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“He wants to bring his two turtles!” said the flustered nurse when I casually asked her how she was doing. I was sitting at the nurses’ station and busily dictating a consultation note for a patient I had just seen. Truth be told, I was not looking for a long conversation.

“I am an animal lover,” she added.

I was confused. ‘I am an animal lover, too!’ I thought to myself. “Who wants to bring his two turtles? What are you talking about?” I asked, baffled.

The nurse explained: “My patient…coming up to the floor for admission from the emergency room. He has his pet turtles with him in a box. He wants to bring them with him. He has no one to take care of them.”

I intently looked at her face to see if she was joking. Nope, she was serious, and, in fact, she was genuinely concerned.

‘This is crazy!’ I thought. I was surprised that the nurse had even taken the patient’s request seriously. I said, “He cannot bring his turtles with him. It is hospital policy. Turtles can carry bacteria, including salmonella. We cannot put other patients at risk.”

I have always felt that nurses have a unique place in medicine. They spend more time with their patients compared to any other healthcare professionals, including doctors. Nursing is a true calling for many, not just a job. I have met incredible nurses over the years who have taught me a lot and helped me become the physician I am today.

This particular nurse, before even meeting her patient, had sensed that these pet turtles meant a lot to him. The concern on her face was clear as day. Thinking that I must have sounded too emotionless, I decided to ask her why the patient was being admitted, although this would not have changed the fact that he was not allowed to bring his beloved pets upstairs.

“Congestive heart failure,” the nurse said. “He is short of breath and fluid overloaded.”

“They are his companions, doc,” she continued. “He cannot leave them. He lives alone, in a car.”

My heart broke for him. I felt bad for the nurse too.

“I don’t know much about how to care for the turtles, but I leave my cats for a day or two at home when I am away, and they do just fine as long as I leave enough food and water,” I said. “I would think he could leave them for a few days too. They might poop in the car, I guess, but that should not be a big deal…” I thought to myself that I probably did not sound very reassuring.

The nurse was not entirely convinced but decided to talk to the patient. She called the emergency room as I continued to dictate my note.

The nurse came back in a few minutes with teary eyes, “He has already left against medical advice, doc. They are his only companions — he couldn’t leave them behind!”

Working in a busy, inner-city hospital with underprivileged patients, I hear many mindboggling stories every day. These are the stories that sometimes keep me awake at night or catch me at an unsuspecting moment.

Life goes on fast around me, but I have a lot of work to do: consults to see, orders to place, treatment plans to discuss, phone calls to make, meetings to attend… I admit that many stories go unnoticed or underappreciated in my busy days. This story however, gave me a pause. I could not go back to dictating my note. It stopped me in my tracks, literally.

Here was an ill man with congestive heart failure and fluid overload. He could not breathe and needed hospital admission. He was living alone in a car with his only two companions, two turtles that meant so much to him he put his own life in danger instead of leaving them for a few days. In his eyes, losing his companions was worse than his own death. I had to let that sink in.

As physicians, putting ourselves in our patients’ shoes is hard. It is even harder when you are pulled to so many directions each day. In addition, in the face of sadness and suffering we witness every day, it takes effort to avoid becoming calloused. The caring nurse and the patient she did not even get to meet in person taught me a lesson of humanity that day.

Gul Madison, MD, is an infectious disease specialist in Philadelphia. She is a 2018–19 Doximity Author.

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