Seeing the Whole Patient
My patients never a make a good first impression. If I'm working with them, it means they've had a stroke. As a result, they are no longer the person they once were either cognitively or physically. Let's face it. No one looks good in a hospital gown and even fewer look good with permanent bed head. My male patients all need a shave. Facial droops change expressions. No matter how many questions I ask I don't get a true sense of who they were.
Therefore I tend to think of my patients in the context of their hospitalization. I meet family members. I learn who does what around the house. I know who works and which hobbies are enjoyed. All of which is specific, factual data that does nothing to describe the patient as a person.
That changed this week. Two of my patients introduced me to their lives before hospitalization. I realized how much about my patients I take for granted. One woman was a singer prior to her stroke. After a treatment session, she played some of her music for me. She had a beautiful voice and played some of the instruments on the recording. To meet her, you would never see that in her. When I asked her why she hadn't told me sooner, she said she didn't think it was important.
The other gentleman was found to have a demyelinating disease. Even though he didn't have a stroke, I'd been following him from his admission. His only concern was being able to return to his profession because that was all he knew. One day while we were walking I mentioned something to do with one of my horses. Turns out he knows the same horse people I do. His wife rides and shows Arabians, although she does dressage and I do hunter. She bought one of her horses from the woman who trains mine.
In both cases, one little comment made those patients human to me. I saw them as they were pre-stroke. They were people, not patients. The realization didn't cause me to change treatment plans or alter therapy. Both were making good progress. I just lost some professional detachment and allowed the outcomes to be more meaningful to me.
Professional detachment is a good thing. I couldn't work with the patients I do if I couldn't detach myself from the situation. But sometimes I focus on the person as a patient instead of the patient as a person. I need to remember there is more to a patient than meets the eye.