A Patient with Ulcerative Colitis

Abstract

He was truly as white as the sheet he lay under, that skinny old man I had chosen for my patient. His sparse, colorless hair stood out at all angles, his gray-blue eyes were sunken and hollow, and his skin hung loosely on his long bones. He lay twisted in sheets and blankets, his huge calloused feet protruding to rest on the cold, hard metal at the foot of his bed. The size of the intravenous needle looked cruel in comparison to his bony, wasted forearm. His face was haggard and his cheeks gray with several days' growth of beard. A Levin tube looped out of one thin nostril. In ridiculous contrast to his drawn face were his large ears-the only prominent features on his head. I learned more about Harold Crain from the Kardex and chart. He was a retired farmer who had been admitted to a hospital near his home three weeks earlier with a myocardial infarction. The infarct healed without incident, but during that hospitalization he developed vomiting, diarrhea, abdominal distention, and fever of unknown etiology. When these symptoms did not abate with various methods of treatment, he was transferred to our hospital. When he arrived he was described by the doctor as being weak and critically ill; however, cooperative and alert. The only significant finding was a tympanic, distended abdomen. The examining doctor thought that he might have arteriosclerotic heart disease with recent myocardial infarct; lower gastrointestinal bleeding from a polyp, or cancer; or paralytic ileus secondary to electrolyte imbalance.