So Lucky!

Mom had to visit the Emergency department one night, as she wasn’t doing so well and needed something stronger than oral antibiotics. Fortunately, the hospital was working well, and we were being seen by a doctor within half an hour of arrival.

He was a young doctor, and even if he wasn’t, he spoke as though he was very young and haven’t seen much of the world. After we told him what the problem was, he turned to the electronic record and was apprised of Mom’s multiple issues.

“Wow!” he breathed, “Aunty* has been through a lot! Do you know how lucky she is to be alive? The condition she had, you know, many people die of it. She’s quite lucky!”

I couldn’t stand it. “Well,” I said, “we take good care of her. And you’re lucky we’re not suing the hospital for missing the condition in the first instance.”

Young man, it may be your first time seeing us, but we’ve been to the hospital countless times, and if we didn’t know better, Mom would be a lot worse off.

Having said that, I’m very pleased with the treatment at this hospital for Mom all these years. Whenever she’s admitted, I get daily updates from the ward doctor, a medication check-up call from the Pharmacist on duty, and a post-discharge follow-up call from the nurse. Most times, things go right. Yet, I believe more than ever that the patient and family must take overall charge and not leave it to the “professionals” alone. Patients are living longer and with more complex and complicated conditions. We just have to help ourselves.

 

*Aunty is a generic way for addressing older women by respectful younger folk in our region.

Forgotten, in a manner

Mom was admitted to hospital for a brief illness, and I was visiting her.

“Hello, how are you today?”

“Hello. My daughter just went off.”

I wasn’t expecting that. “It’s me. I’m your daughter, Mom.”

She looks uncertain, and then, “No,” she says, “My daughter, she just went over there. Can you go and get her?”

I knew she had an earlier visitor, but hadn’t realized she thought that person was me, or so I hope, if she still remembers she had a daughter like me. So I decided to go along, “Oh, she’ll be back in a while.”

It’s really strange and unexpected.

At home, we never go to Mom and ask her, “Do you know who I am?” We assume all is fine if we get a cheery Good Morning! or Hello! The routine exchange of greetings, the signs of familiarity, the ease with which Mom navigates to her regular chair; surely all is well.

Or maybe the problem isn’t Mom, but me. Maybe I’m forgettable. Really.

I once went back to a workplace after a gap of a year. There were a few familiar faces at work that day, but they could not recall me. “Did you work here before? When? Really? No, we can’t remember you” they said. It gave me a turn and my heart pounded. I had a fleeting thought of “Twilight Zone” and then I wondered if I had caused offense and was being purposely “forgotten”.

On thinking back, I think it could be because I was task focused and did not get to know these colleagues personally, or they were task focused and did not see me. Or the turnover of staff was so high that those who stayed did not bother to keep track and remember those who had left.

Whatever, I think I can accept being forgotten. It’s the forgetting I’d rather not have.

A New Conductor

The Geriatrician wrapped up my mother’s first consultation with him by asking me, “So, when would you like the next appointment?”

I thought quickly. He was a very busy Consultant and only took on Mom’s case after some urging by his colleague. That day at the clinic, we had waited over an hour to be seen as he had many patients and was running late. So I said, “I think six months should be alright.”

“Six months?!” he laughed and turned to Mom, “Aunty, I will see you again in six months, and I hope I don’t have to see you sooner than that!”. So he thought I was being a bit too optimistic, but he went along with me, and said we could call for an earlier appointment when needed.

For the past few months, Mom had been seeing 4 different specialists for the various medical ailments she had. Although dementia can be overwhelming on its own, people with dementia can and do have other medical problems. The only reason Mom wasn’t seeing 5 specialists instead of 4 is because the appointment for the 5th was overshadowed by emergent events and nobody remembered to put it back.

Each of the 4 specialists were intent on treating their own organ issues, without seeing Mom as a whole. For example, two specialists wanted Mom on anticoagulants, a third wanted it stopped. At times, I went a bit nuts. Particularly at the junior doctors when they call me to let me know what was happening. You want to what? For what? Can you call the other specialist and make sure he is okay with that?

So that is why we added a Geriatrician to the mix – someone who can see Mom as a whole, review what’s best for her overall and help us decide which medical ailments get priority. We need an orchestra conductor instead of multiple soloists each playing their own tune.