Category: Dignity

Reach Out

IP2 Comments

If you want to end your isolation, you must be honest about what you want at a core level and decide to go after it. – Martha Buck

Mrs. C* was 96 when I met her. She arrived to us from a nursing home after the staff called EMS for altered mental status. As soon as they walked out of the room, she yelled to the nurse, “I’m not really sick, I just had to get out of there, those people are driving me nuts.” Realizing it may be a while before someone from the nursing home could come get her, the nurses sat her in a chair at the nurse’s station near my desk. She said hello to everyone who walked by. To me, she seemed eccentric! She had bright pink hair, fiery red nails, and insisted on wearing a leopard print robe instead of a hospital issued gown. When I complimented her on her attire, she said, “What can I say, I just love beautiful things.” She spoke in such a way that it made me want to continue listening. All of the sudden, I started imagining she had been an actress in her life before the nursing home stay. Her theatrical skills, more than any illness had brought her to the hospital.

She told me about her children, how they lived far away, and about how the workers in the nursing home meant well, but often left her alone for hours at a time. She told me she felt so isolated from the world, and that this, her trip to the hospital, was the highlight of her month. It was interesting to me that surrounded by others, she could still feel isolated. She felt isolated because the deep relationships and companionship she so desperately desired were not present.

At some point after my interaction with Mrs. C, I read that isolation is more detrimental than some chronic diseases and increases the risk of mortality more than smoking. It is not just the elderly who are affected. It is also the poor, the bullied, the grieving, the people on the margins of society, and the rejected. Many people who are lonely and isolated, are too intimidated to speak up and form relationships even though that is what they ultimately desire. The most remarkable statistic…a heartbreaking statistic…25% of Americans have no meaningful social support. TWENTY-FIVE PERCENT without one single person they can confide in, the statistics are staggering.

I am sure there are a million and one things that contribute to this statistic – smart phones, long commutes, work hours, and distractions to name a few. Basically, life in the twenty-first century. After reading those statistics, it has become increasingly more important to me to help break the pattern. Why? Because personal relationships and a connectedness with others impacts human resilience. Personal relationships require communication, encouragement, reassurance and trust. Our personal relationships provide the security of knowing that others will be there when we need them, and likewise we will be there when they need us.

Many would have been irritated with Mrs. C’s constant interruption in their work schedule and the waste of resources she occupied during transport to and from the hospital. However, what I realized after my interaction with her was that her isolation WAS an emergency. So, I’ll leave you with this piece of advice. Work to fill up someone’s emotional cup this week. If you are feeling lonely or isolated, open yourself up to the love of the people in your life. Check on or get to know your neighbors. It may not be easy, neither will it be perfect, but perhaps in time the abyss will begin to fill. Be a healer…the cure could be as simple as conversation. Sometimes, medicine is not about medicine at all!

*Name and some patient information changed to protect the privacy of others

©2019 Inspired Pharmacist

https://doi.org/10.1177%2F000312240607100301

Brushing Up on Dignity

IP1 Comment

I long to accomplish a great and noble task; but it is my chief duty to accomplish small tasks as if they were great and noble. -Helen Keller

A few weekends ago, my husband and I were driving home from a wedding late at night.  It was late enough that we probably should have stayed in a hotel and made the two-hour drive in the morning.  Instead, and he will probably give me some grief for saying this, we listened to and belted out show tunes nearly the entire way home.  I had control of the music, but he was a willing participant.  I digress, though.  Usually when the song “Will I” from the musical Rent comes on, I change it.  It’s a little too slow for staying awake.  For some reason, my husband stopped me this time.  “I like that song,” he said. As I listened to the words, I could not help but think of Mr. B.*

He was mid-forties, tan with an athletic build and sparkling white smile. He appeared to be the type who would not leave the house without perfectly starched and pressed clothing; his dark hair was expertly coiffed.  When I met him, however, he was wearing superman pajama pants.  His mom had given them to him before he was admitted.  She was sick too, he said, unable to be there for support – so he needed to be strong for both of them; he had no other family.  He was newly diagnosed with leukemia and preparing to receive his first round of chemotherapy.  We entered the room to discuss his plan and provide information on the medications he would be receiving.  When he invited us to sit on the couch with him, I knew I was in for the long haul.

It is not that I did not want to take the time to make him feel comfortable, it is just that I was an overwhelmed, impatient, first year resident, merely observing.  I could not really answer any of his questions, as this was one of my first days on rotation.  As the interaction moved forward, one question stood out to me, because he interrupted my colleague many times to ask it. “Can I still brush my teeth?”  The second-year resident curtly answered “yes,” each time.  As we left the room, I briefly contemplated why  brushing his teeth was so important, aside from the obvious consequences of poor dental hygiene.  For some reason, the desire to know the answer to that particular question seemed more vital to him than the wealth of other important information provided to him that afternoon.

I really did not think about it much more until the next day, when again, while we were on rounds, he asked “Can I still brush my teeth?”  Instead of just moving on, my preceptor paused and said, “Yes, Mr. B, but tell me a little more about why you ask that question.”  He answered, “you said when my blood counts drop, I might bleed more easily and gave the example that my gums might bleed when I brushed my teeth.  So, I just want to know if I can still brush them.  It will not feel normal if I can’t.”

Listening for the answer and not listening to respond allowed him to open up and connect with us.  It also enabled us to reassure him.  On the surface, it seemed like such a meaningless question. To the patient, the answer meant independence. By acknowledging his concern and answering the question honestly and with a shared understanding, he felt seen, heard, listened to – cared for.

George Elliott once said, “What do we live for, if it is not to make life less difficult for one another.”  While I do not believe you can take someone’s dignity away, I do believe during trying seasons, one may start to question his or her value. I learned through this interaction that in medicine, and our daily lives, it is important to recognize and give permission to others to discuss insecurities.  Doing so, may provide them with comfort and ease their worry. As for Mr. B, he could rest easy knowing he would not lose the small measure of dignity brushing his teeth provided.  I like to think it gave him a little boost of confidence, just like those superman pajamas.

 

Let’s talk more about it: What does it mean to honor someone’s dignity?

© 2019 Inspired Pharmacist

*Name and some details changed to protect the privacy of others.