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  1. Goodman, Diane M. RN

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Edna was sharp, all hard edges and bony protrusions. Her face had a ghostly pallor, her hair was thin and limp, and her lips grimaced in disapproval. Although in her mid-seventies and frail, her posture was rigid. She was rarely seen without her robe, which she belted protectively around her emaciated frame. The robe was threadbare, of a faded, indeterminate hue that blended into her skin and made her disappear.


But Edna was anything but invisible. Although hospitalized for severe diverticulitis, she barked demands for coffee and spicy chili during each meal, even as she clutched her abdomen in pain. We'd explained to her that certain foods would exacerbate her intestinal distress, yet she continually blamed her medication. When given pills, she'd dump them on her table, line them up, and question the nurse about each one, an exercise she carried out regularly.


These difficulties were minor compared with the "battles of the bedside table." Edna had two tables, having bribed a technician into bringing an extra one to her room. One table held pens, the nursing call button, eyeglasses, reading material, tissues, and a pair of tattered slippers-all arranged with meticulous order. That wasn't the problem. The issue was with the other table, on which her meals were served.


"No, no, no, you've got it all wrong," Edna would screech as the table was raised and lowered into position. In her eyes, every movement we made was careless. "It has to be one inch from the top of the rail, not over the bed." She demanded that her table be aligned with military precision and that her water glass-neither too full nor too empty-be positioned in exactly the right location. Since the right location changed slightly each meal, the placement of the glass would inevitably result in angry squeals. Soon after she was admitted, the staff began to gather in tense little groups as mealtime approached, whispering and offering one another support. It was as if they were about to draw straws to find out who would serve Edna her meal.


Sue, a patient care technician, was the only staff member who didn't see Edna as a bitter, cantankerous woman. She, instead, saw a woman who rarely received visitors. She saw a woman with sadness in her eyes and a tattered photo of a graying poodle carefully folded among her belongings. Sue volunteered to bring Edna her meals, determined to pass the test of the table.


"I don't know how you like the table. Perhaps you could show me," Sue offered, the first time she brought Edna her meal. "If I get it wrong, I'll keep trying." For a moment, Edna was quiet, surprised Sue hadn't immediately taken control and pushed the table where she thought it ought to go. Pulling her robe tightly about her shoulders, Edna sat upright, staring at Sue. Sue waited for the tirade, which didn't come. Instead, Edna took her time explaining exactly how she liked things. The table was quietly moved into position and Edna began to eat. It was the same bland food she'd always been served, but this meal was unaccompanied by loud demands for chili.


When I arrived later with Edna's medication, the two women were smiling and talking. Edna took her pills without a quarrel, barely pausing to acknowledge my presence before continuing to share a story with Sue.


The two became allies, as Edna talked about her life. A retired mathematics instructor, she had always been drawn to precision. Yet in the decade since her husband left, her path had become unpredictable and the previous year had been especially difficult. After caring for a younger sister dying of leukemia, her 15-year-old poodle Muffy also died. Childless, she felt alone and afraid. She needed to assert control somewhere and focused on the bedside tables. But once she found companionship through Sue's efforts, the tables lost their importance. She no longer yelled, or even noticed, if they were not perfectly positioned.


Her health improved almost immediately. She began to eat and take her medication without argument; within a few days we discontinued her iv and were looking forward to providing more variety in her diet. She even abandoned the protection of the tattered robe (keeping it neatly folded on her bedside table) and turned on her long-silent television, ready to take interest in the world again.


It took just two bedside tables, one remarkable caregiver, and several measures of compassion to give Edna back her health and her perspective.