Report of 15 Sept 2019
Good evening -
It is dusk. The cows will be going home soon. The sea has merged with the sky in color. I have eaten a cold mango - you know, the manna factor. I am lucky that the mango hoard is lasting until now. Mango season is typically April to July.
A patient in Adaikalam has died today. She had bed sores which got infected and then got more bed sores. She had no appetite at all, thus we could not nutritionally get her buffed up for surgery, which she needed. Scott had surgery once on his back; it left a gaping hole and we altered his diet - I put beef on the menu almost every day. The hole healed in about 6 weeks. We had no such luck with this lady: she would not eat, thus a tube leading from her nose to her stomach had to be placed and we poured nourishment into it. My sister-in-law, Susan, even gave me recommendations on what to feed; Susan is an excellent nutritionist/dietitian and I welcomed the advice hugely. Our staff were very diligent, considerate and loving (this is usual at the Banyan, so now you know why I work here) with their care, and the patient died. We knew the end was coming.
Through all this, however, I told our staff that I was grateful the patient was with us, that she was going to die with us and not untended on the street, homeless. 1/3 of patients with mental illness become homeless. Not this lady. She had a home with us, and a family, and received love and attention and dignity in her passing. She died as she lived: with our respect and affection. For this, I am profoundly grateful.
It does not alter the fact that I feel some things could have been done differently. Many doctors go through this soul-searching. The buck stops with me. At one locum assignment in the U.S., when a pharmacist gave me wrong advice and I subsequently questioned the person, the answer was "Well, Dr. Weiss, you are just trying to put the blame on me for a decision that you made." I said, "Not at all, the ultimate provider in charge of this patient's care is me, and I take complete responsibility for the situation. I do wish to question you on your recommended antibiotic." The buck does, indeed, stop with me and the pharmacist seemed mollified. Folks in the U.S. are perennially scared of a lawsuit.
Kovalam was fine.
Scott and I were out and about yesterday. We live well outside town, thus plan our sorties into town carefully. We attended an excellent talk on stroke at a fine local hospital, ate at the hospital's cafeteria, and then went to 2 markets. These are places where the vendor sells directly to the client without middlemen. Scott has several cotton shirts bought at such places and my father has unfailingly admired them, so we bought him one. We also saw a play, being supporters of theater. Today, my sister, Anu, came into town and we met up with her. That was fun. We attended a market of home chefs, who had delicious fare on sale, and we bought quite a few things.
We spoke with the boys - quite unfailingly the highlight of my weeks - yesterday; that was the merry fest it always is and though it was very late for the boys - 10.45 PM and after - they were genial enough. Trying to find a time suitable for all has become a quest: Naren and I sleep early and wake up early, and Navin may or may not remember the time we set up to chat. All sorts of merriment, but the boys make it work.
Our swimming pool has reopened and I was fortunate to get a swim in this morning. It was before news of the patient arrived, thus I had no melancholy to manage with the swim, it was just a swim - just the dancing water, the lights in it, the bubbles my breathing and strokes made, the blue sky and me. It was therapeutic. The day goes well when I have swum. It has rained off and on, and the pool water has fresh rain water in it, not stale water cleaned and re-cleaned. Thus I did not sneeze my eyeballs off after the swim. Scott had a cup of hot tea for me after my swim and that also helps reduce the sneezing.
I will talk to my father when I am done blogging. That will be nice.
Enjoy your loved ones. Give them a hug or - if you are not a hugging family - a kind word.
Unw -
R
It is dusk. The cows will be going home soon. The sea has merged with the sky in color. I have eaten a cold mango - you know, the manna factor. I am lucky that the mango hoard is lasting until now. Mango season is typically April to July.
A patient in Adaikalam has died today. She had bed sores which got infected and then got more bed sores. She had no appetite at all, thus we could not nutritionally get her buffed up for surgery, which she needed. Scott had surgery once on his back; it left a gaping hole and we altered his diet - I put beef on the menu almost every day. The hole healed in about 6 weeks. We had no such luck with this lady: she would not eat, thus a tube leading from her nose to her stomach had to be placed and we poured nourishment into it. My sister-in-law, Susan, even gave me recommendations on what to feed; Susan is an excellent nutritionist/dietitian and I welcomed the advice hugely. Our staff were very diligent, considerate and loving (this is usual at the Banyan, so now you know why I work here) with their care, and the patient died. We knew the end was coming.
Through all this, however, I told our staff that I was grateful the patient was with us, that she was going to die with us and not untended on the street, homeless. 1/3 of patients with mental illness become homeless. Not this lady. She had a home with us, and a family, and received love and attention and dignity in her passing. She died as she lived: with our respect and affection. For this, I am profoundly grateful.
It does not alter the fact that I feel some things could have been done differently. Many doctors go through this soul-searching. The buck stops with me. At one locum assignment in the U.S., when a pharmacist gave me wrong advice and I subsequently questioned the person, the answer was "Well, Dr. Weiss, you are just trying to put the blame on me for a decision that you made." I said, "Not at all, the ultimate provider in charge of this patient's care is me, and I take complete responsibility for the situation. I do wish to question you on your recommended antibiotic." The buck does, indeed, stop with me and the pharmacist seemed mollified. Folks in the U.S. are perennially scared of a lawsuit.
Kovalam was fine.
Scott and I were out and about yesterday. We live well outside town, thus plan our sorties into town carefully. We attended an excellent talk on stroke at a fine local hospital, ate at the hospital's cafeteria, and then went to 2 markets. These are places where the vendor sells directly to the client without middlemen. Scott has several cotton shirts bought at such places and my father has unfailingly admired them, so we bought him one. We also saw a play, being supporters of theater. Today, my sister, Anu, came into town and we met up with her. That was fun. We attended a market of home chefs, who had delicious fare on sale, and we bought quite a few things.
We spoke with the boys - quite unfailingly the highlight of my weeks - yesterday; that was the merry fest it always is and though it was very late for the boys - 10.45 PM and after - they were genial enough. Trying to find a time suitable for all has become a quest: Naren and I sleep early and wake up early, and Navin may or may not remember the time we set up to chat. All sorts of merriment, but the boys make it work.
Our swimming pool has reopened and I was fortunate to get a swim in this morning. It was before news of the patient arrived, thus I had no melancholy to manage with the swim, it was just a swim - just the dancing water, the lights in it, the bubbles my breathing and strokes made, the blue sky and me. It was therapeutic. The day goes well when I have swum. It has rained off and on, and the pool water has fresh rain water in it, not stale water cleaned and re-cleaned. Thus I did not sneeze my eyeballs off after the swim. Scott had a cup of hot tea for me after my swim and that also helps reduce the sneezing.
I will talk to my father when I am done blogging. That will be nice.
Enjoy your loved ones. Give them a hug or - if you are not a hugging family - a kind word.
Unw -
R
posted by Renu at
5:50 AM
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