Saturday, January 23, 2010

Clusters of Bad Luck

I know that it is easy to see "patterns" that are actually meaningless. That said, sometimes it appears as if, in our hospice program, certain diagnoses come in bunches. It will seem to me in some weeks that every other patient has pancreatic cancer, or end-stage coronary disease, or lung disease, or something. Perhaps there is some store where the Grim Reaper shops that offers half off on overstocked terminal conditions. A blue light special on anoxic brain injuries?

Sometimes it seems as if the kinds of complicating bad luck that families experience come in clusters as well. We may have several families in our program that have experienced multiple losses in the last couple years, or that have out of town loved ones trying like crazy to make it to see the patient in time, or that have other really sick loved ones to care for. We've had weeks where it seems that every other family has a family member who copes by using alcohol in ways that complicate the whole family's efforts. Not surprising given that we live in a culture where advertising would make us think that alcohol makes us better, stronger, and more attractive. Unfortunately using large amounts of a depressant to cope with depressing reality generally makes things worse rather than better.

On the other hand we have families that, under the terrible stress of a member's illness and death, show themselves to be wonderful and grace-filled in every way. I've been in rooms where 4 or 5 generations are present including little babies who are passed from lap to lap, and where those most in need are supported with respectful tenderness. One family member was concerned what staff members would make of the laughter that occasionally bubbled out from their doorway into the hall. "We enjoy each other's company," the family member told me. One could imagine the comfort brought to our patient, resting comfortably but not really talking, to hear his family enjoying him and enjoying each other as they always had. I think it's great.

I think it's especially great when there are families on the inpatient unit who have things in common, maybe little kids near the same age. They meet in the family dayroom where there's a TV and coffee and etc., and the kids may play together, and the families often care for one another in very tender and helpful ways. It can help us to help someone else, and thus I have seen women about to be widowed reach out to one another, exchanging phone numbers, talking in the hallways, encouraging each other. I have seen musician visitors to one family going to another patient room to play songs or sing with another family. I have seen families who love to cook bring enormous platters of food to the family area, reasoning that "everyone here is going through the same thing, and we all need to keep our strength up." HIPAA makes these shared efforts harder, but it is uplifting to notice that all the privacy regs in the world can't stop people who need to bond from bonding and caring.

Even deaths can come in clusters. We've had weekends where no one dies at all, and one memorable one where nine people died in 24 hours. Who knows why? Perhaps mere coincidence, perhaps atmospheric conditions. Perhaps heaven and earth have come very close in what the Celts call a "thin place," and more than one spirit has slipped through.

And now I need to prepare for work. This week brings a bunch of families who are trying like crazy to care for their loved ones at home, against great obstacles, and some of those loved ones may end up needing transfers for inpatient care. It also brings family members newly sensitized to questions about hospice, wondering if this choice is really "right" according to their religious beliefs. Hopefully there will be a baby or two to admire, maybe a dog to pat, a joke to share, and a way to make a difference for someone.


Blogger StorytellERdoc said...

What a fantastic post! I loved your honest words and I feel you hit the subject right on the head. I especially love your recognition of the graciousness of families under stress--a true test to one's faith and hope. Well done, I'll be checking back.

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