:: to the teeth ::   thoughts on social justice, medicine, race, hope and beats
"Another world is not only possible, she is on her way.
On a quiet day, I can hear her breathing." :: Arundhati Roy ::
"The most common way people give up their power is by thinking they don't have any." :: Alice Walker ::
Wednesday, September 22, 2004
Asthma as a symptom of GRIEF?
i was doing a night shift this week, earning my whole-grain bread and organic butter, as a hospitalist. my job there is to admit patients from the ER and hang with them until the morning shift MD's come on. it's good money and fairly light work. average of 3-7 admits a night in a system that actually works, except for getting old medical records...
so a lady came in to the ED with two weeks of an asthma exaccerbation. non-smoker. she had tried everything at home from mdi's to nebs. she was buzzing on albuterol and still feeling like she couldn't get her air in. when i saw her, she had already spent about eight hours in the ED getting high dose nebs and IV solumedrol with no resolution. she was able to speak full sentences and her O2 sats were okay but her chest sounded tight with wheezing and poor air movement. x-ray negative, blood work normal.
classis asthma exaccerbation. well, what had caused it? i asked all the usual questions about illness, environmental factors, work factors... no hints.
so i'm interested in these body pressure points and i've been learning reflexology. since she'd had everything done that western medicine could do, i offered her a reflexology treatment while still in the ED. she accepted, it's baasically just a foot massage anyways, who wouldn't want one?
there are points around the mtp joints that represent the heart and lungs. i started working these areas, which were painful for her, but tolerable and the most amazing thing happened. her story started to unfold. she shared with me that two weeks prior she had had a dream of her sister who had died while giving birth to her third child. the child had also died at the same time. tragic. this lady was raising her sister's two other children. after that dream, she had been unsettled and had taken a road trip to go visit the grave of her sister and her mom, who are buried together in Roswell, NM. (where all the aliens are!)
in 13 years, she had never let herself experience GRIEF. the treatment relaxed her enough to be able to name the process she was in and helped her breathe more easily. GRIEF can be overwhleming and scary, as many of us human's already know. it was a privilege to be able to help her transition from 13 years of fear of grieving to a healthy engagement with her feelings and her natural life process. somehow that treatment helped her frame her "illness" in a way that gave her insights and therefore, some level of control and comfort. the ED is an intimidating place. certainly some people share really intense things there, but generally, the setting is so hostile to care and love that people find it almost impossible to talk about the sory of their lives.
so was it an asthma attack or not? hell yes, and an ER doctor could have just treated it with nebs and steroids and been done with it. her grief is her problem, it's not going to kill her. but the real question here is how deep down the rabbit hole do you want to go? blue pill or red pill?
there are techniques and tools and skills and ways of relating to people that open and connect and empower. and there are styles of practice that minimize and limit and control and define the parameters of exchange. ideally the choice would be based on the notion of what's therapeutic for the patient but often it's based on what's comfortable for the provider. and in a racialized, classist world with most providers coming from positions of unexamined privilege. sometimes we have to get uncomfortable as providers, to sit next to people who are in places of consciousness that we cannot even begin to understand.
for medical students and nursing students who often feel like leaches with nothing to give and way too much to learn in a fairly intense environment, consider spending a few days learning reflexology, or any other touch technique, and you may find yourself a more valuable memeber of the care team than the attending physician. with that being said, you probably are a more valuable member of the team than most attending phsycians anyways... :>
posted by andru | 9/22/2004 10:02:00 AM | |