I'm not a doctor or a nurse, but I have patients. It's amazing what you can learn to do. I take temperatures, check blood pressure, administer chest physio, nebulize, adjust medications, give enemas. I can even insert a feeding tube.
A few days ago, Masiji's blood pressure shot up to 150 over 110. I cured her.
Of course I called Dr Sebastian for advice, but the cure came from me. And it was that simple. A little time; a little attention; a little touch.
Masiji is a person who needs excitement and variety in her life. She likes drama and she thrives on attention. And it struck me as I was checking her blood pressure the evening of the day it shot up, that as a widow living far from her own children, nobody touches her now. Although she lives with us and even shares a bed with her sister, she has almost no physical contact with anyone.
Being unwell automatically means touch. My hand on her wrist as I check her pulse. On her shoulder as I help her out of her sweater so I can put the bp cuff on her arm. Fixing the stethascope under the cuff, my hand now beneath her elbow to hold it steady. It struck me.
And so, though Sebastian told me I should check her BP once each day, I decided to do it twice - morning and evening. I added the little detail of bringing a notebook so I could write down the result. As far as possible, I stuck to the same time each day - to show her I was taking this seriously. Every day I would explain again the difference between the systolic and diastolic readings and why we were more concerned with the second number than the first. Every day, we discussed her medications, discussed the need for exercise and stress reduction and how she really should lose some weight. Every day.
And it was while I was doing all this that I realized how much of medicine is not the interventions - the medicines, procedures, surgeries and tests - but the human contact, the questions, the listening, the concern, the attention, the touch.
When I accompanied Vikram to Delhi for his six-week checkup (almost flying colors! almost complete recovery!) I was struck by the contrast between the two doctors we met. One spoke almost exclusively to me, in English, focused on the test reports and the brain scan rather than on Vikram and didn't lay a hand on him. The other spoke in Hindi, asked V a lot of questions, listened carefully to his answers and, in a startling - these days - divergence, actually physically examined him. Vikram came out of the first session feeling anxious and confused; out of the second relaxed and hopeful.
How much of good medicine is about listening, about genuine concern, about touch?
It's not easy. Patients, by nature, are plaintive and querulous. Their concerns are the only ones that matter and they have no idea of all the other things the doctor or nurse is thinking about. To them, their headache, their coughing, their pain is the only thing in the world. But good doctors enter into their world and help them to find the road out.
Yesterday, when I went into Masiji's room to check her blood pressure, she waved me away. "Not today," she said. "I know it will be too high."
"Why is that, Masiji? What happened?"
Turned out she and Mummy had had an argument. An inconsequential fight over nothing in particular, though she needed to tell me every single detail. My job, clearly, was to listen. No advice, no pointing out any inconsistencies. Just to listen.
When she was finished talking, I took her blood pressure. 140 over 70. She was cured.
A few days ago, Masiji's blood pressure shot up to 150 over 110. I cured her.
Of course I called Dr Sebastian for advice, but the cure came from me. And it was that simple. A little time; a little attention; a little touch.
Masiji is a person who needs excitement and variety in her life. She likes drama and she thrives on attention. And it struck me as I was checking her blood pressure the evening of the day it shot up, that as a widow living far from her own children, nobody touches her now. Although she lives with us and even shares a bed with her sister, she has almost no physical contact with anyone.
Being unwell automatically means touch. My hand on her wrist as I check her pulse. On her shoulder as I help her out of her sweater so I can put the bp cuff on her arm. Fixing the stethascope under the cuff, my hand now beneath her elbow to hold it steady. It struck me.
And so, though Sebastian told me I should check her BP once each day, I decided to do it twice - morning and evening. I added the little detail of bringing a notebook so I could write down the result. As far as possible, I stuck to the same time each day - to show her I was taking this seriously. Every day I would explain again the difference between the systolic and diastolic readings and why we were more concerned with the second number than the first. Every day, we discussed her medications, discussed the need for exercise and stress reduction and how she really should lose some weight. Every day.
And it was while I was doing all this that I realized how much of medicine is not the interventions - the medicines, procedures, surgeries and tests - but the human contact, the questions, the listening, the concern, the attention, the touch.
When I accompanied Vikram to Delhi for his six-week checkup (almost flying colors! almost complete recovery!) I was struck by the contrast between the two doctors we met. One spoke almost exclusively to me, in English, focused on the test reports and the brain scan rather than on Vikram and didn't lay a hand on him. The other spoke in Hindi, asked V a lot of questions, listened carefully to his answers and, in a startling - these days - divergence, actually physically examined him. Vikram came out of the first session feeling anxious and confused; out of the second relaxed and hopeful.
How much of good medicine is about listening, about genuine concern, about touch?
It's not easy. Patients, by nature, are plaintive and querulous. Their concerns are the only ones that matter and they have no idea of all the other things the doctor or nurse is thinking about. To them, their headache, their coughing, their pain is the only thing in the world. But good doctors enter into their world and help them to find the road out.
Yesterday, when I went into Masiji's room to check her blood pressure, she waved me away. "Not today," she said. "I know it will be too high."
"Why is that, Masiji? What happened?"
Turned out she and Mummy had had an argument. An inconsequential fight over nothing in particular, though she needed to tell me every single detail. My job, clearly, was to listen. No advice, no pointing out any inconsistencies. Just to listen.
When she was finished talking, I took her blood pressure. 140 over 70. She was cured.
8 comments:
These are the tips all children should take who are taking care of their old parents.
Healing has to be so holistic to really work..its so true.Medicines have their limitations.There is more power in words.touch and showing caring.
This is so well expressed,Jo
Thanks, Sumita. I find it's easier to write about it than to do it!
And Jyotsna, thanks to you too. You should both read the comments on my facebook version of this story - so many people share their own accounts of how this kind of healing has happened in their own lives.
You create yourself in ever-changing shapes
that rise from the stuff of our days –
unsung, unmourned, undescribed,
like a forest we never knew.
You are the deep innerness of all things,
the last word that can never be spoken.
To each of us you reveal yourself differently:
to the ship as coastline, to the shore as a ship.
- RILKE
You create yourself in ever-changing shapes
that rise from the stuff of our days –
unsung, unmourned, undescribed,
like a forest we never knew.
You are the deep innerness of all things,
the last word that can never be spoken.
To each of us you reveal yourself differently:
to the ship as coastline, to the shore as a ship
-RILKE
Thanks, Ajay. (And I promise you I have never edited out your comments! Must be an internet glitch.)
Hi
I was introduced to your Blog by a relative of Glenn MacGowan who I believe is your cousin... We go back a long time,
However, more than that both Shirley and I are Doon people. I was born and raised there whilst Shirley is the daughter of a Colonel (Thompson) from Clement Town. My mother was Queenie Barnes, one of the founder Teachers of Cambrian Hall.
We used to have a Mrs Chopra then who lived at the corner of EC Road. She had the same looks as you do have and I was wondering if you are somehow related...?
I was born in Doon (1953)
Glenn and Dorothy met us when they came to teach at Ranchi where we were at the time (1979 / 80)
I am amazed at the good work you are doing and will keep visiting
Sincerely
Ray Barnes - Patna
Hi Ray! Thanks for the lovely comment. Glenn McGowan is, I think, a relation of a facebook friend of mine in the UK who is married to a McGowan and has put me in touch with many of her relatives. I'm not related, as far as I know.
And I am first-generation in India. I'm American and my parents are Irish and English. My husband is a Chopra from Mumbai, originally from Lahore. How the world spins!
All the best to you and your family!
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