Yesterday in clinical, it was my turn to pass meds for the first time, but that just ended up being another part of a day that kind of took its own path and really made an impact on my life.
I was assigned a patient who presented with a large skin infection secondary to an almost-lifetime of Multiple Sclerosis, an awful autoimmune disease where essentially, a person's immune system attacks their nervous system. It's really an exceptionally devastating disease. As it progresses over the years, it slowly injures a person's nerves, impairing their physical functions. Walking, talking, simple movements, cognitive functions, sensation, sometimes even breathing... it is indiscriminating and ruthless. One statistic I read said that 15% of all MS patient deaths were caused by suicide.
When I first went in to see my patient, i was unsure of what to expect. Of course, I had heard of MS, but I'd never seen it firsthand. I was surprised to see a beautiful woman, a little older than my mom, laying in bed with a well-dressed man in the chair by her side. I could tell by his face that he was friendly but had a defensive guard up to protect his vulnerable wife. They both smiled and seemed genuinely happy to meet me. They instructed me to call them by their first names instead of "Mr" or "Mrs." Patient was quick to explain, "I'm not Mrs. ___. Mrs. ___ is my mother-in-law!" :)
My patient's particular disease process caused her to be bed or chair-ridden, and she only had control of one of her arms. She could not even sit forward for me to listen to her lungs. She asked for her husband to do most of her moving and lifting, and I could tell she had such a deep trust in him. I asked how long they had been together, and they had been married a very long time. Not too long after she was diagnosed with MS, they met in college at a friend's wedding. He obviously saw past her health difficulties and found her beautiful soul. The rest was like a fairy tale... only with the unusual villain of a severe chronic illness and the expectation of MS's always-progressing path.
Throughout the day, I couldn't help but to really observe this couple. Their relationship was truly captivating...
Patient couldn't do much completely independently. She could speak well with the exception of sometimes forgetting a word or a date. Cognitively, she functioned pretty well, and we had many conversations. Patient could move her right arm and hold a glass of water, but she was pretty much otherwise paralyzed. Patient and her husband seemed to be a couple of means, and from what I gathered, Mr. was able to take care of Patient most of the time, which I'm sure was a large factor in strengthening their close relationship.
I have never witnessed such a deep trust as I did in this couple. Patient literally depended on her husband for everything, and I could tell he was far past used to it. He was good at it, too. Mr. knew every single med his wife took, and he didn't even have to think twice about the dosages and number of pills. During morning med pass when he thought I gave her one pill too few, he questioned me and had me go over the drugs all over again. (It ended up being that she was scheduled to get the remaining pill at bedtime.) He could describe in great detail her previous hospitalizations and illnesses. He knew exactly how she liked things, and he knew exactly how to hold her to carry her to the chair or the bathroom. He could sense her needs even before she expressed them, and he knew how to handle or perform every single component of not only her health but her well-being. The way Mr. explained things to me, I was sure he really knew what was going on and had lived most of his life trying to keep his wife as happy and healthy as possible. When she hurt, I sensed pain in his eyes. When she was frustrated with herself, I could sense his disappointment. His questions to me were so well thought out that I knew he was determined to really understand the answers so he could digest information the information that his wife could not.
There was such a seamlessness to their relationship. It was like he instinctively knew when to pick up where her capabilities could no longer reach. He knew her limits like a science, and he let her do for herself what she could. For the rest, he would jump in like her savior and communicate what she could not express or assist where her strength failed. There were no gaps in this love. There was no doubt that they were as one person. None at all. They shared feelings, fears, knowledge, and most importantly such a primitive, deep trust and a truly unconditional love.
* <3>
Their story reminds me of Jonathan and I. When he met me, I had already been dealing with serious illnesses, yet his love went past that. I wonder how my patient told her husband-to-be about her illness. I wonder what thoughts ran through their minds. What were they afraid of? What obstacles did they have to work through? Was she embarrassed at first for him to see her at her worst? I'm sure my patient and her husband spent a lot of time getting to know each other, and Mr. undoubtedly worked very hard to be to his wife what he is today.
I wonder how afraid Patient is. I'd like to think her heart is at ease because she knows it's in the palm of her husband's hands. I wonder if Mr. knows just how much he means to his wife, or is he just focused on taking care of her and keeping her comfortable day to day? I wonder if Jonathan and I will mesh like that when we're their age. Will he really be such a seamless, continuous part of me that he can feel what I feel, know what I know, and fix me before I even know I'm broken? Will he know just how essential he is to my happiness, safety, and well-being? Will he know his selflessness is never taken for granted? Will he know how much he is really loved, even when my strength fails me?
Love is an amazing thing. It is so strong, humble, and desperate. It is full of faith, hope, and encouragement.
3 comments:
Hi fiancee,
That was one of the most powerful things I've read in a long time. What you talked about is something I have challenged myself to become for a while now. I hope to never let you down and to be the one that is there every step of the way.
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