Today, one of the longest overstaying patient I had finally went out of the hospital.
Everyone gonna miss this jolly, friendly guy for sure.
But he seem not happy.
He’s being escorted out of the hospital and into a jail, for a crime he committed before he was admitted.
Guess, he liked the ambiance of this hospital than the place he’s going to live in for some time.
If I was in his place, I’d be sad too.
In the past, I work closely with rehabilitation physician in the course of treating my patients. Since I went into private practice in the province though the lack of a Rehab physician in my area pushed me to learn and give rehabilitation regimens to my post op patients. What i discovered first was not really about the nitty gritty of giving exact instructions on physical rehab regimens. The necessity to communicate clearly and cultural sensitivity plays an important role and could save you from embarrassment or worst, the barking look of your own patient.
Mrs. Cruz (not her real name) is a 56 year old soon to be retiring school teacher I operated on after she sustained an bi malleolar ankle fracture from a vehicular accident. She was a stern looking bespectacled woman, barely smiling but very sharp with her unending probing questions. She claimed to know me when I was still an elementary grade pupil (although, I couldn’t remember exactly if she was one of my teacher), but I suspect she isn’t the type of teacher you and your nasty classmates could play jokes on. Anyhow, I operated on her uneventfully and she is on her first week of follow up post op. Time for rehab I said.
She was accompanied by her equally stern looking husband, a former military man from the looks of his eyes when she came in my clinic.One of her son was waiting outside the clinic and was I guess an added “assist” should the need arises. I just came from two succeeding ORs, barely had any sleep and was pretty tired from whole day of running around the hospital seeing patients. I am in my usual cool emphatic composure, but it was 4PM and my energy is almost spent since 7 am that day.
“Good morning Mrs. Cruz,.. Sir!” I said. Greetings which was met by a querying look from both persons. “Hows your operative wound madam?” “Have you been dressing this daily?” I continued. “Yes” she said. I went through the routine of checking her post op wounds, examining it and then removing the sutures after seeing the wounds are all healed already. I then checked her ankle joint’s range of motion. It was a bit stiff even if I did one good operative job and has checked the range of motion intra op to be “full”.
Time for a “rehab” I said nonchalantly to Mrs. Cruz.
I was skimming her chart and fumbling on my phonebook at the same time for the cell number of our in house physical therapist. I noticed the couple looked stunned and was looking at me squarely liked I said something really awful.
“Rehab, doc?”. Mrs Cruz didn’t blink to ask me again. Half stunned, half in disbelief.
“Yes, Rehab” I replied a bit annoyed and spent.
Then Mr. Cruz, face red in embarrassment, looking more serious and agitated now, butted in “Doc, my wife is a teacher, she doen’t have any vice at all, at this age, I really find it hard to believe she is using any drugs!!!” in Tagalog.
“Ugh!Oh no, no..that’s not what I meant! Her ankle needs physical therapy so she can walk painlessly again on that foot!”
The rest of this story brought back the adrenaline in me that day. I was totally insensitive, perhaps because I was so spent with toxicity. In a provincial community where I practice, social stigma for drug addicts and sensitivity towards implying one is using any addictive substance may cost you your life. In this part of the country (and in some other parts too), “Rehabilitation” means drug rehabilitation. Many believe its derogatory and I guess, I learned my lessons that day.
Perhaps clarifying things out, being socially sensitive and a bit more of patience, will save you from your own “close calls” with ‘rehabilitation”.
In all my years of practice as a physician and orthopedic surgeon, it dawned on me that I get the ultimate satisfaction from patients’ “‘smiles” at the end of their treatment program. There’s no doubt also that I get extreme satisfaction from technical masterpieces of orthopedic work that came my way during the course of my practice. But there’s none yet so far, as equally as pleasurable and satisfying as seeing your patients beaming with a smile on the last day of your rehabilitation program.
One time, when I was alighting my car on a parking space near a fast food center, I almost had a misstep after a short, muscular guy shouted, “Doc A!!!!” . The guy is sporting sunglasses, a Lakers bull cap, city shorts and tennis shoes. He was beaming with a smile and was waving his hand frantically while moving towards me. I stopped for a moment standing near the stairs, totally confused at who this stranger is coming towards me. I didn’t recognize him even if I tried so hard to remember his face. When he was an arms length away from me, he extended his right hand for a handshake and is now smiling and laughing at me. “You don’t remember me now doc?!” said this stranger. “I’m Mr. B!, the one of your patients who had this below knee amputation after that bombing incident near our marketplace, remember?” I looked down his lower extremities, I barely recognized his prosthetic leg despite the city shorts he’s wearing! “You’re Mr. B?!” I blurted surprisingly. “But you look and walk so “normal”! “Thanks to you doc. If it weren’t for your help, I’m probably be some useless person, begging my ass in the streets by now”. For a moment, I felt like a big man beaming with pride. I smiled back and offered a tight handshake and a hug.I was so damn happy he was smiling and was walking like a normal person again!
I treated Mr. B in the hospital for more than a month, trying to save a mangled lower extremity brought by an exploding improvised explosive device( IED). Undergoing several operations, I was hoping I could save a few inches more of an amputation stump, so it wont be an above knee amputation. It’s relatively easier to rehabilitate below knee amputees than patients with above knee amputations. But there’s more than to amputations and surgeries for this patient. I was trying to help a person recover from a traumatic experience and help him become functional person again, contributing to his community. I was giving him hope that even with prosthetics, even if without money for prosthetics, he’ll live a normal, life again. That was the challenge.
Together with his family, we inched our way, through rehabilitation and difficult obstacles along the way. Finances were dwindling and prosthetics are almost always costly and difficult to obtain in this part of the world. Rehabilitating patients with prosthetics is even harder. Most patients complain that it is far more eassier for them to just throw of their prosthetic leg and use crutches instead for the rest of their life. But me and Mr. B is pinning our hopes on, hope. We annoyed many agencies with our persistence – foundations, prosthetic centers, rehabilitation centers. When Mr. B finally got into an in house rehabilitation for the differently abled person, I lost contact with him for more than 6 months. He was in another place the last time we talked on the phone.
Then this unexpected meeting happened.
“You mean, you are really Mr. B?” I was asking him again and again out of disbelief. “Opo, doc!” his huge smile is most viral. I can see the very happy, lively and “normal” guy in him now. It was as if nothing happened in the past. This guy, who was at the brink of depression months ago, is one very happy, one very normal person again.
I tell Mr. B’s story to all my patients who are at the brink surrendering to their afflictions. He even serve as a model for my patients that has had amputations. Even such traumatic experience couldn’t erase one of man’s hallmark of ” humanity”- hope.
As for me, I smile with pride and confidence telling this story to all my other patients. I always take pride in my patient’s stories of hope and how’d they’d live through years despite their predicaments. That was always my mantra in this profession. Hope for my patients, smiles in their heart. I’d be one very happy doctor if I can at the very least achieve that…
Lift your head, baby, don’t be scared
Of the things that could go wrong along the way
You’ll get by with a smile
You can’t win at everything but you can try. “With A smile, Eraserheads”