“Can you see Mom today?”
I told Beth to bring her mother Rose right in. “She only trusts you and she was sent home from the ER again. She had such chest pain. They said her heart is OK so it must be gastrointestinal. Right? And besides, she is losing weight, doesn’t eat enough. What do you think?”
Rose and her husband Sam had been patients of mine for many years. She was now 88, he was 89. Sam was suffering from dementia/Alzheimer’s. Rose was heartbroken. It was clear that her role as caregiver was literally killing her.
“He doesn’t seem to recognize me all the time” Rose said, her eyes welling with tears. “And you know how smart he was? He was valedictorian of his City College class and founded a very successful accounting firm. It is so sad to see him now.”
I could say little to her. “Does he seem to be suffering?” I asked.
“No….but I am.”
“Of course, it must be so hard to see him like that. But you have to take care of yourself now. You need to find time for yourself, away from Sam. Distract yourself. See your friends, grandchildren, go to the movies. And don’t feel guilty. See how you wound up in the ER. Rose, I you don’t find some peace, you will get sick. You won’t have the strength to be there for Sam”.
“I know this for a fact.” I told her. ” It happened in my own family.”
I thought back to my own life situation. Both my parents have passed on. But my father took responsibility for my mother as she was dying from dementia. He never acknowledged his own suffering. He probably didn’t realize how the daily stress was affecting him. As we were waiting for her to die under Hospice care, he “crashed” and almost died from overwhelming pneumonia. It was clear that his immune system had been horribly compromised. How? From unremitting stress over my mother’s condition. Soon my family was dealing with two dying parents. My father’s only desire was to be there when his wife died. Although she was “supposed” to die the day he was hospitalized, she miraculously lasted the five weeks that he was an inpatient.
She died a week after he was discharged and I was there when they reunited. She didn’t realize that he had been gone for more than a minute. I left the two of them alone. After the funeral, he fell and fractured his hip.
He survived several more years with relatively good quality of life. But his immune system never fully recovered.
So I see the scenario being play out again and again. Rose and Sam, Frank and Millie (my parents)–race and ethnicity become irrelevant. It is about love and loss. It is about being a witness to the most horrific of events– the loss of someone before their body dies. When the mind goes, there is little left but a shell. It is the hardest blow to take.
As a doctor I can’t help but bring my own life’s lessons to the exam room. It is a sacred place– where space and time give way to the challenge to heal what needs healing– be it mind or body.
And frequently it is both.