“Only people who are capable of loving strongly can also suffer great sorrow, but this same necessity of loving serves to counteract their grief and heals them.” ― Leo Tolstoy
I haven’t blogged about WORK yet...Not really.
Friday I treated a woman who was “status-post stroke.” It was a massive stroke. And trust me, that term, “massive stroke” is right up there with the term “cancer.” The situation is not good when you hear a doctor utter those words.
The woman I saw Friday looked at me very early in the visit, with honest eyes, and said, “I am just done with all of this.” I knew what she meant and had heard that “white flag of surrender” tone before. But to be sure I asked her to explain what she was talking about. She was “ready to die” she went on to say. “I can’t eat or swallow, I am a silent aspirator (which means she will get pneumonia easily), I’m in diapers, I can’t walk, and I am in pain all of the time.”
This is the hard part of my job. What do you say to that?
After some gentle conversation that centered around assessing her depression scale (which turned out to be low), it was obvious that even though the impairments she had listed out were depressing, she was not depressed. She was just ready to die. She was totally at peace that her body had been robbed of all of it’s function, and after a year and a half of fighting to get it back--unsuccessfully--she was just done. She was proud that she had “fought a good fight” for as long as she had. But she was ready to take the “next train home,” she said.
My job deals with this decision frequently. More specifically...this question: “when is time to stop fighting?” It is a very hard choice to decide to die. Our minds don’t handle it well, sometimes--even when our bodies are ready.
In response to my patient on Friday, I could only think of one thing to tell her to console her in the bowing of her head in defeat. I told her my story...which is not really “my story”--but a story about how someone else’s misfortune can lead to something good for someone else. I told her about how I ended up being a physical therapist. It was the only thing I could think to tell her to help make sense of everything she was feeling in that moment.
The story starts like this...
“Let me tell you about the worst stroke I have ever seen,” I said.
“Worse than mine?!?!?” the patient questioned with anger and suspicion.
“Much worse,” I answered.
One of my best friend’s grandmother had a “massive stroke” my Freshman year of college. I was doing very poorly in school and struggling on multiple levels. I had no direction. No drive. No God. No dream. No purpose.
Then, one evening, a phone call came from the family going through this nightmare from the Mother of my friend (her Mother was the one who had the stroke). “Lucy, you have to come see this place (HealthSouth) and these people (the therapist)!” “You were born to do this...”
So I went to HealthSouth to see for myself. I remember the moment I knew my friend’s Mother was right. I was watching a girl (about my age) who had sustained a spinal cord injury and lost the use of her legs learn to get her sitting balance again. There was a moment I witnessed that was like watching someone teach a child to ride a bike for the first time. The therapist held onto the girl until the last possible moment, withdrawing her support as slowly as she could. When the PT knew the patient was ready, she let go of her. The patient balanced on her own for a few seconds before she even realized that she was doing it on her own. Then the patient realized the success and believed. The therapist knew the patient could do it, but she had to teach and support the patient in a way that allowed the patient to learn at her speed. That was the only way to get the girl to believe she could do what was being asked of her.
Well, I was hooked. It was the coolest combination of coaching and teaching that I had ever seen.
In the next three years I figured out a lot about myself. First and foremost, that I was horrible at physics--but that part of the journey is for another blog.
I got into PT school. And more importantly, I was able to look at the woman on Friday and tell her what I was able to tell my friend’s grandmother before she died: “Your suffering was not in vane...it led me to my dream job, deepened my faith, and it taught me to fight.”
After I finished “my story,” I told my patient, “Maybe your life since your stroke has had a profound impact on someone too...and even if you don’t know for sure that it has, I would bet you will know one day.”
It’s hard to see the silver lining in our hardship in that way, but I think it is important to recognize that the way we go through our troubles can have a profoundly positive impact on those around us. I thank God everyday that my job forces me to keep a realistic perspective on what is important in life. Watching my patients struggle and overcome the basic hurdles of being able to walk and toilet for themselves without assistance makes it easier to not complain about a flat tire, or the fatigue of a short nights sleep, or an expensive grocery bill.
People tell me all the time during work--“you must have to be so patient to be a therapist.” Haha! Anyone that knows me knows darn well I am not patient at all. What I DO have is good perspective.
There is a scene from the 1980 classic “Oh God!” (and I think it was “Oh God: Book 2”) where George Burns plays the character of God. In it, God responds to a little girl named Tracy’s questions. She asks God, ‘Why do bad things happen?” His response was so simple it baffles me: “I kept trying to make a world with just the good but it wouldn’t work. I couldn’t have the light without the dark, the heat without the cold, or the bad with out the good,” God says.
And as a therapist I have learned you can’t have strength without struggle.
I will conclude with the thought on loss (the Tolstoy Quote). My patient will soon get her wish, I have no doubt. She will die...she is ready...and that is okay. The two hardest fights we ever face in this world are likely birth and death. If we could remember our birth, I’m sure we would recall being squeezed through an opening that small, being hit with a 30 degree temperature drop with no clothes on, and breathing air for the first time as a traumatic experience.
So why should it surprise us that exiting this world is any harder than entering it?
As for my patient, I hope she leaves behind a legacy to those that have loved her here on earth. They have watched her “fight the good fight” and that is where their strength will come from when is is their time to do the same thing. Just like my grandparents showed me (and others I have loved and lost)--there is a way to fight with grace and honor. And when that battle is won, it leaves behind a legacy where the sorrow that follows the loss is healed by the same love that causes us to grieve losing them in the first place.
Saturday was a dear friend’s Birthday. She would have been 36 years old if she was here to celebrate it. I know that my grief for her is healed by the same love that respects how bravely she fought--very much in the same way my patients do.
I think Tolstoy was right. Sorrow isn’t fun. But love, though it causes the sorrow, can heal us. And healing is good thing.
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The Sheep behind my parking space... |
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...have good perspective. Much like... |
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...my happy cows. |
If you are enjoying this Blog, you may enjoy my friend Will’s too.