I keep thinking about a conversation I had a few weeks ago. I met a man for lunch. It was supposed to be a date. Instead it was a discussion about an ex-girlfriend of his who'd had a stroke. She was in her 30s and the stroke was a result of cocaine use. He praised her and how hard she'd worked to be able to walk again. My lack of sympathy for her shocked him. Our lunch ended with him telling me I'm a bad therapist because I don't feel sorry for my patients.
My lunch date confused lack of sympathy for a specific stroke victim with a general lack of caring for all stroke victims. I feel sympathy for my patients but it is a double-edged sword. If I feel too much sympathy, I can't work with them. I need to be objective to be effective. If I stopped and thought about things too deeply I don't think I could do what I do.
Strokes can be devastating. Every patient I see is someone's parent, child or spouse. For the majority of them life will not be the same post-stroke. As long as I maintain a clinical perspective, I can work. The minute I allow myself to see them on an emotional level I lose my protection against what I see. I sympathize for them but I have to step back in order to work.
I think all health care providers struggle with this to some extent. It's a common topic for students. PTs are more susceptible because we spend more time with our patients than other disciplines. We get to know them as people. Sometimes we become friends with them. Acting stern is my defense. We all have one.
A few weeks ago, I had a woman who got to me. She could have been me. We were similar in appearance, living situation and age. She worked with horses. She lived alone so no one found her for nearly 24 hours after her stroke. I worked with her a few times but had to step back. I followed her progress on the rehab unit. She made excellent improvement. I just couldn't work with her.
So, I don't feel sympathy for a 30-something who has a cocaine stroke. She would improve whether she received therapy or not. She'll probably have another stroke within a few years. Most of our cocaine strokes are frequent fliers. I work with them but don't have much sympathy. One of our nurses brags that she is an old ICU nurse. Nothing gets to her. She is brash and rude. I'm better than that. Lack of sympathy doesn't mean I can be cold.
Regardless of the cause, I worry about my stroke patients. I follow them through their hospitalization to ensure a proper disposition. I want them to get better. No one deserves a stroke and what ensues. I always do the best I can. Sometimes I just don't feel sorry for them.