Many years ago, while spending some time in the lab, I had a part-time job in home healthcare. I had three patients. They were all over 85 years old. The only male patient among the three had had a stroke and his loving wife needed help taking care of him. She was an extremely loving woman but of a slight build so it was really hard for her to do all she had to do for her sick husband. They didn’t have kids but the love they had for each other filled the home.
The other patients – two women – provided an interesting case study. They were both in their 90s. One was a widower while the other never married. The widower had spent her life working with the homeless and needy the other used to be an attorney. They both never had children. However, the home of the widower was always warm and welcoming. The other not so. The widower got visits constantly from nephews and nieces. In the year that I took care of them, I met only one relative of the old attorney – a young nephew. He visited once. I gathered there was more family out there but they never visited. The widower was spry, active, witty and sharp. The old attorney not so much. Somehow, she was always ill even though she really had no debilitating chronic ailment.
Over time I wondered what role the family of lack thereof played a role in the health of these patients. The man who had had a stroke was sick but mending nicely from all the care from his loving wife. The widower was was always looking forward to a nephew or niece visiting and looked great for her age in spite of several chronic conditions. The attorney, well…
That year made me think of family a lot. It made me think of the support that family brings. It made me wonder about the warmth it can create and the health benefits.
Years later, I found myself in Kentucky. Now Kentuckians are very family-oriented people. Having my extended family in Ghana, they make me miss them everyday. Each morning in the preoperative area in the hospital, one can see several children and grandchildren waiting to give a grandma a kiss before she goes off for her new valve, fathers surrounded by kids before that knee replacement, mothers with sisters before that mastectomy – all celebrating family and the art of support.
Imagine my surprise one morning when I went to see a patient preoperatively and did not see a soul with him. Of course I had to bore. The man was in his mid-60s. I found out that he was divorced and not in contact with his former wife. He had no children but had one living brother who lived in another state. I asked if the brother was going to be there. He said no. The nurse asked if he had the brother’s number so she could call him and keep him up to date (During surgeries, there is one family member who is kept up to date on the progress of the procedure). He said he didn’t have a number and that they communicated by email! I was stunned. By email?
He went on to have his surgery and did well but all day that day, I couldn’t get him out of my mind. It made me think of family and support….again!
Facing surgery and anesthesia is a very intimidating prospect for most patients. Even tough men who have been through the rigors of war show cracks preoperatively. Having loved ones around helps one greatly through this time. The immediate expression of love and support reassures and raises one’s spirits. To imagine a patient going through this period alone boggled my mind.
Now sometimes family can be a hindrance. Family members can be disruptive and delay decisions on important procedures. Everyone in OB knows of the husband who passes out at the sight of the epidural needle, gets a concussion and unintentionally delays his wife’s care. In all however, family support in times of illness is indispensable.
It is not only in the perioperative period that family support is advantageous. Another important instance where family matters is in the care of people with chronic diseases. Patients with diabetes, cystic fibrosis, mental health problems and even addiction all do better when there is support at home. Several studies show that this support prolongs lives and decreases the incidence of complications. Family helps patient keep their medical appointments, monitor parameters like their blood sugar and blood pressure and take their prescribed medications. They provide the emotional support that is often so direly needed.
Even though the overriding theme in this piece seems to be about family, it is really about support in the time of illness and need. After all those years, I kept seeing the importance of support. Support through the tough times help emotionally but also seem to translate into more stable vital signs, faster healing and better outcomes. Even though it comes easier and more readily from family, in the absence of one, good friends can offer that support. It reminds me of the refrain from the old Bill Withers’ song:
“Lean on me when you’re not strong,
I’ll be your friend, I’ll help you carry on.
For it won’t be long ’til I’m gonna need
Somebody to lean on.”
Over the years one thing is become rather clear – that in the art of healing, support may be the part we physicians cannot control but is direly needed.