Worth

At least once a week a patient verbalizes a belief about their worth.  It is usually, "I am not worth anything... anymore"  This makes me incredibly angry!!!  Angry at America who sees age as a weakness.  Angry at health care workers who give the impression that a patient is merely a cog in the machine of hospital.  Angry at myself for not knowing how to respond.  Angry at decay and death, which I don't believe is what God originally intended for this world.  Angry that a patient's body is giving out on them.  Angry... and sad... that a person expressing their felt worthlessness to a perfect stranger probably means that they have fought all their life against feeling worthless. Looking for worth in their body has failed.  Looking for worth in their career has retired.  Looking for worth in their relationships has died. Looking for worth in their money has been paid out in hospital bills.  Looking for worth in their ability and energy has laid down and said, "I am too tired to get up right now."   There I am, 84 and laying in a hospital bed... gorgeous white hair just like my grandma... will I have a sense of worth?  Will I feel the need to tell the first kind person I see that I am worthless?  If 50 year younger me walks into the room what would I say to my older self?

A lifetime in 15 minutes

Time stood still for me today.  No lie!  I walked into a patient's room and time stopped! There he was... an adorable old man who wears his shoes every time he walks "because they give me good stability".  I asked all the usual questions: Are you in pain? Have you fallen recently? May I test your arm strength? But the answers I received were brilliant.  "Maybe a little bit... in my buttocks"  "Well yes... but my family never lets me walk anywhere without one of them in front of me and one of them behind me.  So my son-in-law saw me starting to fall and he just grabbed me and lowered me to the ground"  "My right hand is weak because I fell out of an airplane... it's okay... it was still on the ground"   Minutes turned into years and before I knew it we were bearing our hearts to each other.  He told me about living with his daughter and feeling like he is robbing her of her life.  And I started to cry.  (Work cry of course.... eyes filled with tears but no spillage... but I could have wept right there)  And suddenly he was my own dad... needing a bit of help to get in and out of bed and having a nurse come to the house 3 times a week to bath him.  Behind his statement I heard the "I am old and not worth much anymore... definitely not worth the time of someone young with so much life left to live."  So I let him have it... I told him he was worth every damn minute of her life and mine too... of course it was tempered a bit differently but I think he heard my heart. I am pretty sure he started to cry (War veteran's cry of course... reddening of the eyes but no spillage) I also heard him say "they just don't listen to me." Now as I am sitting at home... years older from my 15 minute encounter with a beautiful life... I wonder about the line between care and respect.  Do we children care so much that we forget to listen to the simplest request?  "Go out with your friends, I will be ok here for 2 hours." Do we begin to hover to the point of debilitating our loved ones?  "Seriously kid, I can put on my own shoes... not the way I used to... but necessity gives birth to invention."  As I left my friend he told me to keep on smiling and I threw him my best EVER smile!  He chuckled and I felt like I could conquer the world. 

Sad Day

It was a sad day to be an acute care occupational therapist.  An elderly couple admitted because the EMT found their house in disarray and the husband threatened to shoot himself and his wife.  Their family did not know... and my heart breaks.  She told me that she "has a soft spot for that guy"  Then the guy who has been in the hospital for over 6 weeks.  When I first saw him he had no problem putting on his socks... today I had to do it for him.  What do I do with days like this?

15 minutes of sunshine

"Thank you for being cheerful." This is how my day ended at work. In acute care I am in and out of patient's rooms so fast... 15-20 minutes... out of bed, put the socks on, walk to the bathroom, use the toilet, wash the hands, brush the teeth and the hair and then back to bed or a chair. So many times the experience of patients in a hospital are long grey days: all blending. Together with equally grey people: pushing, pulling dour-faced. Mixed with the fog of pain, pain killers, sickness and disease. I find joy in being 15 minutes of sunshine in someone's grey hospital stay.

I'm Back!

SO it has been over a year since I have come back from Africa and I just wanted to let you know I am going to start posting again! I would like to say it is because of great demand but the truth is... I need to write here... I think it might be cathartic for me. I started a job on August 8th and after about 3 weeks I was already tired, stressed and a little jaded! Sure acute care is intense and fast and you need to know a lot about medicine... I like that part... the hard part is the sick people. (pause for sarcastic comments about working in a hospital) I don't easily brush off other people's pain and suddenly I am surrounded by lots of pain! As a student I really struggled with the physical pain... patients yelling or crying because it just hurt so bad. My heart would drop a little each time. But now I am struggling with the emotional and mental pain. Years of family pain brought to the surface by an aging parent who is no longer safe at home. Anxiety of being in a new place with a different language where you either can't hear or you can't understand. And now that I am an OTR/L, it is my responsibility to recommend where I believe in my expert opinion a patient should go. Anyway I need to find the gold nuggets. The bits of my job that remind me why I went to school and why OT is such a good fit for me. I like to think I am compassionate. I acknowledge that I will become jaded by the system and angry at it's injustices and frustrated by my inability to do anything about them. But I don't want to become jaded toward patients or to what I am doing. I don't want to blow off my job or my patients because I can't handle the pain... but I sure can't ignore the pain. And I am an extrovert so talking/typing is helpful in processing. I think that some days the pieces of good will be easy to see... like yesterday when a patient told me that I had a great personality for what I was doing and how she liked me and thought we could be friends in different circumstances. How delightful to be that kind of encouragement to someone in the 30 minutes I have with them. And the very next patient was comfortable enough to ask how he was going to wipe his butt with hip precautions! Last night I was thinking if I could just do the orthopedic case load everyday I would have more obvious moments like these. But today I think differently. I had to evaluate a little old white haired lady. This is not unusual since about half of my patients fit this criteria! But this lady had an old stroke and the left side of her body was contracted. She was on a stretcher looking lost, confused and afraid, her only ability to communicate was with her eyes and face. I was one of four people who transferred her back to her bed and it took two of us to sit her on the edge of the bed and one of us to keep her sitting up. At one point during the beginning of the process I just went to her side and held her hand and introduced myself. When our eyes locked, she had a flash of recognition, and I thought "she thinks she knows me". I started thinking... do I look like someone in her family? or one of her care takers? this could be my mom in 20 years... this could be me in 50 years... alone in a sterile place where strangers are pushing and pulling and demanding. Several times during the assessment I found myself holding her hand and she continued to look at me like she knew me. and I swear that when I spoke to her a little fear left her eyes. It wasn't until I was writing her note that I realized I had seen her before and assessed her... could she have possible recognized me from when I saw her last month? Could it possibly be that in her limited awareness she looked into my eyes and her soul said "we could have been friends in different circumstances"