“Doctor, he cannot be moved. Could you arrange to see him at home?” Admittedly, a request like that is almost never exactly welcome at first blush. Sometimes, you know such an appointment can be managed from a distance (if the patient’s problem isn’t serious). More often, you worry about practical difficulties (how to find the home—now much easier since the advent of GPS; whether there will be a convenient parking space; how much can you do without your usual office facilities; and, most importantly, how you’re going to carve out the necessary time—several multiples of a routine office visit—from your already busy workday).
In practice however, you rarely regret a home visit. Once you overcome your hesitation, and the practical obstacles, you get to know your patients in a different light when you see them in their own daily environment, which certainly impacts on their health and quality of life in many ways.
A patient’s home tells you a lot of things that would never come to the fore in the orderly, sterile environment of a medical office. The space available, the furniture, the clothing, the heating, the overall appearance, the presence or absence of a family support system: all these and many other details have their own significance. How accessible is the place? Are there stairs that need to be negotiated by a handicapped person? Can he or she move around, or is constricted space a complicating factor? Is it a home or a prison?
Along with these practical features, you learn some lessons that are rarely if ever raised in textbooks or journals or at scientific conferences. For example, how does a working woman manage the care, year after year, of a bedbound, totally helpless, uncommunicative, fully dependent husband? She has escorted him from hospital to hospital and has converted their house into a chronic care center, even though any hope for significant progress has waned over the years. She has relinquished her own living space and time; she works and runs errands and keeps vigil every night. And she still has the strength to smile, and in response to the doctor’s praise for the love she shows to her “living dead” husband, say, “Doctor, he understands it and responds to it!”
Admiration is too poor a word to express your feelings. You bow your head, realizing how low you stand compared with such Souls. With a capital S.
Anthony Papagiannis
Thessaloniki, Greece
1 thought on “In a Different Light”
Thank you for your powerful piece, In a Different Light. The way you highlighted the quiet strength of caregivers, especially the wife caring for her husband, really moved me. Your reminder to see patients beyond the office and in their own environments struck a chord. It’s a perspective that has deepened my understanding and will stay with me.
Thank you for sharing such an impactful story.