I had battled with mom the day before about going to the see her primary care physician or to the emergency room.' She instructed me drive her to her doctor's office, but while there her chest pain became unbearable. 'I really don't want to go the hospital because they may keep me,' she lamented. I kept driving in silence.
Now, as I waited by her hospital bedside, she' opened her eyes only briefly, but she smiled. She was glad to see me.' She whispered, 'I'm in the short-stay unit.' Does that mean my end is near?'' I laughed and said, 'Oh no, that means you will be coming home soon, once you've recovered.'' She grimaced as she took in a breath that showed on her face and with a slight groan, she exhaled.' She whimpered. 'The doctor did tell me that everything was fine now, but I just wanted to be sure they didn't think I was heaven-bound.'
As a medical student, I've learned from my peers that parents are challenging as patients.' The reading available about this subject is sparse, but many physicians have told me an assortment of stories ranging from horrific to compassionate about caring for parents, partners, other family members and friends. My mom has at times invited me to come with her to doctor visits. On other occasions, I have insisted that I go with her.
In these situations, I've always identified myself as a physician-in-training. For the most part I've remained silent, observant and tense during these clinical encounters.' When I've interrupted, it has been to offer facts. I'm usually scolded by the patient and acknowledged as helpful by the clinician.' When Mom and I have debriefed after these visits, there are usually inconsistencies in our retellings. I point these out and ask her to follow-up if necessary.' Otherwise, we agree to disagree.
Time and experience have helped me find my role as a caregiver and advocate for mom. I focus on being her daughter.' I offer support with careful listening, trying my best to remain present.' My focus is on common sense advice with basic explanations about conditions and treatment plans, while urging follow-up conversations with clinicians and medical teams.' This much I can do and do well.
Once mom returned home from the hospital, we had almost daily conversations about medications. We reviewed symptoms that she should pay close attention to and talked through changes coming in the days ahead.' I was able to explain the significance of the procedure my mom would be having, but we were both familiar because my grandmother was in the same situation just a few years earlier.' Like my grandmother, Mom would have to take medicine, make dietary changes, and reduce the effects of stress in her life with physical activity and other changes.' I wouldn't be there in person, but we could talk, text and Skype. She did her reading, talked with her doctor, prayed and set a plan for herself.'
I've learned that it is challenging to help patients understand that the healing process can be long and unpredictable.' Interventional catheterization, the procedure Mom underwent, is modern medicine at its best. While less physically traumatic than open heart surgery, it does require time for healing. It's been a year now since mom's procedure and her recovery has had some setbacks. Nonetheless, she's made progress.
Recently, I found myself unable to take on my yearly challenge, to walk, jog, and run 100 miles in the weeks between Memorial Day Weekend and the 4th of July.' I felt overwhelmed and uninspired to get moving. It seemed too lonely. I needed a partner. When Mom overheard me telling a friend as much, she volunteered.' I was surprised and cautious.' We agreed to early morning walks at sunrise three days a week.' We'd each move at our own pace.
We decided to go to the park that I like sometimes, and at other times remain in our neighborhood. Our motivation and momentum continued with each week, to my surprise. I'm jogging more and Mom's complaining less about incline of the hill on the path. We're averaging about 45 minutes, 3 days a week, together.' On the drive home, we do chat about travels to places we'd like to visit. Mom's healing and so is our relationship, and this has added to my life as well as my medical school experience.
I've been told to treat patients as if they were my mother, to offer competent care with empathy and compassion during clinical encounters.
But it's become all too obvious to me that it's complicated when a patient is a loved one. Health care professionals and their patients need help in navigating these situations, especially within real communities where people work, live and play together. In the working and lately in the playing together, Mom and I both are steadily healing and learning together.