Patient #1 - Loneliness
My first appointment today was with a man I've been working with for a while. Actually, Friday is our last day together. He has a lot of issues - chronic pain, post-traumatic stress disorder brought on by his career as an FBI agent, Parkinson's, depression - the list goes on and on. Very nice guy - I enjoy our sessions as long as I steer him away from political topics. Today I asked him what he felt his main limitation was after all our weeks together. His answer - "Loneliness". This is the type of patient who breaks my heart. He tries so hard and has so many things stacked against him. There is only so much I can do to help. Sometimes when he starts ranting about the government and Obama and healthcare I feel my internal eyes rolling upward (sigh, not again . . .) but I understand. He needs something to focus on and voicing his opinion about everyone who is "out to get me" makes him feel empowered and perhaps not quite so helpless.
Again - sweet guy. Look at this pillow he has sitting on his bookshelf . . .
He walked past a framed photo today of himself with his three children in happier times. He said "That photos makes me cry. Some people might call that selfish. I call it love." He makes ME want to cry.
Sometimes, however, he says things that make me feel really happy. A few weeks ago I was saying good bye to him and I reached out to shake his hand. We shook hands and I said "Have a nice afternoon and I'll see you on Thursday." He replied "You know, I can tell you have a lot of character." I raised my eyebrows as if to say, "who, me?" He continued "You look people straight in the eye when you talk to them. Not a lot of people do that." I found that interesting, because sometimes I feel like I'm NOT looking people straight in the eye, like I'm looking at every little part of their face EXCEPT in the eye. I guess I've been wrong all along.
Patient #2 - Confusion
My second patient today was another gentleman who I've also been visiting for several months. I basically just go in there and do chair exercises with him because he's not allowed to put weight on his right leg for a while. This guy has a lot of issues too - Parkinson's and dementia, a bad combo. Every time I see him it's like we're meeting for the first time. "Who are you? Who sent you? Where's my wife? I won't do the exercises without my wife. Who sent you?" His dear sweet wife is also there but also has significant dementia and talks about her parents and grandparents as if they are still alive. She has a lovely smile and it's always much better when she's sitting beside him because he gets a big smile on his face and does his exercises without complaining. Every now and then I'll get a sly little grin from him and he'll joke around and I get the inkling of something a little deeper there, just for a moment.
On certain days he's extra resistant to doing the exercises and I find myself having those conversations inside my head, saying all the things that I would never say out loud. "Just do the freaking exercises, for crying out loud! How many times do I have to tell you that the doctor sent me, that this is good for you, that I'm the physical therapist and just kick your foot up, damn it, before I scream!!!" But I just smile and gently encourage him to do the things I want him to do. The silent conversations help me get through the toughest days. This is how I practice patience.
Patient #3 - Tragedy
This one was tough today. I went into my third patient's home expecting the easiest visit of the day. This lady had a total knee replacement and those type of patients are usually a piece of cake - three times a week for two weeks, exercise the knee, work on walking with a cane and get them to outpatient therapy by the third week. I was not expecting to find my patient in the throws of despair, having just received the news the previous evening that her grandson had passed away. I won't get into the details of what happened for fear of disclosing any private information, but let's just say it was very sudden and unexpected.
Having experienced the loss of my dad so recently, I knew the best thing was just to let her talk and not to say too much beyond sympathetic murmurings. The poor lady was in shock and as she told me the details of what had happened I felt my eyes welling up and I thought oh, no! I CANNOT lose it in front of this poor lady who I just met a few days ago!!! That would not be good. I managed to hold it together but it was a long, tough hour. I felt bad making her go through the exercises but she wanted to do it. I left feeling emotional and confused.
Patient #4: Fatigue
My fourth patient is a sweetheart - very nice, elderly Asian man who speaks no English so his pleasant son translates for me. The poor guy sleeps in the cold basement of the townhouse that belongs to his daughter and her husband, along with a Rottweiler who sits in a crate during my visits, staring at me longingly while drooling profusely. I really want this poor man to be able to go up and down the stairs so he can get out of that depressing basement for more than just his meals, but every time we try he stops about halfway up and just sits down on the steps in exhaustion. I feel somewhat helpless with this type of patient because there's not much I can do beyond what he's physically capable of. I'm usually in and out of there in less than an hour and I leave feeling a bit useless. He always gives me a sweet smile and a nod as I'm leaving which makes me feel a little better. Today I smelled like incense for about half an hour after I left there - the smell reminded me of something, but I still can't put my finger on it.
Patient #5 - Resilience
I don't usually see five patients in one day, but today I had to squeeze an extra one in. This guy is someone I'd seen before Christmas for about six week but then he became ill and we had to put things on hold for a while. I was looking forward to seeing him because he's always very complimentary of my expertise as a physical therapist. He's also just a very nice man.
When I returned to work in November after my dad's funeral all of my new patients were men. This particular man was one of them. As I visited him and helped him to improve his mobility despite many hurdles in his path (chronic edema, heart ailments, shortness of breath, etc.) I found myself forming a real bond with him. Here was a man who had one physical ailment after another thrown at him and yet he persevered with a positive attitude and an unending willingness to comply with his therapy. It didn't hurt that he repeatedly called me the "best therapist I've ever had" and basically showered me with praise every time I visited him. I started scheduling him at the end of my day because that way I'd always end my day on a high note. I opened up to him and told him about my father and he expressed such a genuine interest in learning about my dad that it endeared him even more to me.
Today when I saw him he was markedly weaker than he'd been a month earlier, but still with a cheery disposition and an interest in my own well-being. As I took him through the standard tests we are required to do now with all of our patients, he commented on how scientific I was in my approach and added "You must get that from your dad." He tried his best to keep up with everything I asked him to do, despite the fact that he was obviously tired and low on energy. We ended our session with the promise of another visit tomorrow to get him back on track with his exercises. His parting comment was "Your mom must be very proud of you."
Do I need that extra bit of patience with this man? Do I have silent conversations with myself when I'm with him? Not one bit. In this situation, he is the one with patience. He has learned to be patient with himself and with his body which repeatedly fails him. He teaches me what it means to be patient, not just with others, but also with myself.
Unfortunately, sometimes that means by the time I get home to my husband and two kids, my patience has worn out. But that's another blog post for another day.
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