My resident came to me with a new patient who he wanted me to follow: “This is an elderly lady complaining of dizziness and fatigue [details changed]. On a scale of 1 to cute, she’s cute.” He was right. I immediately made a connection with Alice [pseudonym]. Even through her pain and discomfort, she was always pleasant and smiling and quietly encouraging me as a student of medicine in her gentle Southern twang. An aura surrounded her that she had experienced a lot of life and had perhaps learned some of its secrets.
When it came time to discharge Alice, I was selfishly sad that I would no longer have the pleasure of her company. That was when I decided that I would ask her if I could visit her in her home as part of a required assignment for this clerkship.
The point of this assignment is to emphasize the human component of the patients we see. My perception of my patients is very much colored by the only environment in which we have interacted, the hospital. I may have had some enjoyable conversations with Alice, and I may have met some of her family and friends, but my perspective of her throughout her hospitalization was necessarily one-dimensional.
What is her home environment like? I knew that her son was taking care of her, but what is the exact nature of that relationship? How does she manage her medications? How does she get around the house? What does she do for fun?
Alice and her son welcomed me into their home. It’s a small house located on a busy street, and it’s equally busy inside bursting with plants and pictures. Alice was in the living room when I arrived; I watched her get out of her chair and make her way to her motorized wheelchair 10 feet away, assisted by her walker. The whole process took about 2 minutes.
Alice explained that she likes to move about by herself, but her son is usually nearby to help her if she needs it. She further explained that her son does all the chores around the house, including managing her medications and preparing food. I noted the dozen or so medicine bottles perched on a tray built into her walker and the smell of an early dinner coming from the kitchen, where her son was humming and cooking away.
I asked her about her hobbies and what she does to keep herself busy. Without trying to hide her disappointment, she described how she had previously been very active in her church community but is now unable to get out and socialize. She doesn’t leave her house much at all. Even getting to her doctor’s appointments is a big deal.
Then she voiced her biggest concern: “My son is getting tired. It’s a big job taking of caring of me. I don’t know when I’m going to have to move into a nursing home.” I realized that this issue must weigh heavily on her mind. I didn’t have any easy answers for her.
We spent the rest of our visit together looking at pictures on the walls and talking about the people from her past who she has loved. Then it was time to leave.
“Goodbye, Alice. Thank you for your hospitality.”
“There ain't no goodbyes, honey. I’ll see you in the Hereafter.”
Beautifully written!
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