Apr 14, 2013

Daily thoughts - Caring for the sick, elderly and the forgotten

Before my Dad passed away in September of 2010, I took care of him for 4 months and witnessed how he deteriorated. It was difficult but I could handle the physical aspect of it. Running errands, washing, changing diapers, cleaning his wounds were challenging but a night's rest always recharged me the next day. The hard part was seeing him fall apart before my eyes and not let my face betray how I truly felt. Ive known my father as a man who always looked for that silver lining amidst the gray clouds. Even at a time when he was obviously dying, he still told me that he was going to walk one day and do his daily routine. Sadly, I knew it was not going to happen yet I showed up each day and cared for him and patiently listened to him retell stories for the nth time. That was almost 3 years ago. I miss my Dad everyday and I cherish that time I was given that rare moment to take care of him hands on and experience what its like to be a caregiver, albeit without a certification. 

Ive taken care of other sick people in the past too. In Medical School  I had my first full blown diabetic patient who was not aware she was diabetic. The moment she showed up complaining of her painful leg, I could tell already it was very bad. I could literally smell it. Of course I didnt break the news to her. That was the job of the resident doctor. But I remember that experience vividly because I almost passed out when I took off the bandage from her leg. It was not just the overpowering smell that made me gag, it was the sight of maggots spilling out of the open wound that shocked me. I asked myself, how can someone have diabetes and not know they have it? You dont wake up one day and discover your leg is rotting. It starts from a small wound. If you notice a wound isnt healing no matter what antibiotic you put in it, you are supposed to go see a doctor. but this patient was very poor. Her family couldn't afford to pay for her medical expenses. 

In retrospect, I am more empathetic now with that woman and her family's situation because when my Dad was sick, we ran out of money to pay for his medication and hospitalization. And I left my job overseas because noone was there to take care of him at home.

Another experience of working with patients was during my duty for Psychiatry at a National Center for Mental Health (NCMH) in the Philippines. I interacted with patients who had intact bodies but were undeniably mentally unstable by DSM standards. Or what lay people would jape as crazy, insane. I befriended one guy from the Chinese Pavilion. I am not sure how the name came about but most of the patients were male and hailed from Chinatown Binondo (there are different pavilions in that institution and it is based on the nature of the cases). This guy seemed so normal that I didnt believe he was a patient. He told me his unique and shocking story.I remember crying on my way home that day thinking about it. The man was diagnosed with paranoid schizophrenia upon admission. He has been hooked on drugs for a couple of years before his parents decided he needed treatment. His family occasionally visited him for a year. After one year, they stopped visiting him. He said they did send him letters and later on the letters stopped too. After 3 years, he was discharged. So he went home to his family only to discover they were gone. They have moved somewhere and the neighbors didnt know where they were. The man went back to NCMH and never left. I asked the Psychiatrist about this patient and he told me that he had a relapse and is now severely depressed. He doesnt want to be discharged and prefers to live among the crazy people there who are locked up..

It is not a glamorous job to clean up after sick patients and the elderly. But is a job that is noble and enriching, in a moral perspective of course. I would lie if I said I enjoy changing soiled diapers. Be it babies or adults, I just dont consider it something I want to do if I had a choice. Just the same, the experience with taking care of my  Dad and other sick patients (especially the elderly) has made me more mature as a person and not just a skilled "caregiver". Seeing that kind of vulnerability especially in a grown person (the sick loved one), makes you (the caregiver) more aware of the reality that one day you too will need someone who hopefully will take care of you with respect and patience.  I have a bit of a long way to go in terms of completing all the requirements for the profession I want, but the goal is clear. In my own way, I want to contribute in improving a sick person's quality of life. 

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