The apartment must have been at least 90 degrees. Three large cages in the living room held eight squawking birds, one of which whistles an old Latino song incessantly. My patient breaks into song along with the bird several times during the visit. Between the heat and the singing, I felt like I might pass out.
As I attempted to check orthostatic blood pressures (vital signs taken supine, seated and standing in relatively quick succession) , one of my patient's friends burst into the apartment. Yelling almost at the top of her lungs, gesticulating wildly, the new arrival pushed a double stroller into the living room which contained two screaming young children. Amidst the tumult, a third child---perhaps eight or nine---sat down on the couch in utter silence, watching me take my patient's blood pressure and pulse.
The oppressive heat seemed multiplied by the extra bodies in the room. My patient's temperature was 99.7 and she looked faint. Her friend almost violently shoved a plate of food in my patient's lap and began spoon-feeding her as my patient tried to answer my questions. Each time I tried to ask a question again, the friend would interrupt, yelling "You're not taking care of yourself! You need to go to the hospital! Let's call an ambulance!"
Meanwhile, the two children---still strapped in the stroller---began to shriek louder as the parrot again began the incessant whistling, my patient again singing along.
I packed my bags and headed for the door, feeling quite faint myself. Muttering my goodbyes and advice, I escaped to the humid city air, cars streaming by, horns honking.
"I have to get home," I thought, looking at my watch. It was 2:35 pm---disappointingly early. No rest for the weary, and no escape for the overwrought.
Sensory overload? Just one more occupational hazard.