Tuesday, November 22, 2011

Missing The Boat

Arthur's voice rattled as if small bits of gravel were stuck in his throat. His words resonated over the phone and felt more like commandments then questions.

Lillie's coming back home?

By home, he was referring to the assisted living that they both had inhabited for the last few years. But Lillie developed a severe case of shingles and was transferred first to the emergency room and then to the nursing home.

She was like many of the other patients in the dementia unit. Her complaints of pain were both persistent and monotonous. When it was explained that her belly discomfort came form shingles, she would calm down and become quiet. Moments later, however, she would forget the explanation and start to moan all over again.

As the weeks passed, Arthur would call from time to time. The nurses rumored that he was abusive and controlling. Lillie's son mentioned that having them apart was not necessarily a bad idea.


So when Arthur made plans to move into the nursing home and sleep in a bed alongside his wife, there was a general uproar. The nurses scurried in and out nervously expecting his arrival. The administrator paced back and forth in her office. Lillie's son sat quietly in the room with his mom.

When Arthur arrived I was surprised that the small thin frame belonged to such a powerful voice. He barraged the staff with a series of demands. They shook their heads but dared not disobey.

The months passed and a routine was established. Every now and then Arthur would spew forth another unreasonable request. The nurses felt less trepidation and grew bold over time. They began to understand that his bark was much worse then his bite.


I walked into their room this morning for my monthly visit. Lillie was perched low in her wheel chair and Artur was stooped over her, sitting on his bed. The TV was on and they were holding hands.

I flipped through the chart as I talked to them. Lillie's use of pain medication had dropped seventy five percent since her husbands arrival. I asked Arthur about her tremor.

When her hands start to shake, I reach out and hold them. She then stops within a few seconds.

There was no signs of being overbearing here. There were no accusations of alleged abuse.


There is no doubt that as health care practitioners we need to make decisions based on slivers of information. We become like cameras. We store a series of snapshots and use them to tell a story.

Yet clearly we occupy such a small portion of our patients life. We miss 99.99% of their existence. But sometimes it is in those miniscule moments, when doors are shut, that we see a true window into their souls.

If we are lucky, we may get a chance to be a part one of those moments.

If we are not-we might just miss the boat.

No comments: