Today was just plain hard, no way around it. It was peopled with the usual array of folks - nurses, patients, staff (which is sometimes just ick to deal with, honestly), a laboring mom . There was endless paperwork, pages, results to sign off and relate. Surgeries scheduled, a surgery cancelled amid concerns for a possible heart problem. A rush Rush RUSH day. A no-peeing/eating/sitting day for 14 hours straight. It started with tough conversations with my own 2 sons, and it did NOT improve until this evening, when -- can't you just see it coming??-- I got to see "Anne's play" again. But THAT ... is not what I'm going to talk about tonight.
I am so blessed. So privileged to help people. And even more privileged to be taught by THEM. The women I meet and touch and gentle (yes, it's a verb in my world). Today I was blessed to have the opportunity to be taught again. In my harried state, I might have missed it. That chance to remember the deeply personal why of what I do. But her infirmity, her absolute dependence on the mercy and kindness of others ... made me slow down and become again the doctor, and the human being, I want always to strive to be.
She appeared on my schedule as, "WWE/pap. Pt with cerebral palsy/wheelchair." That little intro. will cause me to breathe in, breathe out, breathe IN ... anyday. WWE = well-woman exam. So, in this case... not exactly. Pap = well, we all know what it = , don't we?! And if the patient is a Well woman, she can usually cope with stirrups and dropping her knees out to the sides despite the awkwardness of an exam that so completely exposes her. If, on the other hand, she is a middle-aged woman with severe cerebral palsy who just happens to be wheelchair bound, with limited mental capacity and a tendency toward "tantrums" (her mother's word, not mine) ... well now, that puts a little different spin on things.
Her back is so permanently arched that her constant view is of ceilings and sky. Her limbs have multiple contractures, which means she has NO flexibility of her joints, and her arms and legs are spokes projecting randomly from her emaciated trunk. She weighs 80 pounds. She wears a diaper (again, her mother's word). Her mother, by the way ... is God's own angel. She must be in her 70's. She was recently widowed - in 2004. She treats her precious child with ... profound respect. She sees her daughter as she IS, with clear eyes neither harsh nor maudlin. This mother does not look away. She does not seek to make excuses or apologies for the person her daughter is NOT. By her example, this mother teaches me, again, how to treat my own children, and the children of all my patients' parents.
What terrible sadness this mother must have felt in the moment of knowing her sweet, perfect little girl was not to be. She would never skip rope, play hop scotch, run laughing into mommy's open arms. Snuggle her head into mommy's neck ... sweet aphrodisiac, that. NEVER. Not ever. Not once in 48 years. So what was left to do? Just love. Respect. Assist. Nurture. Gentle. Accept. And she has.
It took 4 of us move the "patient" (uck, that word so does not fit what I feel in this moment) from her wheelchair to the exam table. We left them in privacy, mother and daughter. I returned when the un-dressing was done, the gown and drape were in place. I sought to be as loving as the mother, as respectful, as genuine and plain. I hope I was. I think I was. I sure hope I was. It was an Honor.
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