Thursday, April 06, 2006

Going beyond "medical" care

Practicing medicine is extremely demanding and sometimes it seems that it is almost impossible to manage the medical needs of extremely ill patients, let alone the psychological needs. It feels like there is no time to delve into side effects that are not mentioned or to address questions that are not voiced. Rebecca Peterson's experience of her husband's illness and death remind us that addressing these needs could relieve some of the burden on dying patients and their families.

Rebecca Peterson's essay, accompanying a very moving article on NPR, offers insight into dying of a brain tumor. Stewart Sellman was diagnosed at age 48 and died within the year. The article describes his progressive deterioration and the impact on his wife and two school age children. It manages to capture the horror that contemporary cancer treatment can be.

Although Selman's doctors took excellent care of him medically, they left him to struggle on his own with the side effects of his treatment. His wife did not realize until later that her husband's bouts of mania and paranoia, which destroyed their home life, were known side effects of his treatment. Because she did not know, she did not think to ask the physicians for support and treatment to ease the symptoms, and because she did not ask, the physicians did not offer the information that these symptoms might occur and could be treated.

As Selman's wife, Rebecca Peterson relates:

... it would also be such a relief if health care professionals not only warn of possible side effects, but have a plan in place for remedying them. Further, it is incumbent on the health professionals to not ignore the behavioral aspects of treatment, especially in illnesses involving the brain. It is immensely difficult to tell a doctor in front of your loved that they are imagining things that didn't happen – especially if your loved one doesn't believe you, and in fact, Stewart rarely believed that his behavior was unusual.

Peterson's plea serves as a poignant reminder about why medical care is about so much more than "efficiently" applying medical knowledge.


Anonymous Happystance said...

I found those entries about Stewart Selman and Rebecca Peterson to be searingly honest and very moving. I run voluntary workshops in laughter and resilience for carers and I frequently come across people with complex emotional responses to the people for whom they are caring. It is difficult for carers when there is a diagnosis that gives someone 'permission' to be ill. When the person for whom they are caring has medically unexplained symptoms, then it just seems to add to the chaos and uncertainty.

10:37 AM  

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