Tuesday, February 22, 2011


“Just relax, this won’t hurt” and then the skin is pierced, the tissue squeezed or the joint twisted. The word relax is related to the word laxative which is related to the word many say after the doctor, nurse or therapist say “just relax, this won’t hurt”. A person might just be reluctant to participate in further care.

Although, I’m not an etymologist, I do wonder about the words we choose and the expressions we depend on when treating patients. Another is, “don’t worry”. To worry is to think about the future as in, what will happen if I have this test, or take this medication. Naturally, most of us do not want to be in a chronic state of worry but given what life presents us, to worry may be an appropriate response.

And then the movie-like dialogue “you’ll never walk again”. I had a patient over 30 years ago, whose pelvis was partially severed along with multiple crush injuries due to an accident on a freeway shoulder. While she and her husband were outside their parked car, on a slope adjacent to the freeway trying to figure out what caused the breakdown another vehicle rammed through them.

I met Eleanor approximately two and half weeks later after she’d coded and been resuscitated numerous times. I was a weekend therapist, the first P.T. to have seen her. When I introduced myself she forthrightly stated, “I’ve been told I won’t walk again, but I will. Do you want to help me?” A marvelous person, determined, willing, knew things would be difficult, knew things would hurt.

Now my work is devoted to keeping the frail elderly in my community mobile. For some, they want to drive a car; others want to use a 3-wheel rather than a 4-wheel walker when attending a luncheon outing. Each knows – at some level - that they may not achieve their desires and they know they don’t have much time. To tell them “not to worry” would be disingenuous but to tell them “to worry” would be thoughtless, if not cruel.

A few decades ago there was discussion in my profession about what skills or behaviors were found in a master clinician. Distinct attributes would be culled and analyzed to replicate in future generations. A part of my definition of a master or effective clinician is one who develops a basis for trust with each of their patients by providing useful information. When I move this leg, Mrs. Connelly it may be uncomfortable; let’s try to avoid that by doing it this way. Or, I know Mr. Grant you want to return to driving, here are some things you need to be able to do to drive safely.

As a doctor, nurse or therapist you say you don’t have the time to prepare your patient for a test, treatment or decision? How would you rather spend your time?

Eleanor not only walked – but devoted her life to volunteering at a hospice near her home. I was teaching a course on the Psychology of Disability a few years after working with her, and was able to renew contact. I asked her to visit the class. Not knowing she would be a guest, I’d prepped them about the accident event, the extent and nature of her injuries, the rehabilitation effort. I played an audio tape that I’d asked her to make at the time about her near death experience. And then, she walked in the room, sat down and spoke to the group about what it means to own one’s life.

No comments:

Post a Comment