It's so simple to be wise.  Just think of something stupid to say, and then don't say it.     Sam Levenson (1911-1980)

Tuesday, December 30, 2008

"You Should Have Met Me Before..."

I'd been hearing great things about a certain patient, a young woman, but my previous attempts to meet her had fallen on bad timing.

I always get a little nervous approaching a patient for the first time... I never know who I'll be meeting, what state she'll be in, especially at the early stages of diagnosis.  Overwhelming emotional storm?  Breakdown?  Confusion?  Denial?  Contradictory, shifting affect?  All of the above? Will she even register our introduction, or -- often as not at this early stage -- will she mistake me for a physician or nurse, and set forth a litany of disjointed questions about medicines, central catheters, fevers? 

But yesterday morning, there was G, smiling, inviting me into her little corner of the outpatient clinic.  Is this a good time? I ask.  Of course!  Why not? is her immediate answer.   She is already succumbing to the soporific effects of the meds she's received, but with little encouragement she gushes into a brief description of herself.   She has this job and that hobby. She is involved, engaged, active.  
You should have met me before.  I was the athletic type.  I used to run, do aerobics all the time. I was a teacher, I had a whole class of kids, ran a whole educational program.  I love art, love to write.  
I'm trying to keep up, listening at 100 km/hr.  I tell her we can offer her art therapy, bibliotherapy.  Meanwhile I'm noting all the was's and used to's.  That part has me a little worried;  she's only just begun treatment, and she's already left central parts of her identity behind.  She is clearly a doing person -- and for now, she is not doing, therefore she does not feel fully herself.  I can relate, all too well.   

I weigh my options.   Do I remark on the used to's, thus beginning the teeniest intervention without having had the time to really meet her, or do I let it go and make a note for later?  

Her oncologist steps in to inquire about her general welfare, and I gain a few more minutes to think, listen and decide.   I am impressed with how readily and directly she describes the recent state of her digestive system.  After all, he may be a physician, but he's a guy, and she's a young woman... who seems to understand the value of accurately reporting her physical state.

He goes, and we resume our conversation.  Meanwhile, I've made a decision.  You're still a teacher, you know.  You're on a break from teaching, but you're still a teacher.  And it really shows that you're an energetic, athletic person, despite all these tiring treatments.  We move into a brief discussion of what it means for her to be forced into this unwanted break from her active life.  At this first glance, she seems to know exactly what her limitations are, and what she still can do.  She is eager to move forward while she can.
I want to learn some art techniques, and I want to meet the bibliotherapist.  We should get started, right away.   But for now you'll have to excuse me, I'm a little stoned from all these drugs, I think I'm falling asleep...
I tell her it's been a real pleasure meeting her and excuse myself.   Her enthusiasm and optimism are contagious, and I find myself smiling as I exit the room.  I'm so happy to finally meet her,  I mention as I pass her oncologist. What a fantastic person. 

He looks up.  Don't get too attached.  Looks back down at his paperwork.

A sudden rush of air, and all that contagious enthusiasm has collapsed.

He means well.  Maybe he was just trying to look out for me, or for himself.  And yes, I am aware of the dangers of her illness.  But getting attached is part of the work.  I can't do my job without it.

Anyway, it's too late.

Keep the balance,



SuperRaizy said...

This was a very moving post. It's so true- being ill seems to rob people of their sense of identity: "I used to be a teacher, now I'm a patient. I used to be athletic, now I'm sick." I'm sure that you helped her out a lot by just listening sympathetically.

muse said...

I just don't have words for this. Yasher koach, how do you find the strength?

RivkA with a capital A said...

Wow. I was fine... 'till I read the doctor's words.

I wonder sometimes, about that very issue. Getting attached.

What can I say? I think my caregivers are "attached" to me. Either that, or they do a good job of faking it!

I can relate very strongly to the me "before" and the me "after." It's hard to accept the new limitations, even when they are not so new anymore....

I used to be a tour guide, an educator, an activist.....

I still do a lot. But not what I used to....

A Living Nadneyda said...

RivkA - I think one of the very special things about you is that you are very you, wherever you are and whatever you do. The limitation part sounds very difficult, and frustrating, and at the same time, I believe the people who know and love you think of you as the same person you have always been, despite -- and because of -- your life experiences and challenges.

The doctor is an excellent physician, and a sensitive person. His comment threw me for a real loop but I can understand the feeling... to connect deeply with people, again and again, and to see them suffer and sometimes die-- we have to protect ourselves in order to keep connecting to people and still keep ourselves whole. It's a terrible irony.

I have no doubt that your caretakers are very attached to you.