Thursday October 1 Healing vs Treatment

I get up early. I anxious to see you and see how you did yesterday. I was thinking about the medical community and how it’s not really rewarded for healing. No, physicians and nurses are rewarded of treating patients. There is a difference. Healing involves the patient and requires a good relationship between medical care-giver and patient. Treatment is an act done to you. I think, there are times when life in a hospital gets so busy that the staff forget they are in the healing business, not the treatment business.

The other problem is that with the fast life of a teaching hospital, a patient can lose their identity. You are not known as Chris Cashen, husband, involved father, loyal friend, serious runner, funny guy, wood worker plus all the other hats you wear. You are known as the “45 year old male with idiopathetic critical hypertension that caused a significant hemorrhagic stroke of the right basal ganglia” … in bed 2.

They define you by your disease, the latest chapter in your biograghy, not by the whole book. It’s easier perhaps for the medical staff to think of you this way – but I don’t think it leads to good healing.

A relationship between patient and healer is fundamental for the best outcome. Without that bond there is an only a veneer of trust. Without a good level of trust, healing can not be complete. No wonder alternate medical practices are becoming more popular – people need people to heal … not treatments.

Family and friends play a role here. In your case, where there is no real relationship between you and your doctor, the doctor needs to develop that relationship with your support group … US. Since you were moved out of the stepdown intermediate care unit, I haven’t felt a realtionship.

OK, I guess I have finished venting now.

You are sharing a room with 2 other patients. It’s noisier and I haven’t seen a nurse yet. It’s 9am. The fan is on you. Courtney, the nurse, says your temperature is 37.4 – just below an actual fever. I wonder if it’s because if the urinary tract infection.

Physio Steve and Jill get you sitting up you are almost sitting without much help and you are lifting your head much better then 2 days ago. You are even looking around the room.

That maybe the advantage of missing a day with you – I see bigger changes.

We talk – actually I talk, you listen. Periodically, you try to talk but most of the time I can’t hear what you say. The odd time, when your voice is louder, the lady in the next bed who snores muffles it! It’s very frustrating for both of us.

We do some lip and tongue exercises – it wasn’t as much fun as it sounds. You actually have improved your tongue strength from Tuesday and you can even little puff sounds with your lips.

I brush your teeth and put some cream on your feet. You seem to enjoy this especially your right foot. The calluses are all starting to peel off leaving behind soft baby-butt like skin. Some women pay big bucks to exfoliate like that!

Your left hip is very sore. I suggest it’s because you have been recumbent for so long. Jill thinks not. “He’s too sore for that reason. The hip xray from yesterday didn’t show anything so some more xrays will be taken to look at the spine and pelvis.”

You seem restless, your right leg is constantly moving – I suddenly clue in. “Do you have to pee? Is that why your leg is so restless?” Vigorous Thumbs up. I go to find a nurse but before I leave, I ask you not to touch your NG tube so I don’t have to put on your restraints. I believe you nodded.

I go find a nurse and come back to you – I’m gone, maybe 3 minutes, and you pulled out your NG tube. Oh Gosh. I can’t trust you right now. I know you are sick of the tube – I try to explain that it is your only source of food and you need it.

The nurse comes and places a catheter – your face doesn’t show it – but I feel the relief. Within minutes of finishing the job you fall asleep.

In the video I saw Tuesday about Jason, the musician, the lack of facial expression after his recovery bothered me. Facial expression is such a big part of communication. I guess we can live with an emotionless face but it will be hard to get used to. On the other hand it might enhance your dry deadpan delivery when you being funny.

Physio Elaine is back to work your arm. You were still sleeping when she came – so you were a little goggy. She worked with your arm and tried to get you to look left. You were sleepy.

Shortly after Elaine left, Sue the speech therapist came in. You are a little brighter for her. She talked with you about how to communicate. She was trying to find the best way. You liked the thumbs up, thumbs down approach. She shows you a paper with the alphabet on it and asks you to spell your name. You start out strong: C…H…then you pause and hoover over the R then point to the S and then the I. She asks if you can see the board well – you gesture so-so with your hand. “Is it difficult to think how to spell?” Thumbs up.

We discuss what would help. She suggested that cue words might help. You may not be able to think how to spell – but you might be able to still read. We test you with Tara and Quinn’s names. You identify the right name to the word. This might work. I start making a list of cue words: Pee, Poop, Headache, Heartburn, Pain, Back, Shoulder, Hip, Knee Left, Right, Chair, Bed, Mouth Dry and Tired.

I leave the disability papers with the nurses for the doctor to fill out and sign. As I pack up to leave the nurses are putting back the NG tube. I’m sorry Chris – I won’t mention the NG tube again – just keep practicing your lip and tongue exercises and maybe we can get rid of it.

Marsha got me the phone number of the patient liaison for the hospital. I called and left a message to call me.

We get back from our third music lesson with Chella. Quinn’s enthusiasm is starting to fade. Hopefully it’s because he is still not well.

I return some dishes our neighbors, Harold and Leslie. Harold is also recovering from a stroke and helps me understand what things are like from your side. He tells me of a Stroke club that’s in Truro. They meet very regularly and act as a support group and resource for information. There is even some gym time to help you with your recovery. I know that this is a peak into the future but it is good to know there is local help.

The kids are in bed. I decide to tackle your room, the man-cave. I want to find the charger for your ipod. I start to tidy up. Your room seems empty and lonely.

The day we first saw our house I remember well. Sandy, the real estate agent, said after showing us a house we weren’t too thrilled with. “I do have other house. It’s not listed yet but it’s in the area you are looking.” We went to see it. You were interested. As we toured the house, I was thinking “Ohh it’s so dark” – I like the sun and sunny windows – it was too dark I found it hard to breath. I didn’t like the house.

You did. The more we toured – the more you liked it. And when you saw the ‘extra’ room downstairs – I think you fell in love. You envisioned immediately how that room could be your space. You were sold.

It took a little time and some convincing to bring me around. And I have to admit that the large lot size was very attractive to me. I could envision immediately how that could be my space.

Thanks to you we found our home and I love it now … We just need you back in it for it to feel full and lively again.

I never did find your ipod charger … maybe … soon you can tell me.