My Files

At work I have a unique opportunity to share some really private moments with people who are virtual strangers. Quite often within 5-10 minutes of meeting a patient, I am following them into the bathroom. As an occcupational therapist* I work in a small community hospital where my job is to evaluate a patient’s ability to care for himself at home, including everyday occupations such as getting dressed, bathing, grooming, toileting, plus other less tangible things like cognitive ability and safety awareness. I wear scrubs to work. Among the key players in my drama are McHipFracture and McDocWearingTooMuchCologne. It is far from glamorous.

I once placed an octogenarian’s breasts in her bra, as her sacral fracture required her to bear down into the bed with both hands in order to relieve some of the pressure from her back, as she sat at the edge of the bed. She was working toward being able to dress herself again.

Several years ago, a patient inquired desperately as to whether I’d seen her MRI. Even if I had, I wouldn’t have been allowed to inform her of the impressions. This stout woman in her early 40’s was desperate for answers as to why she was falling with increasing frequency. During our session, her neurologist entered the room. “Doc, did you see the MRI?” she implored. Expressionless, the 4th year resident stated flatly “You have multiple sclerosis.” then turned on his heel and left as abruptly as he’d arrived.

Today I was shooting the breeze with my patient, Joe** while he stood at the sink, brushing his teeth. Ignoring the cumbersome oxygen tubing stuck up his nostrils, he smiled and talked animatedly as he grew noticeably short of breath. His weak heart made mundane tasks cause him to breathe as hard as if he’d just sprinted a quarter mile. He was about the same age as my dad, but I had to give him a lot of support just to stand up from a chair. I asked him when he started to get sick. He said “On April 5th I found out I had cancer. I had just been in South Carolina playing golf.” I nodded. Inwardly I cringed, remembering where I was on April 5th this year. I was alternating between absently going through the motions of my life, moping around, wondering when I would ever feel normal again in the aftermath of an extreme case of a broken heart. Silly, Silly woman!! Get a real problem!!! I chided myself.

This feeling stayed with me through the day. My dealings with patients typically get tossed carelessly into the mental file, “work.” Within “work” a select few are awarded more careful organization into designations such as “rare case,” “interesting brain injury,” or “my mom’s age with a poor prognosis” Certain people, like Joe, get their own file folder “touched me,” reminding me that life and health are temporary.

*For more information on occupational therapy go to http://www.aota.org/
**not his real name

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