Two experiences from recent weeks that continue to teach:
The patient who shared that when
she was 4 years old she had been a witness to her mother’s murder, which
appeared to be a thread passed from generations – the difficult life her mother
lived, the patient’s challenges, and now a potential estrangement from her own
young daughter.
I believe we had established a strong connection in
the encounter and, upon reflection, was encouraged that I thought to (1) use
the relationship as a point of reference, “You appear to feel safe sharing this
information with me. Thank you. With whom else do you have this kind of
relationship; who else will hear you on this subject as you work through its
meaning now?” and (2) I did not slip into problem-solving mode, but kept my
attention on acknowledging the emotional weight of what she was sharing.
While the encounter seemed successful to me in the
moment, I wish I could have followed up sooner.
I was saddened to have learned today that the intervening week was rife
with medical challenges for the patient. I met the patient again – she was
unable to talk but could mouth the words “I want to go home.” She nodded responses to a few questions and
was tearful and agitated. I offered the
metta prayer I had mentioned to her the week before –acknowledging both her
concern for others and the wish we had discussed that she would care for
(mother) herself. I held her hand as I
recited the prayer; she appeared to calm and fell asleep.
The patient who’s hope was to be
able to be happy.
The content of what the patient communicated over
two meetings was devastating, especially given that she closed her narrative by
revealing that she deserved the
genuinely difficult things that have happened to her – from hard work as a
child helping her crippled father act as a building superintendent, to a
lifelong struggle with eczema and boils, sole responsibility for EOL caregiving
for her parents, a boyfriend who had several strokes and not is more in need of
care than a support to her, estrangement from her siblings, theft, poverty, kidney
disease and diabetes.
When I asked about the relationship as a means to
probe about her sources of support, she noted that it was quite unusual for her
to share all this information with anyone. She sees a counselor once a month,
but the time is limited as it is focused primarily on prescribing medications.
When I
challenge her on her sense of having deserved all these difficult experiences,
she noted that there was something she did that would explain it all – some
“sin” that she was not “ready” to share with me. She had spoken of her non-active Catholic
faith, nonetheless I asked and she rejected the idea of a dialog with a priest,
and she seemed offended that I made the offer.
The offer seemed to be perceived as a breach of the trust she had
invested in this relationship. The conversation ended with the dinner meal tray
- she abruptly shifted from pensive and teary to dismissive. I left, sensing I
had gone as far as we could in this encounter.
Her story stayed with me. She is close to my own age – though would be
taken for much older. Her experiences
had a raw veracity – they took place on streets in neighborhoods where I grew
up – a few blocks away and a few years apart – but miles away in their
outcomes.
How do you get to be happy? Life is never particularly fair and I don’t
believe in fate, let alone an interventionist deity. All Buddhist have to offer is a path to shift
perception – this seems so out of reach for someone so locked into such a
self-defeating and not-unjustified world view.
Defeat.
Hopelessness. That is
consistently hard for me to be with.
