So I had my first ten shifts working on a neuroscience patient care unit.  The type of patients on the unit is a new unique challenge for me as per my limited experience in caring for neuro-patients.  Many of the patients have dementia etc.  Let’s just say its a bit of a “crazy wandering old people unit”.  And I love it.  There is nothing like being held captive by an agitated patient that kept saying “You people just want to bamboozle me”.  The most challenging part is keeping tabs on where my patients are.  The other day, I stepped out of the room for 2 minutes and my patient who decided to have a heart attack on my shift bolted for the nursing station and projectile vomited next to the printer.  Two days later, that same patient improved remarkably enough to chit-chat and inquire about my love life.  Sometimes I wonder about the quality of life that these patients are going to have after a severe heart attack or stroke along with progressive Alzheimer’s and dementia etc.  And then little things happen.  Little moments that triggers indescribable emotions that emit incredible warmth…  An elderly patient with Down syndrome and progressive dementia on a good day screams intermittently at least 3 or 4 times a day at length intervals until Haldol is administered.  One afternoon, after spending 10 minutes in the room with her talking to her and playing with her teddy like a toddler, she actually bursted out laughing and giggling as she busted a few dance moves to the 80′s tunes on the radio in her bed.  No one has ever seen her giggle like that in the 3 months she has been on the unit.  It was magical.  This wonderful woman was a very high functioning person with Down syndrome, she had travelled lots and participated in the special olympics.  And then I realized that it is not about what the quality of life she is to have in the future.  What was important is the life she lived before her losing her independence – she made the best of it.  As for the rest of her life, I think those brief and rare moments of happiness will suffice.