Disclaimer: Although I have medical knowledge, I am not a practicing physician. For medical advice, please consult a health care professional!
Gastric cancer is not at all pleasant. It hurts. It hurts like f###ing hell. In later stages it can be 7-9 on the “pain Richter scale”, as I like to call it.
My mother suffered for years with it because her young doctor thought it was just stomach flu, “tummy twinges”, indigestion, or just the usual complaints of a 92-year old biddy.
There’s more to say, and bear with me, me lassies and laddies, for I’ve tales to tell. …
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So Mom had been having these “tummy twinges” for years, but just thought it was indigestion or generally part of “growing old”. She really liked her doctor, a youngish woman of the same ethnicity so they could converse in her native tongue, thought she was really “nice” and sympathetic.
Until the pains started to get worse. Dr V, thinking it was just indigestion, acid reflux, or erosive esophagitis, prescribed a variety of meds … but nothing seemed to work.
Then, on a hunch, I suggested an occasional glass of sherry, since it seemed to work for me (not actually knowing how severe her pains were, since, like the typical Eastern European, especially if a woman, one mustn’t complain).
That “sort of” helped, a little, but that was a mistake on my part. But her Dr. V agreed, let’s give it a try.
I didn’t know then that she had gone through at least 5 heating pads in an attempt to alleviate her pains. 5! None of which were working when we found them; clearly, she had them on 24/7 to help, and they all stopped working, one after the other. That was awful to know.
One day she called to say she just had to call her doctor again because the pain was unbearable, and the doctor finally agreed to have her transported, by ambulance, to a local hospital.
We went to see her.
The doctors there had wanted her to have a CAT scan of her stomach. She was afraid. She didn’t know what it was. She thought it would be invasive. She almost wanted to die. No-one even tried to explain to this little, lonely, frightened old lady what was involved — the medical terminology was far beyond her comprehension.
Until (((E))) and I showed up, and carefully, patiently (she doesn’t like impetuous people, so (((E))) was better at this than I) explained that “it’s just an advanced X-ray (Roentgeni kiirid)”. She then, dubiously, consented, and upon coming out of the lab, said, (translated) “That’s right! A big machine, but I didn’t feel anything!” Then more dubiously, “Will this really help?”
Aside note: Mom wanted a cure, not a treatment. So she would be prescribed medications, and upon feeling better, stop taking them. Whereupon the dose would be increased, same result, over and over again, until another doctor realized what she, and her prescriber had been doing, tossed them all, and had the original doctor (who was by that time well into his 80s) resign his practice. Mom didn’t like that.
So she expected the CAT scan to “help”, i.e. to be part of the cure, which of course it wasn’t, but only to assist in the diagnosis, but she really didn’t understand that, and it was really difficult to get it through.
Another aside: She was no dummy. She had a University education in her native country (Dipl.Mus., 1932) and was an accomplished pianist, organist, choirmistress, poet, and composer, in addition to being her country's first female verger/sacristan.
In Canada, she was invited to join the Royal College of Organists, but never got around to it (!) because she was "too busy".
Well, the ending is sad. She was finally diagnosed with terminal stomach cancer, having suffered pain I know not for years, and spent her last weeks in a hospice before passing away, aet. 94.
Lessons that physicians and other health care practitioners must learn when dealing with geriatric all patients:
Old People are not stupid
- Explain what’s happening, what you’re doing, and don’t assume
- Don’t dismiss their complaints
- Explain why you’re doing this procedure
- Pain is not something to be casually dismissed
- Monitor their medications carefully
- Don’t assume anything
- Be honest: will this procedure be invasive? Will it hurt? How badly? For how long?
- Early and accurate diagnosis is vital
- Explain, explain, explain!
- Be sympathetic, not dismissive
- Explain again
- And again
- And again
- And don’t be impatient
- Be considerate
- Be thoughtful
- Be respectful
- And don’t make fun of his/her teddy bear (talisman, amulet, or protector)
- Keep at it until the patient understands
- Be patient to your patient.
Yes, I know! Physicians and HCW are busy people, under stress, with time constraints and they don’t have the time to deal with everyone as patiently as my idealisation above.
So let me boil it down to three:
- Listen (and I mean really listen)
- Explain
- Be respectful.
M’kay?
And if your patient appears to be “babbling”: maybe he/she’s just speaking a foreign language.
Puhka rahus, kallis emakene (1908-2002).
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