Barrett Dorko
17-05-2008, 03:09 PM
It’s been a quiet week in Cuyahoga Falls…
Me: So, how did you feel the day I actually saw you?
Patient: (Pause) I don’t remember.
After three months of switching me daily between two very different facilities the company contracting for my services has decided to leave me in one place for the duration of my agreement. Now I can settle down, organize my records, drive in the same direction each day and maybe, just maybe, my patients will remember their reaction to care long enough for me to figure out how they’re actually doing.
My thoughts about geriatrics and the application of neuroscience to manual care have come in waves the past few weeks and I finally feel ready to commit some of them to a blog entry. This is it.
As my Aunt Alice once pointed out to my siblings and me when she saw us recoil from the crowds of unusual looking strangers in downtown Cleveland – “These are just people.” Her speech ended there but she spoke firmly and I got the point. The surface tells us nothing and unless we consider the possibilities beneath and seek some depth of knowledge we’ll reveal our prejudicial nature and miss a lot. “Looking good” for the patient is as important as it ever was, or not. What I find of interest to me is something both easily hidden and revealed within the context of their current situation. I’ve found humor, sadness, loneliness, gratitude, regret, despair, fear, desperation and determination – and all of that in a single patient over the course of a couple of sessions. These qualities are unrelated to their physical capabilities.
I’ve said in the past that people learn themselves out of pain. Movement plays a role, of course, but so does memory and attention. It’s not possible to say when any patient crosses that boundary between what they’ve known and the acquisition of new knowledge. The therapist has to probe this gently. They have to figure this out as best they can and accept what they find.
I remain convinced that even thirty seconds of Simple Contact and ideomotion can have a profound and enduring effect though I have no data to indicate this; just the quiet acceptance of the patient in my hands. Many have been unable to speak.
Every time I inch forward toward some actual control over the mountain of paperwork needed to justify care I am pushed back very firmly by someone or something that needs even more.
A variety of therapists surround me. None seem truly interested in changing the way they think or behave. If they read much it’s not obvious. Most are nice enough, I guess. I get along, but say very little about where I’ve been or what I think, that is, compared to what’s going through my head about what I could say. I’m passing through and they know it. So do I.
My parents both died in settings such as this but I never “see” my mother. Something in my brain has saved me that vision and for that I am grateful. I see my Aunt Alice though. She’s everywhere among the beautiful, smiling women in their 70s and 80s living independently in this sprawling complex. I enjoy discovering her again and remember our many visits before she smiled no more. The men simply don’t remind me of my father, but while walking by a room the other day I saw his shoulders.
After a year away from patients I’ve discovered that I can still do this, that I can sit quietly and wait, I can say the right thing and, sometimes, the wrong thing. It appears to flow naturally from me though I know how long and hard I’ve worked at its cultivation. I don’t consider myself a “natural” caregiver but the task is integral to my becoming something else. I’ll let the students and readers I’ve had and will have decide what I want that to be.
I think I know, but these days sometimes I have to work to remember
Me: So, how did you feel the day I actually saw you?
Patient: (Pause) I don’t remember.
After three months of switching me daily between two very different facilities the company contracting for my services has decided to leave me in one place for the duration of my agreement. Now I can settle down, organize my records, drive in the same direction each day and maybe, just maybe, my patients will remember their reaction to care long enough for me to figure out how they’re actually doing.
My thoughts about geriatrics and the application of neuroscience to manual care have come in waves the past few weeks and I finally feel ready to commit some of them to a blog entry. This is it.
As my Aunt Alice once pointed out to my siblings and me when she saw us recoil from the crowds of unusual looking strangers in downtown Cleveland – “These are just people.” Her speech ended there but she spoke firmly and I got the point. The surface tells us nothing and unless we consider the possibilities beneath and seek some depth of knowledge we’ll reveal our prejudicial nature and miss a lot. “Looking good” for the patient is as important as it ever was, or not. What I find of interest to me is something both easily hidden and revealed within the context of their current situation. I’ve found humor, sadness, loneliness, gratitude, regret, despair, fear, desperation and determination – and all of that in a single patient over the course of a couple of sessions. These qualities are unrelated to their physical capabilities.
I’ve said in the past that people learn themselves out of pain. Movement plays a role, of course, but so does memory and attention. It’s not possible to say when any patient crosses that boundary between what they’ve known and the acquisition of new knowledge. The therapist has to probe this gently. They have to figure this out as best they can and accept what they find.
I remain convinced that even thirty seconds of Simple Contact and ideomotion can have a profound and enduring effect though I have no data to indicate this; just the quiet acceptance of the patient in my hands. Many have been unable to speak.
Every time I inch forward toward some actual control over the mountain of paperwork needed to justify care I am pushed back very firmly by someone or something that needs even more.
A variety of therapists surround me. None seem truly interested in changing the way they think or behave. If they read much it’s not obvious. Most are nice enough, I guess. I get along, but say very little about where I’ve been or what I think, that is, compared to what’s going through my head about what I could say. I’m passing through and they know it. So do I.
My parents both died in settings such as this but I never “see” my mother. Something in my brain has saved me that vision and for that I am grateful. I see my Aunt Alice though. She’s everywhere among the beautiful, smiling women in their 70s and 80s living independently in this sprawling complex. I enjoy discovering her again and remember our many visits before she smiled no more. The men simply don’t remind me of my father, but while walking by a room the other day I saw his shoulders.
After a year away from patients I’ve discovered that I can still do this, that I can sit quietly and wait, I can say the right thing and, sometimes, the wrong thing. It appears to flow naturally from me though I know how long and hard I’ve worked at its cultivation. I don’t consider myself a “natural” caregiver but the task is integral to my becoming something else. I’ll let the students and readers I’ve had and will have decide what I want that to be.
I think I know, but these days sometimes I have to work to remember