The LOL's will get you every time.

I went into work yesterday, expecting to find my favorite patient in her usual, non-verbal, only-able-to-communicate-by-grimacing state.

I was really surprised when I walked into her room to say hello and she said, as clear as a bell "I really have to pee".

I was even more surprised when she refused a bedpan and wanted to sit on the toilet, and I was shocked to find that, despite my protestations that she wouldn't be able to, she was able to sit upright with minimal support from me and my compadre. She really did have to pee, too, and used the toilet successfully the rest of my shift. I told her that I'm going to have to stop telling her all my secrets now she can talk....

It was like a scene from 'Awakenings'; she talked up a storm all evening, right up until I left for the night. I'm hoping that when I go in today, she'll still be able to talk, that yesterday won't have been a one-off. However, if she can't and it really was just a random thing, I'm going to be able to take great comfort in the fact that I got to talk to her for an evening.

It's moments like that that make the assaults, the slaps and the bites and the pinches and the downright nastiness I get from some patients all worthwhile. She got to me a long time ago, this LOL who everyone thought was basically unresponsive and who's facial grimaces were random. I talked to her nonetheless and came to realize in very short order that she really was in that shell of her body and that she DID have some purpose to her grins and frowns.

BTW, I got bitten AND pinched by the same patient last night (a different patient than the lady who started talking). After each time she did it I'd step back and say "now that's not nice! I know your mama taught you better than that!" and she'd just smile sweetly at me like she was proud of what she'd done. Because of the nature of her disease process, she doesn't know any better, bless her....but that doesn't make the bruises and teeth marks smart any less this morning.

EpiJunky is right. It's the LOL's that get you every time.