I walked into Brad’s
hospital room to see how his night went. Brad was a 59-year-old male with
severe Alzheimer’s disease who had recently suffered from a new-onset seizure.
He now had an altered mental status and was confused, delirious and agitated.
He rolled around in bed
restlessly. His arms had bruises imprinted on their side from his flailing arms
hitting the sides of the bed. His hands were covered with white padded mittens
to prevent him from pulling out his feeding tube and lines. He wore a diaper
because he was incontinent. A red rash caused from a side effect of a new
anti-seizure medication covered the side of his face, his chest and the left
side of one leg. Blankets were crumbled up on one side of the bed. He thrashed,
he thrashed, and he thrashed.
“Brad!” I started, “It’s
Liz, the med student.” I decided first to assess orientation. “What’s your
name?” His eyes were partly closed. He rolled to one side, then the other.
Mumbling constantly. He finally stated through his mumbling that his name was
Brad. I stated that this was correct and asked for his last name. Brad mumbled
some more, unable to answer. He wasn’t able to speak in complete sentences and
did not know where he was or the year.
Then I asked, “Brad, can you
tell me your wife’s name?” Brad halted. He immediately stopped rolling and
looked off into the distance. The sounds of Brad restless movements were
replaced by silence. Pure silence. Brad’s agitated face slowly relaxed. His
gasping breath became calm. He looked at me briefly, rolled over, and stated,
“It’s Caitlin Miller. And I love her.” A moment of clarity. In a brain that
was slowly succumbing to Alzheimer’s disease. In a brain that had been acutely
altered for days due to a seizure. In a confused person who is unable to
identify his full name, location or the year. In that moment, he still knew love.
_____________________________________________________________________
I met another patient named
Patty a few months ago. I was working at the neurology clinic and had the
opportunity to see Patty on three separate occasions. Patty had been suffering
for years from Huntington’s disease. Patty’s ability to move her muscles was
becoming increasingly impaired. She sat stiff and hunched forward in a wheel
chair, but her body often burst into uncontrollable jerking movements. The
effect of this disease on her body resulted in abnormal facial expressions,
difficulty chewing, swallowing and speaking. She required constant care and was accompanied
by her home nurse. She did not and
could not speak to answer my questions. She just stared straight ahead, her
body writhing uncontrollably, while her nurse did all the talking.
I took the interim history
from the nurse. At one point, I asked about family in the area that might also
be able to support Patty. The nurse explained that all family was out of the
state and that they do occasionally communicate by sending pictures of Patty’s
grandchildren. I reached over to touch Patty’s knee as I asked, “How are your
grandchildren doing?” I looked at Patty’s face. A face that rarely showed
emotion. A face that is losing the ability to express itself due to her
disease. A face I’ve looked into for over two hours that always had remained
expressionless. The corners of her lips slowly inched upward. Her eyes softened and she glanced longingly ahead.
And during a rare moment of clarity and understanding, she thought of her
grandchildren, and smiled.
______________________________________________________________________
I
have an inkling. That in a brain being slowly overcome by disease, there are
certain connections that remains intact the longest. As demonstrated by Brad
and Patty, these connections, just might be, the ones of love.
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