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November 02, 2010

Don't be "Circling the Drain"

Yesterday, as I was walking out of Surrey Memorial Hospital, I jumped in my car to head for the ferry and I turned on CBC radio. It was pretty interesting timing. The show White Coat, Black Art with Dr. Brian Goldman was on. The episode was called When Your Life is Circling the Drain.

If you're in a hospital, and you overhear a health care person saying this about you, apparently you're in deep du du - or you soon will be. It's a horrible term. Apparently, it's the slang for about to die as in "Holy shit, he's circlin' the drain."

Somehow the reality of this little problem (that as humans we each have a limited life span) has not been an internalized part of my father's attention. Until the last month, or maybe even the last couple of months, he's never considered himself old because he's always been healthy, able bodied, of quick mind. That makes sense but  it doesn't change the realities of aging. At 92, he says there's "lots of people older than him".

Now, it's probably a really good thing to never consider yourself old. Except, when you're ill and you're 92 and things are going wrong. Then, it might be better to start to think about what it all means and how you'd like your end of life to unfold. But, hey, that's just me.  I tend to be too much of a realist for my own good.

The thing is, navigating "the end of life" requires an amazing level of communication skills. And, men and women from "that generation" are not known for their amazing communication skills when it comes to the really important, emotional stuff.

When you're having to be there for an elderly parent, the unspoken stuff doesn't go away. Like, for example, when you see family members tending to the unwell one in hospitals what you don't see is the family dynamics. End of life duties don't take into consideration that the child who may end up having to do most of the caregiving because of proximity may have been treated badly and unlovingly by the parent. Is that fair?

Is it fair that unlike in the movies, people don't tend to change at the end of their lives. If they weren't able to say anything of emotional significance or acknowledgement during your life, they don't suddenly become Carl Rogers.  It's not a Hollywood movie. Deborah Winger and Shirley McLean are not in the building.  Unresolved resentments only multiply when caregiving is added to the obligations.

What I really dislike about the entire hospital system is that there seems to be so little place for meaningful communication. Visitors and patients become like shuffling zombies. What the patient really needs is not magazines or bananas, they need someone to bring some open ended questions that might initiate some meaningful dialogue. 

What the family needs is a much easier way to get information without feeling like they've just accomplished something major when the doctor is actually able to "be caught" and can then spend less than 5 minutes explaining what's going on. What other business can you think of would you be getting paid to do something so important and never have time to explain to your clients, the details, unless they happen to "catch" you?

It's insulting that after being able to navigate life for 92 years, some doctors still don't see the crucial necessity of dealing with their patient directly. I couldn't help but notice that the doctor told me to come out into the hallway to answer my questions when in fact, he was talking about a patient who is mentally able. What's with that?  It leaves me having to return to my father's bedside to reinterpret the news about all the tests and what might be coming down the pipe. Isn't that his job?

It's all very stressful and sobering and navigating "the system" and trying to communicate "the bigger picture" of what certain decisions will mean requires a level of functioning that needs so much energy at a time when your energy is being consumed by everything else that's going on. 

In short, it sucks and it makes you feel a little bit like you're circling the drain of overwhelmingness yourself.


harriet glynn said...

Oh. So difficult. I hate hospitals. I was imagining myself in one the other day without fresh air and any access to the natural world (what's wrong with that picture?), and I thought seriously, I'd rather walk into the mountains like the eldery Inuit used to do. Not that that has anything to do with communication. But then again, maybe it does given all you have is a hall, a caf, a bed and a TV lounge. Sorry to hear about your dad.

Gayle Mavor said...

Thanks. That's a very strange thing to imagine. I like the Inuit way. Do they still do that though I wonder?

heather said...

I experienced the same feelings with all the times I spent at the hospital with my father. It was very difficult to get a straight answer from any of his doctors.I was thankful that he was in hospice when he passed and not in the hospital.

Gayle Mavor said...

Yes, it's crazy that when it comes to the most important thing we have - ourselves - when we're sick, apparently, getting information about what's wrong, depending on where we live and who the doctor is, it's such a challenge. I'd like to know how things evolved to be that way and why so many people have put up with it for so long? I think it's especially true for the elderly depending on who's there to ask on their behalf.