – the term “violation” comes to mind. But really what we’re doing is attempting to put your body in a position to best heal itself while we just provide the support.

One of the things that patients complain most about, interestingly enough, is when we don’t allow them to eat or drink. Nil per os – or NPO – is the designation for nearly every surgical patient who has an active issue. Part of this is to allow the GI track to rest, which sometimes is enough for recovery. Other times this is needed in anticipation of surgery. When a patient undergoes induction of anesthesia, the risk of aspiration – or regurgitation followed by choking – is greatly reduced if the stomach is completely empty.

It’s always been interesting to me that patients complain about being NPO at least as much, if not more, than anything else. We literally have patients who are recovering from gun-shot wounds to their bowels, or who are fighting life-threatening pancreatitis, or who are going to the OR imminently for repair of their pelvis which was fractured during that horrible car accident just a couple hours ago, and all they want is a simple drink of water. That’s it. They are experience excruciating pain and discomfort, not to mention emotional turmoil – and all they want is some water. And the answer is no; the risk of complications with anesthesia is just too great, and too unnecessary to take.

One of our attending surgeons recently made an interesting observation. On the trauma service here, we are forced to deal with a fair amount of death, and therefore a lot of end-of-life issues with patients and families. He observed that in conscious patients who are nearing death – and for whom we are providing comfort measures to – one of the last things they will do is ask for something to drink.

Yesterday was Good Friday, the celebration of the remembrance of Christ’s crucifixion. Because of certain circumstances, I was scrambling to find a church to go to, and my best option was a Catholic parish just a couple of blocks away. I’d been told before – by someone who, like me, loves the Episcopal tradition but who, unlike me, had Catholic roots – that while the Episcopal faith was beautiful, the Catholics just always seemed to get Good Friday right. I half smiled as I wondered where she would be going to church that afternoon.

The Mass was indeed lovely. And as it happened they read the Passion from the Gospel of John. Some scholars will remark that the big breakthrough in Biblical studies came with the understanding that the four Gospels were not necessarily four different historical accounts, but rather four different works of historical literature, written with different biases and for different purposes.

The Gospel of John is unique in that it explicitly has Jesus, while hanging on the cross and just before he dies, looking out and saying “I thirst.” He is given a quick drink, and then exclaims “It is finished.”

And now we wait.