He's back again.  Same old shit.  Heart failure, uncontrollable diabetes (he had another diabetic crisis; he's in our MICU), COPD that requires the use of oxygen 24 hours a day, and cataracts in both eyes: he is nearly blind.  He is well over 6'5" inches tall and weighs well over 300 pounds easily.

He's a medical nightmare waiting to happen.  Sam Kicking Horse keeps us hopping in more ways than one.

His wife, Wanita, doesn't help matters.  She is loud, obtrusive, demanding, as much of a pain in the ass as her husband.  Between them, they have six kids who range in age from 2 on up to 19; the oldest kids stay with their mother; an 11-year-old girl watches over her two little brothers, who are probably turning the MICU waiting area into their own virtual playground.  I have seen the kids and they are all dirty and unkempt.  They look like they are poor.

I try to feel sorry for them, but I find it hard to.  Sam and Wanita are both difficult to deal with: one is as bad as the other.

Just yesterday, when Sam came in, he was talking out of his head: we knew he was having a high blood sugar crisis.  It was well into the 300's: normal blood sugars run anywhere from the 80s to lower 100's.  His blood sugar readings have ranged from 340 to 380, which is unhealthy and can cause numerous complications to the diabetic patient, including acid build up in their urine, which, in turn, can harm the kidneys even further (and Sam's kidneys are already shot), cause coma, and other issues.

Sam Kicking Horse is a very sick man.  If he makes it this time I will be highly surprised, and so will the other nurses who are tending to  him.  

They just have to put up with Wanita and the older kids.  Nobody really cares for him or his family all that much.  I can see why.  

The only nurse who can deal with him well is Louisiana Sandusky, but then she can deal with just about anybody.  She may be little in size, but she's one of the toughest people I know.  In other words, it takes an awful lot to rattle her birdcage.  She doesn't put up with people's crap; she will tell 'em so and will not back down.  She's the perfect example of "dynamite coming in small packages".

Guess that's why Louisiana is one of the charge nurses because she knows her job inside and out and knows it better than a lot of doctors know theirs.  She probably could do her job in her sleep: I wouldn't put it past her.

I just wish we had more Louisiana Sanduskys on this staff.  Things would run a hell of a lot smoother, and patients wouldn't be so difficult or demanding.  I know I am not like her.  I let things get to me too much; there have been days where I have wanted to quit nursing, but then I think about my daughter, who needs me, and my husband who is out of work, and then I have to keep going for their sake.  If I didn't work, I wouldn't be able to provide for my family and I would be letting them down.

Anyway, back to my story.  

Sam Kicking Horse has always been something of an enigma to our staff.  We try to take care of him as best as we possibly can, but when he refuses to take care of himself or listen to us, then he can expect to have a return trip here to Nashville Memorial (or whatever hospital he happens to be closest to when he first takes sick).  I just wish he realizes what he is doing to himself (and his family).  It's obvious the man just doesn't give a rat's butt about himself; otherwise, he wouldn't be in the mess he's in.

I just hope we can help him and get through to him this time.  If not, then we're looking at the distinct possibility of losing him, and I am beginning to think that the guy has a death wish because it's obvious that he is miserable.  

Sad.  Very, very sad.

~To be continued.~