Thursday, October 20, 2011

Waiting For Help

Years ago I was resting in the wonderful light of a fall afternoon, dozing and drifting; my true source of the relaxed state. In the quiet I heard a tap, tap, tap. I didn’t want intrusion and went back to my daydream. In a few more moments, tap, tap, tap. I did not get up.

I learned the next day that my 92 year old neighbor had struggled, crawling out of her apartment onto the balcony to get help. Help from me. I saw her in the hospital. She never came home. All I have are some baking tins her grand nieces wanted me to have.

I know the intellectual response would be: “I couldn’t have done anything. She’d had a fatal stroke.” We didn’t know about early stroke intervention at that time.

But this is a completely inadequate response. Each time an animal is loose from its owners wandering the street, or someone trips and falls in an intersection, they need help. Our help. My help.

There is never the right time, enough time but each day we can make that effort. Our unwillingness to do so is a weapon of social destruction.

Walking down the hall at the small rehab hospital I work at I’m either focused on the next three things I’m to do or those little white call lights blinking and beeping. . .little cries for help. If I’m stressed I try not to make eye contact with the room’s inhabitants, because all my efforts to be a patient advocate come to bear and the patient in need will ask me to help them with picking something up, going to the bathroom, getting a question answered. They need the help then, not when I’m available. Oh sure, there are aides on the floor who are busy helping others. There is no queue, no soft voiced operator that will talk them through the intervening minutes. Many can wait; there are provisions for an accident in bed. There must be an equation that describes helping and waiting that addresses attention, anticipation, and anxiety.

Research tends to focus on victim versus bystander. The hapless victim - an inadequate description for a person being pummeled while others walk by.

I’m sitting at Kaiser, waiting for my third appointment of the morning. Made two appointments in advance, but was able to sneak in the third and have a procedure done. I love making waiting time work. With my mini laptop I can write this narrative, with my cell discuss the contents with my brother. So, even though I should and could be emptying my bladder for my next appointment. I defer that bodily need because there is something more fun, compelling, or just plain accessible to do.

Frankly, I hate to wait. I like to help, most of the time I love to help. But I seem to have limits.

I know that talking at people about the whys of waiting: “you are next in line”; “Suzy went on break”; “Suzy is helping someone else” and so on. Our brain just can’t take in the rationale. Waiting, becomes impatience, begets irritability.

I’ve been waiting to continue with my blog. I’ve been diverted with other compelling activities. A full-time job; an annual event; vacations. Great stuff, so much so I was willing to defer something I wanted to do which was writing.

When visitors enter the rehab hospital and see elderly persons sitting in wheelchairs, there is a visible response, ‘there but for the grace of god go I’ sort of look. Just because Ruth is sitting in a wheelchair at 4:00 in the afternoon with her head down should tell the world that she’s worked out for two and half hours, had a full shower, met with her family and continues to recover from her total knee replacement, while she is contemplating her recent visit to the neurologist to determine the cause of her arm tremors. She has a lot to do, and she is busy. Ruth is not waiting at all, unless you think she is waiting for the other shoe to drop. In that way, we are all like Ruth.

I think there is a place for a study here. As people recover from their medical procedure whether at home or at a hospital is there a relationship between their use of the call button or requests for help and their state of mind, their functional status? On the surface it seems like common sense the better the person is, the less they’ll need others. But I’m not sure we understand what calls for help really are. Perhaps with better understanding we might be better able to help those who are waiting for it.

How does waiting for a bedpan compare to waiting for a transplant organ? What are the levels of anxiety during the pre-help process? And just who will respond to a request/plea for help? Someone who has attended an in-service on niceness? Do men respond less than women, do those of the same race respond more to each other? Are we expecting heroes or helpmates as responders?

For clinicians this is the rub. Patients seek help from us and what we want to do is assess and treat. Help may be derived from this, but they most certainly will need to wait to get it.

Help with this article:

Eagly AH and Crowley M, Gender and Helping Behavior: A Meta-Analytic Review of the Social Psychological Literature, Psychological Bulletin Vol. 100, No. 3, 283-308, 1986.

Wegner DM, Crano WD, Racial Factors in Helping Behavior: An Unobtrusive Field Experiment, Journal of Personality and Social Psychology, Vol. 32, No. 5, 901-905, 1975.

The Good Samaritan Experiment

Science of Generosity, University of Notre Dame, 2009

Wilhelm MO, Helping Behavior, Dispositional Empathic Concern, and the Principle of Care (abstract), Social Psychology Quarterly, March 2010, vol. 73, no. 1.

Nauman, SE, The Effects of Norms and Self-monitoring on Helping Behavior, Journal of Business Behavioral Studies

Maister D, The Psychology of Waiting Lines 1985

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