Friday, May 15, 2009

A Friday work afternoon in May

This afternoon I had three new patients in a row, all very senior, a rare event - usually I treat people 20-ish to 60-ish..

Lady number one, age 85, recently hospitalized for food poisoning, a week ago. Had a cataract removed just on Tuesday. Said that she developed sharp pain in her neck and shoulders while being hospitalized for the food poisoning, that it was better but not gone, and didn't want to delay the cataract surgery because she didn't want to have to wait for the next available slot. So she toughed through it and turned up in my clinic, brought in by her daughter who I treated a decade ago. She definitely couldn't move her head on her neck much. She had never had any treatment ever before from anyone. Her husband had died 4 years prior, and she had moved overseas to Canada to move in with her daughter. Tough lady.

So, I worked carefully with her, and in the end she could move quite a lot better on one side but still had pain on the other, so I added a few pieces of stretchy tape, made sure the tape was holding her skin comfortably so she could move less painfully, showed her daughter how to remove them after a few days.

Lady number two was about the same age and had stumbled - although she had not fallen, she had sprained her ankle. She was wearing a brace on it, and limping. She had been to the PT her doctor had sent her to, but found she didn't like electrodes or ultrasound or the heat pack. She said her ankle had felt worse after. We had a provincial election here on Tuesday, and where she had gone to vote, a scrutineer had given her one of my business cards. She made an appointment and here she was.

She had lost her husband less than a year ago - they had been married nearly 60 years. She still could hardly believe he was gone. She was a treat to treat. Her nervous system responded extremely well to hands-on work, and by the end of the hour the swelling was way down and she had full range. When she got up she could walk normally. I asked her to leave the brace off. She hugged me. Twice. Might be back to have her fingers worked on.

The third new patient was an elderly man with pancreatic cancer, which had been diagnosed a year ago and treated with chemo. He looked really good. Thin but good color. He had pain in his belly. His son, who had been in for treatment for a few different problems, had made the appointment. I had been really clear on the phone that there were certain sorts of pain, like cancer pain, that my attempts wouldn't be able to help, but that if there were other kinds of pain as well, perhaps what I am able to offer could help with that. When he came in, I had the same conversation with the dad. As it turned out he had old shoulder injuries from sports, and very restricted shoulder range on both sides, so I took that on. I worked on skin (dorsal cutaneous nerve roots) along both sides of his spine, the sides of the trunk (lateral cutaneous nerves of the torso), the shoulder blades (many different nerves at different levels), and the front fold of the armpits (intercostobrachial nerves and supraclavicular branches of the superficial cervical plexus). Both arms were able to raise up all the way after. He still had the belly pain, of course. I reiterated that I didn't think what I did could help that, that the patches were his best bet. He said he was thinking of having acupuncture, that they offered it at the cancer clinic. I said I thought whatever they offered at the cancer clinic, under supervision, should be OK. We all shook hands and he and his wife left.

Quite the day, with three brand new elderlies all in a row. Elderly people make me go all soft and tender. They always have. Not sure why. They are living heroes to me.

I treated an old woman once shortly after I graduated. She was in her nineties, was being hospitalized for something I can't recall. Her hands bothered her a great deal. They were gnarled and thick-knuckled. She said, "Look at these hands. They are ruined. Whatever you do, don't use cold water to wash your vegetables. I used cold water all my life, and look what happened to my hands! Use warm water. It doesn't matter - you're just going to cook the vegetables anyway!"

I took her advice. I've never done anything under cold water that couldn't be done in warm.

Another 95 year old I worked with scoffed at herself one day about being a "dried-up old prune." I objected immediately. I pointed out that prunes were nothing but plums which had grown more condensed and had concentrated their sweetness. She was a poet. She got that in a deep place. I think she thought better of herself after that.

Once when I was in my mid-twenties, I was in a medical building for one reason or another, and caught one of those glimpses that lands like a snapshot, glued in the brain forever. An elderly man came off the elevator. He was short, but pulled himself up to his full height, as fully as he could. He was dressed impeccably, hat, jacket, tie. Shined shoes. For whatever reason, I suddenly saw him as living poetry, and my throat caught in that moment with the poignancy and beauty of it all. A life nearly all lived out. Fully. Upright. Dignified.

1 comment:

Phenix said...

This is the kind of stuff that you should write a book about. The mix of the poetry of the human experience/condition with the techniques and impact that one woman has/had in those lives.

This would be ten times more powerful than the James Herriot series about his work as a vet.