Wednesday, January 4, 2012

Emotional intelligence and dignity in medicine

I had to grab this photo opp with Scary Santa at Oak Haven Nursing Center.

I'm not sure if he is Mrs. Claus's partner or not, but at 7 feet plus that would give Mrs. Claus a shot at being an NBA wife.  I smell a reality series about a real Santa housewife.
Mrs. Claus- future star of reality TV.
Me and Scary Santa at Oak Haven

Having just placed my grandmother back in the nursing home at Oak Haven as I prepare for my return to Buffalo, NY, I am again pondering patient dignity and emotional intelligence in medicine and medical decision making.  I had my grandmother, who is a total care bed-ridden patient, at home with me at my house in Effie (which was until last month my mother's home--my mother just died of liver cancer).

When all you can do isn't enough:

I hired round the clock sitters to attend to my grandmother in her hospital bed in the living room while I cooked gumbos, cobblers and puddings to tempt her appetite.
Her two sons and I had hoped for an improvement in her declining condition with one on one care, home cooking and personal attention.  Though my grandmother suffers from no particular disease or syndrome other than advanced age (her 94th birthday is a week away) and progressive dementia, her physical and mental status has declined rapidly since my mother's recent death (her only daughter and eldest child).  Simply said she has given up.  She no longer moves any part of her body voluntarily and must be prompted to chew and swallow as she is fed.  This is most disconcerting, as eight to ten weeks ago, she was ambulatory, feeding herself and interacting with family.

So how do I take the next step with her without "giving up" or losing dignity?  Our best efforts were not enough to stop or slow her decline.  She occasionally told us that she no longer wishes to live.  Yet placing her in the nursing home (where my father also is), though necessary, still seems unsatisfactory.


I admit it is certainly a relief to have some modicum of privacy back as we stop the constant parade of hospice caregivers and sitters through our home.  I am glad to say goodbye to having a stranger constantly sitting in my living room around the clock and the flow of 8-10 people it took to care for her and the burden of scheduling and payroll.  But I do feel selfish as I enjoy this relief.

Emotional intelligence

So as I ponder PA school and continue the interview process, I am thinking about how one brings emotional intelligence to caring for the sick, elderly and dying.
I recently read an excellent article by a medical school student in Indiana on emotional intelligence in medicine.  Molly McPheron writes about her understanding of her own emotions as she balances her medical studies with life and learns to recognize illness in the faces of her patients.  She rightly cites a need for a safe place for medical students to delve into their own emotional IQ and explore it for the sake of their patients.

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