July 2nd, 2007 by Dr. Val Jones in Medblogger Shout Outs
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I was really touched by Signout’s blog post about a charming octogenarian. It’s patients like these that make you glad to be a doctor… Signout writes:
I have a secret crush on one of my patients, an 85-year old man
who’s recovering from a bad pneumonia. After a weeklong stay in the
intensive care unit, he has recovered at a remarkable pace: the day
after he was extubated, he was out of bed with a physical therapist,
making his way slowly around the ward with a walker and a big smile.
What motivates him to work so hard at recovery, the
nurses say, is his love for his wife. They have been married 60 years.
She comes in to see him every day, wheeled around by their daughter.
The whole time she is there, they say, he holds her hand as if it is
the last time he will see her…
This man is the cutest patient ever… and the dear fellow reminds me of my husband (only a little bit older – the patient is older, not my husband – er, you see what I mean). One of my single friends asked me how I knew that Steve was the man I wanted to marry, I told them this:
“One day it suddenly occurred to me that if I had a traumatic brain injury or suffered from severe dementia and was totally incapacitated – Steve would faithfully care for me, never leave my side, and devote his entire life to my recovery or best quality of life. When I realized that he would do this for me without a second thought… I knew I had to marry him.”
Now, I’m not sure that Steve finds that image particularly romantic – but I do. It’s a doctor thing I guess.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 9th, 2007 by Dr. Val Jones in True Stories
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My grandmother was a kindly woman. She grew up in a frontier town in Alaska, the daughter of
a photographer. She lived simply, and
spent the majority of her waking hours figuring out how to stay warm. Much to her delight, her mother eventually
moved to San Francisco,
where she was able to thaw out and bloom.
She went on to marry a charismatic business man (one of the
early founders of Technicolor Films) and had 6 children, the first of whom was
autistic. It was a great challenge
taking care of all those kids, with her husband away on business much of the
time. And there were no special services
for children with autism then. So it
came as no surprise when my grandmother seemed a little forgetful and frazzled. But that forgetfulness was not so innocent as
it turns out.
Memory lapses grew into more advanced confusion, as her
children noticed that she was becoming unreliable. She would forget to pick them up from school,
couldn’t remember where they were going next, and didn’t recall what they had
told her only moments prior. My
grandmother had early onset Alzheimer’s disease – and it would take her on a
path of no return.
By the time I was old enough to know my grandmother she was
being cared for by home health aids. She
was still extremely sweet and gentle, and could have short conversations that
were interesting and engaging, but she had no idea who I was, or why we were
speaking. Still, her Victorian
upbringing caused her to be extremely well mannered – never letting on that she
secretly wondered why this “nice young girl” (a perfect stranger) was spending
time with her in her house.
But the strangest part of grandma’s journey with Alzheimer’s
was that it took her on a reverse tour of her former life. She seemed to be reliving each day that had
had the most emotional impact on her – in descending chronological order. So that some weeks she believed that each day
was her 60th birthday… and then she’d move on to each day being her
58th birthday, and so on… But the most heart-wrenching span of weeks
were when she thought it was the day of her husband’s death. She wept all day long, reliving the
experience. We would ask her why she was
crying, and she’d look at us incredulously, “Well, don’t you know that Kay died
today?” Our lack of appreciating that
obvious fact added to her extreme loneliness… as if she had lost her husband
and no one else cared or noticed. We
would try to dissuade her of that notion, reminding her of the actual date and
who each of us was. But alas, the
neurons that housed her emotions seemed to outnumber those that ordered her
memories, and so only time could change her of her perception of reality.
We all watched grandma deteriorate over the years, being
dragged backwards through time by some invisible force, verbalizing her
experiences as she relived them. It was
a kind of bizarre way to learn about her life – through the eyes of a woman who
told old stories as if they were currently occurring.
But eventually the stories ceased, and she regressed to a
non-verbal state. Her mind had finished
its story telling long before her body was ready to let go.
Grandma lived until the age of 96, and passed away
peacefully in her sleep. I can only hope
that she was dreaming of pleasant events in her early childhood when she
slipped into the ether – a baby in a shadow of memory.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
April 28th, 2007 by Dr. Val Jones in Opinion, True Stories
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A psychiatric nurse once relayed an observation to me that I
have been pondering for the last decade.
We were working together in an inner city “dementia unit,” populated
with patients with end stage Alzheimer’s, vascular dementias, and brain
disorders of unclear etiology.
Individuals were parked in geri-chairs in institutional hallways, others
were in bed in 4 point restraints for their own protection, still others were
muttering to themselves in wheelchairs.
We were discussing the case of a particularly unpleasant
patient – he would swing at people as they got near him, trying to hurt them –
scratching, punching, even biting if you got close enough. His favorite thing was to grab nurses’, or
other female staff’s, breasts or crotches. He rarely succeeded at this, since most staff
were aware of his tactics, though he sat in his chair nearly motionless, like a
Moray eel in a reef cave, small eyes and snaggle teeth, mouth open slightly at
all times, taking slow deliberate breaths as he waited for an unsuspecting ocean
dweller to wander inadvertently into his reach.
I asked the nurse how she thought he had gotten to be so
rotten. She replied simply, “When people
get older they become more like themselves.”
That one sentence has fascinated me ever since. Could it be that as we age (and our minds
lose their ability to maintain the social graces we were taught), we slip into saying
things in an uncensored manner, and behaving the way we truly want to? Or is the difference between “sweet little
old ladies” and “mean old biddies” a matter of how much damage there has been
to their frontal lobes?
The scientist in me would like to explain away all agitation
as an organic brain disorder. But I just
don’t think we can reduce human behavior to neuroanatomy. The complexity of a lifetime of circumstances
and individual choices – and their interaction with personality – are soul-defining.
Perhaps age brings wisdom and life experience… or maybe it
unveils the truth about who we’ve been all along. Either way I have a feeling that when the time
draws near for our bodies to give up our souls, we can catch a glimpse of what people
are “made of” in their final words and deeds.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
April 12th, 2007 by Dr. Val Jones in True Stories
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I worked in a hospital that was so old that the bathroom doors in the patient rooms were not wide enough to accommodate a walker or certain kinds of wheelchairs. The hospital had resisted any upgrades, because the building codes stipulated that if any improvement was made, all of the necessary upgrades were required. The cost to fully comply with the new codes was enormous, and so in some twist of bureaucratic irony – nothing changed for decades upon decades.
One morning I entered one of my patient’s rooms to check on her. There she was, 4’11”, 85 years old, with a white bob and a thin frame, wearing nothing but a hospital gown tied only at the neck. She smiled brightly as she caught my eye. She was clutching her walker, attempting to exit her bathroom straight on. I watched her as she slowly inched towards the narrow door, bumped into it and then backed up to try again. She made several valiant efforts to get out of the bathroom, holding onto her walker for stability. (Though none of the attempts involved turning the walker sideways to fit through the door.) Trapped and befuddled she smiled at me good naturedly and concluded, “I think this hospital gown is too heavy.”
When I remember this patient, I imagine how so many people are trapped in the healthcare system that is old and poorly designed. They want to get through barriers to care, have inadequate resources, and a limited understanding of what’s actually blocking them from the help they need. If you feel that “your gown is too heavy,” I hope that Revolution Health can make things better for you… we want to empower you to understand the problem and get the help you need. Let us know how we can help!
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 5th, 2007 by Dr. Val Jones in News
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In this latest report from the BBC, we see that our friends across the pond are just as obsessed with appearance as we are in America. Apparently, women in their 70’s and 80’s are getting cosmetic breast surgery and face lifts.
One surgeon is quoted as saying:
“We have a growing population of pensioners – and for those who want to maintain a good appearance, ageing gracefully, the surgical options are there.”
Since when did gracefulness have anything to do with surgery?
I wonder if we’re missing the more important things in life (friendship, love, kindness, charity) by focusing on our exteriors? Beauty is a matter of the heart, I think.
Sophia Lauren once said, “Nothing makes a woman more beautiful than the belief that she is beautiful…” but then again, it looks as if she’s chosen to have extensive cosmetic work done as well.
What do you make of the growing trend in plastic surgery among seniors?
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
