Here, There and Everywhere

Posts tagged ‘medicine’

The Real Story About Syria

The Real Story About Syria

The politics around Syria’s civil war are complex, but the reason to care about Syria’s millions of refugees is simple – there is very real suffering happening with our fellow humans. Real people like you and me whose lives have been up-ended. Millions of people who have done nothing to bring this upon themselves, who are struggling to survive, and who may never be able to return home.

With or without military intervention, the flood of Syrians displaced by the conflict, both within Syria and as refugees in neighboring countries, will continue.

All the news about weapons, governmental bodies, and military actions ignores the truly massive humanitarian crisis that continues to dramatically unfold.

This is 12-year-old Amina and 7-year-old Sahed with their grandmother, 80-year-old Amina. “I miss my friends from my old school the most. I don’t know what has happened to them,” says young Amina. “My wish is to be able to see again properly,” says her grandmother, 80-year-old Amina, of her failing eyesight, “and see Syria again.”

Syrian_refugee_family_copy

CARE is helping refugees in Jordan and Lebanon and people affected by the crisis in Syria. As the crisis escalates, we are also starting to work in Egypt and Yemen. The more than 8 million people affected by this disaster are looking to us to help by providing basic life saving support, such as: food, shelter, clean water, medicine and medical care, and the means to stay warm when winter approaches.

Please give what you can today to help those fleeing the violence in Syria, and others caught in the crosshairs of political unrest around the world.

I believe that – as human beings, confronted with the suffering and needs of others – you and I can and must do something to help. If you suddenly lost your home, wouldn’t you want to know that someone cared enough to reach out and support you to maintain your dignity while getting you through an unimaginably difficult time? I know I would.

Together we can make a difference to help each other in times of need. Please give what you can today.

As you listen to the radio and scan the headlines, keep the faces of the refugees above in your thoughts. They are the real story. And they need our support.

With greatest hope,

Holly Solberg
Director of Emergency and Humanitarian Assistance, CARE

Reading About Death

Excerpt from Good Grief: Love, Loss and Laughter.

How much information about dying, death and grief can we handle?

Jackie told me that after she was diagnosed with pancreatic cancer she was inundated with information, suggestions, advice and stories. She felt overwhelmed, confused and disoriented. Not only was she trying to make sense of the diagnosis and all its implications, she was also suddenly having to make decisions about what kind of treatment to choose, if any.

On top of such monumental choices, friends, relatives and health professionals bombarded her with written material on statistics, outcomes, recovery, remedies and self-help and self-care groups and organizations.

I asked her if she would rather have not had all the information and she said, “No, I’d rather it was there than not. It isn’t the information per say; it’s how it is presented. I want it when I ask for it, not when others think I need it. I want to decide which things I wish to research for myself and which things I’d rather have someone else look into. I want to have some control about what comes my way and how I process it. There is enough out of control in my life as it is.”

When I inquired as to how people would know when and how much to provide she replied, “Simply ask. All they have to do is ask and do so without judgment or ‘should’ attached to their question. Support offered when requested, without someone else agenda attached, is the best medicine.”

How may pamphlets, handouts, magazines and books can we read when we are taking care of a loved one who is dying or have just had someone die?

Brian took care of his wife (they’d been married for thirty-three years) for four and a half years until she died from complications of Alzheimer’s eight months ago. He told me that, “There were days when I could barely read the road signs, let alone an entire book. Taking care of Samantha took every ounce of energy and attention I could muster. One day a good friend of mine dropped off a little pamphlet about self-care. At first I didn’t think much about it and just appreciated his show of concern. But every once in awhile I’d sit down, pick the thing up and read a sentence or two and try to do what it said. It wasn’t anything monumental, but it helped me step back from my situation off and on and take a deep breath. After Samantha died I tried to read a book or two again, but found I couldn’t concentrate for more than a few minutes. I’d read the same sentence about three times before I realized what I’d just done. People gave me books about grief, but most of them were too big and intimidating. Again, it was this same friend who simply gave me a few handouts which had some common reactions and suggestions for coping with loss, which helped the most.”

Do the words written on a page help us prepare any better for the inevitable or make the process of mourning any easier?

When Francis’s mother was dying of congestive heart disease and came on to hospice services, the social worker gave her a handout that had information on a variety of topics (about hospice care, advanced directives, how to provide bodily care, etc.). It also included a page called “Signs of Approaching Death”, which provided information on what physical changes “usually” happen as the body begins to shut down. Francis told me that the information helped her think about planning (both health care and financial) a little sooner than she might have otherwise and that the section on Signs of Approaching Death were especially helpful.

“Not long after I’d read that page, she started to decline.” She explained. “If I hadn’t known those things ahead of time it would have been VERY scary. As it was, I was able to relax a little bit and not freak out when her breathing changed and she began to slip away.”

Francis echoed Brian’s reactions about reading books on grief after her mother died and added, “I don’t mind something more extensive, as long as I can keep it awhile and look at sections I need to, when I want to, then put it down and come back to it. The books have helped normalize my experience. They’ve let me know that many others have gone through what I’m going through and that I am not going crazy.”

Twenty years ago there were only about twenty to thirty books available about death, dying and grief. There are now hundreds. The disadvantages to having so many are the difficulty in knowing which are right for you and your situation and which are not. The advantage is that there is far greater choice, they are more accessible and you are more likely to find something that speaks to you directly.

Like Jackie said, “When in doubt, ask?” Find out what kind of information they are seeking and how much they want at any given time.

If something you’ve read has deeply touched you, changed your life, provided comfort, understanding or direction, the words will speak for themselves. You don’t have to sell your experience or convince someone who is confronting illness, death or loss that the words you found so helpful will touch them in the same way.

MORE

The Pressure Cooker

Excerpt from biography Paging Doctor Leff: Pride, Patriotism and Protest.

When Captain Leff arrived at Udorn Royal Thai Air Base in the summer of 1969, one may have thought the greatest threat to servicemen on the base was Venereal Diseases (VD), not the Viet Cong or Pathet Lao.

The dispensary had recently been upgraded to a hospital, and the brass was asking for volunteers in different areas. Arnie volunteered to be the venereal disease control officer. He had some experience with it in medical school and figured he “might as well become an expert in something, since I was going to be there for a year anyway.”

“Servicemen came to our VD program for a number of reasons,” Dr. Leff confides. “One was that I convinced them at orientation that they should see us and not get treated on the Thai open market with medications that were no good. Another reason was that I made a promise that they would not be punished for coming to see the medics with a case of VD. I made that promise based on the U. S. Air Force regulations that were very clear.”

They had an open program that encouraged men to use their services, that there would be no punitive actions, and that they would take care of them. It was free, and it was good medicine.

Because of these assurances and the fact that Dr. Leff kept accurate statistics, by December of 1969, Udorn had the highest number of recorded cases of venereal disease of any base in Southeast Asia. Some would say that was excellent news, to know that it was being reported and treated, but the hospital base commander, Col. Paul Stagg, USAF, MC, thought otherwise.

“The colonel called me into his office and said, ‘The General says we have too many cases of venereal disease this year,’ which makes him look bad. ‘I want you to change the statistics and wipe out the last few weeks of cases so it looks like we have less than we do.’

Dr. Leff replied, “But Sir, if I change these numbers, what if everybody changed numbers? What if body counts were wrong?” Stagg’s response was, “That’s the system.”

“Suddenly, like a flash of light,” Dr. Leff recalls, “the switch went on in my head. It was the first time anyone had said it so bluntly, right to my face. The extent of the lying surrounding the war inundated every sector and every branch.”

MORE

Monks, Meditation & Medicine

When Bob Stahl left his home town of Boston and went to college in Vermont, it was a class in religious studies and a quote from the Tao Te Ching that provided the context and words to what he innately knew as a child ever since his younger brother had died at the age of two. The quote said, “There is no need to look outside your window, for everything you need to know is inside you.” He began looking inside and found his way outside to California.

While attending graduate school in San Francisco, Mr. Stahl was invited to attend an Insight Mindfulness retreat. It was on that nine day retreat that Bob realized he had found his spiritual home. “It caused permanent neurological damage and I’ve never been the same, thank goodness,” Bob grins.

In 1980, one of Mr. Stahl’s professors invited him to travel to Burma to meet her meditation teacher Taungpulu Kaba-Aye Sayadaw. While in Burma Bob shaved his head, wore robes and took his bowl, with the other monks, to collect alms (daily food) in remote villages. After several months he returned to California and helped start a forest monastery in Boulder Creek called Taungpulu Kaba-Aye Monastery. “I lived, studied and worked at the monastery for the next nine years,” Bob recalls.

In 1989 Bob left the monastery and met Jan Landry, formerly a nurse and chaplain at Hospice of Santa Cruz County. They were married and had two sons. He also received a book from a friend called Full Catastrophe Living by Jon Kabat-Zinn that spoke about using meditation in a medical setting. “I couldn’t believe someone wrote a book like this,” Bob says excitedly. “I wrote Kabat-Zinn a letter and he invited me to come to the University of Massachusetts Medical Center. They showed me how their Stress Reduction Program worked, gave me their blessings and said to go start my own.”

Dr. Stahl became a counselor at the Cabrillo College Stroke Center in Aptos, California in 1990 and started teaching meditation. It was the first such program in the state. Within a few years, Dr. Stahl’s Mindfulness-based Stress Reduction Program (MBSR) was being utilized at hospitals throughout the San Francisco and Monterey Bay Area.

While visiting a weekly MBSR alumni support meeting, a woman who once had TMJ (a painful condition of the jaw) said, “When I brought my awareness from the class to my jaw and saw how often I was clenching and tightening it, I was able to relax and let go. My TMJ totally disappeared.” Another woman, who completed the class only six months ago, says, “MBSR was like a life preserver. It has reduced my back pain and anxiety, as well as my reaction to distress.”

The “letting go” of the Mindfulness-based Stress Reduction Program does not require one to become a passive observer, but rather to pay close attention to what IS happening at any given moment. Dr. Stahl quotes Victor Frankel, a psychiatrist and holocaust survivor, who once said, “Between the stimulus and the response there is a space and in that space lies our freedom.”

“We are often like sleepwalkers,” Bob states, “or on automatic pilot, reacting compulsively to our grasping and aversive natures. Insight Meditation helps us find another way to live.”

Mr. Stahl found another way to live as a monk and brought that awareness into his life as a husband, father and teacher. There are a lot of students and clients who are grateful that Dr. Stahl is no longer in his robes, begging for alms in a distant village, but is living here in The States taking one breath at a time.

Dr. Stahl and a colleague, Elisha Goldstein released A Mindfulness-Based Stress Reduction Workbook (New Harbinger Publications) earlier this year.

Health Care’s Invisible Glue

I once had the opportunity of developing intimate relationships with people of all ages and from all walks of life. They and their loved ones often shared deep secrets and lifetime memories. Challenges arose daily, imploring me to make an individual more comfortable or free of pain or to help someone deal with an emotional crisis. As the years progressed, I found that a simple touch, deed or word could profoundly affect the people I cared for.

You may be thinking, “You must be a nurse, right?” No. “Oh, then you’re obviously a doctor or an intern?” No, but close.

I’m talking about life as a nursing assistant, better known by the pseudonym “aide,” “orderly” or “attendant.” Their work with elders in convalescent homes is legendary. Legendary because they continue to work in such facilities with little pay, dangerous under staffing and terrible supply shortages. Conditions are frequently better in acute-care hospitals, but even there they are often seen as appendages to doctors and nurses. Rare is the individual or organization that grasps the importance and necessity of their involvement in the health care system. They are the “meat and potatoes” of hands-on medical care in this country, the glue that holds it together.

Nursing assistants make a crucial difference in peoples’ lives. Frequently, they spend more time with patients than nurses and doctors combined. For some, their presence means the difference between fear and loneliness and even life and death. They are there when we hurt, sweat, laugh and cry.

Some individuals (health care professionals and the public) act superior or snobbish to aides, treating them as if they are lacking in brains or have no motivation to “move up” the social ladder of medicine. It’s not overt or cruel prejudice, it is a basic disregard for the job, the training required and the workers involved.

Let me take you inside the world of a nursing assistant for just one 8 ½ hour shift, when I used to work the swing shift on the cancer unit of a local hospital. This is the real stuff, the nuts and bolts of health care and healing. It’s what nurses used to do before they become inundated with paper work, passing medications and running madly to finish all necessary procedures and treatments and to fulfill all the other responsibilities demanded of them.

After receiving my list of assigned patients and finding out which nurse I’m working with, I begin obtaining patients’ vital signs and get an overall picture of how they’re doing.

The gentleman I encounter in the first room needs his oxygen adjusted and some fresh water and towels.

The next patient, Alice, needs an entire bed change. A 73-year old woman with breast cancer, she has become incontinent and soiled her gown and linens. She is embarrassed and painfully apologetic. As I cleaned her up she spoke of her fear that she was beginning to lose control of her life. When I left, Alice said she felt “clean, fresh and renewed.”

The third person I contacted that evening was Charles, a 60-year old man with leukemia. As we conversed, he asked if I was in training to be a nurse. When he found out I wasn’t, he said, “Oh well, this is a good job for you to start out with for your future.” Just then the charge nurse came in with a frantic look on her face and asked if I could get another patient on a gurney to go downstairs for x-rays.

After I located a gurney on another unit and got the patient ready, another nurse requested that I make a trip to the blood bank to pick up some packed cells (blood). When I returned from the lab, I found my team leader (nurse) at the medicine cart.

We sat down and looked over the “care” charts to decipher what protocol was desired for each patient. Some vital signs needed to be taken and some patients needed to walk, be turned, bathed or catheterized (a tube put in the urethra to empty the bladder). Others had doctors’ “orders” that entailed checking blood sugar levels or collecting sputum, urine or stool samples for lab tests. During report, the nurse suddenly stopped, turned excitedly toward me and said, “When are you going to nursing school? You would make a great nurse.” She looked downhearted when I explained that I had no desire to be a registered nurse or to go back to school. She said, “But you’re so intelligent!” I grimaced and said, “Thanks”. Was she implying that that nursing assistant’s are stupid?

When report was over, I finished the remaining vital signs, lifted one patient up in bed, helped another to use the bedpan and took Alice for a walk down the hall. While shuffling along we pretended we were dancing to, “Tea For Two.” Her eyes sparkled when she told me that she and her deceased husband had been prize-winning dancers in the 1940s.

I informed the nurse that a patient’s IV (intravenous bag) was almost dry and that a number of people had requested pain relief and various other medications. The dinner trays arrived and after checking to make sure they all matched each patient’s diet, we passed them out. One of my folks needed help eating (as a result of an old stroke), so I sat by her bed and slowly gave her a few mushy bits of her soft diet, so she wouldn’t choke. Meanwhile, a patient undergoing chemotherapy was throwing up just two doors down the hall. After emptying his emesis basin (vomit container), I went to supper. Believe it or not, I was famished. It had been only two and a half-hours since my shift had started, but it felt like two and a half days!

On the way to dinner, I picked up a magazine which had a feature story entitled, “What Do Nurses Want?” I got my hot, soggy food, set my tray on the table and turned on the television. The channel I selected dramatized the story of a big-city hospital. As usual, the only characters given any airtime were, you guessed it, doctors and an occasional nurse. Everyone else in the show (housekeepers, technicians, secretaries and nurses aides) were shown as auxiliary personnel who did nothing but get in the way of the featured players.

After devouring my food in the allotted half-hour supper break, I returned to the unit and picked up the patients’ dinner trays. As I walked by Room 264, I saw Sam (a patient with advanced renal failure) falling headlong towards the floor. I leaped through the door and grabbed him just in the nick of time. Sometimes I felt like I was in one of those old commercials were people dove to catch a spill before it hit the carpet. Sam was getting more confused and said he had to go get things ready for the rabbit cage. I maneuvered him back to bed and eventually convinced him to stay in his room for the rest of the night. It took another hour before he realized he was in the hospital, after frequent reminders of who, what and where we were.

Then Michael put on his call light and literally screamed for help! Michael was a young man with AIDS who was in the hospital for treatment of a lung infection. Upon entering his room I found him tense, angry and perspiring profusely. He asked various questions about medications, IVs and food. Everything was worrying him. Was this working right? Was that being done on time? Was he getting the proper nourishment? After sitting and listening a few minutes, it was apparent that he was concerned about something other than mere food. At first, I answered his questions, then I asked him if he could tell me what he was really afraid of? He began to cry. He said he was overcome with feelings of abandonment from a dear friend and the emotional loss of some of his family members as a result of his illness. Fifteen minutes later Michael and I were laughing about the absurdity of life and the beauty of loving and sincere friendships. He only rang for assistance one other time that evening, to have someone turn out his light and say goodnight.

I left Michael’s room, made a fresh pot of coffee for family members and staff, fixed someone’s bed and TV and then took Jackie her evening snack of fruit and juice. Jackie and I had known each other for a few years, as she’d had frequent admissions for chemotherapy, such as her present three-day stretch. She always called it her “dose of poison” for the month and described her hospital visits as, “A working, masochistic vacation!” We spoke of her family, hopes for a cure and her latest garden project. Then she asked about my children and work. After a pause, the familiar questions began. “When are you going to go study medicine?” “Isn’t this just a job you’re doing to get through medical school?” Patiently, I said, “No, I’m not going to school right now.” It seemed futile to explain once again that this was my profession.

The remainder of the evening involved collecting and measuring fluid totals from each patient and spending time with the family members of a man who died at 9:00 p.m. His death was not unexpected, but the grief his family experienced was far greater than they had anticipated (as is often the case). We called the doctor, minister and mortuary. I got his body ready by taking out the IVs, putting in his teeth and folding his hands on his chest with as much dignity as possible. I finished charting on all the patients around 11:30 p.m., said goodnight to my co-workers and friends and called it a night.

Another “routine” shift had passed. As I drove home in the darkness, I thought about the perceptions people have of nursing assistants. Our society says it cares about the young and old, yet it places little value on those who care for the sick and aged or teach our children. Such failure to match words with deeds is, at the least, hypocritical. Why don’t people respect and reward those providing the hands-on care of their father or mother as much as they value the doctor who diagnosis the illness or the nurse that starts the IV or hands out the pills? If appreciation for the work nursing assistants’ do is ever acknowledged by good pay, healthy and safe staff to patient ratios and mutual respect, I think I’ll pass out from the shock.

Doctors and nurses are prime assets in delivering good quality health care. Without them, many would flounder and perish. I’ve seen them work long hours with great heart and dedication. But they are not the sole providers of care, nor do they have an exclusive patent on providing expert and passionate service. They do not work in a vacuum devoid of others’ energy and skills. Without secretaries, housekeepers, laundry workers, department managers, volunteers and countless other technicians, assistants and personnel, the health care system would find it impossible to function, let alone provide adequate or quality care.

Life tends to go in circles. Who will be there when you are feeling sick and miserable or someone in your family is? A nurse, maybe. A doctor, perhaps. Most likely, it will be one of my colleagues, a nursing assistant.

Tag Cloud