Thursday, February 2, 2012

Life and Death

She looked about 8 years older than I am, yet she was two years younger.  She was distraught, talking a mile a minute, and it was difficult to understand why she had come other than "my knee hurts".  She was about 5 feet tall and very, very overweight.

As it happens, her knee had been hurt a week ago in a fall; she had had a chest xray a week ago, and an injection in her knee by her primary care two days ago. It took awhile to pry out of her the details of her injury.

"I fell down. Then my son picked me up under the arms and threw me back down. I think he kicked me".

No, she didn't want to report it to the police.  "A mother's love".  There were other circumstances, no he's never done it before.  Yes, I feel safe; he doesn't live with us.

The only medication she was on was ibuprofen.  Her only  medical problem was fibromyalgia.

The extenuating circumstances?  Her husband had just been diagnosed with terminal cancer and had less than 3 months to live, she cried.  And cried.  And cried.  The son had "overreacted" when they had told him about his dad's diagnosis.  Perhaps the wife had "exaggerated" a bit about what actually went down said the husband with a sidelong glance at me.


The husband looked pale, and none too healthy himself.  Yet it was clear that he loved her and had probably done most of the physical and emotional lugging and tugging for most of their marriage.  She was not a small woman.  She was demanding and dependent.  He knew everything right down to the color of her last bowel movement.  He was a one-man band; caretaker, cheerleader, enabler.

I took her back to a treatment room and settled her into a bed where she was seen by Henrietta. Shortly thereafter I overheard her on the cell phone, "Yes, unless I can walk and get around they are going to admit me".  What?  She had walked in.  I shot a quizzical look at Henrietta; were we on the same page, here?  "No, I never said that", Henrietta whispered, "they seem to have a lot going on right now".

The patient seemed to have no difficulty walking to the bathroom, although the husband was never more than an arm's length from her side tucking in the blankets, fluffing the pillows,dialing her cell phone.  Between phone calls, she wept.

She did not have a fracture.  Henrietta ordered a knee immobilizer but the widest one we have is 29 inches at the top; this lady measured about 9 inches larger than that around the thigh.  Crutches were just not going to work at all.  The only thing I could offer was a couple of large ace  bandages which were nothing more than a band aid, but it seemed to make her happy. That, a Percocet and some Ativan.

As I was going over her follow-up instructions, she suddenly burst into a fresh wash of tears.  "What am I going to do?", she wailed to the husband.  "You only have two months to live, then what will happen to me?"

I was....stunned.  So was the husband, who was now a whiter shade of pale.

"Well....I HOPE I have more time than that.  We never know, we never know.  The doctors aren't always right on the money about these things".

"I know, I just feel so....ALONE", she blubbered.

I have never felt worse for another living human being then I did for that husband.  He had trained her to be so dependent on him that now his death had become solely about her.  My first instinct was a desire to slap her, and it embarrasses me to say that.  But it really wasn't her fault completely.  He had created it and now was helpless to fix it.  I put my arm around his shoulders and said, "Sounds like you need some help", but I included the wife with a glance.

As I mentally ran through my social contact options, community resources, pastoral care, etc, the husband said that they had just talked to their pastor.  Their church was very giving and kind, and they had lots and lots of resources. They just needed to get the ball rolling and plugged in.  I asked if there was anything I could do for them at the moment, or help them in some other way.  They declined, with thanks. The wife wiped her eyes and off they rode into the sunset; he to a death sentence, she to cope with her anticipated loss and grief. As for the son....I can only imagine.

Sometimes the complaint has nothing at all to do with why they are here, we know that.  These people were simply overwhelmed.