fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

Nancy L. Glass

My Family History of Dementia

Many people are afraid of developing dementia, which is increasingly common as we live ever longer. I have a compelling reason to harbor that fear.

My paternal grandmother developed dementia in her early sixties. The diagnosis was made without any of today’s imaging and biomarker techniques, but the course of her decline, it’s clear in retrospect, was typical for Alzheimer’s. Luckily, she never lost her sweetness or her Southern-ness: she remained hospitable and cheerful to the end, politely hiding her pills under her linen napkin.  One afternoon during a drive through the rural South, she kept promising us that the White Cliffs of Dover were just over the next hill!

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Listening

It was an overcast Saturday as I made my way down the hall, examining one elderly patient after another at our in-patient hospice unit. Mr. G was alone, his room dark. He didn’t respond to my voice. I wasn’t surprised:  his nurse had told me he was close to death and appeared comfortable.

I reached for his wrist to feel his pulse with one hand while I placed my stethoscope at the bottom of his sternum. No radial pulse. But the sound of his heart was remarkable: a thrumming, a quivering, a vibration, a sound I’d never heard before but instinctively recognized. He was in ventricular fibrillation, his heart was flailing.

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Kids Always Know

This is a story about failures. First, it’s about my inability as a pediatric hospice physician to do the one most important job in this tender space. Second, it’s about well-meaning, loving parents’ inability to do their part in that job.

Jacob was a smart, funny, elementary-age kid, great with Legos.

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