An Unmeasurable Vital Sign

“How do you do it?” my dear friend asks me. A marriage and family therapist, she finds it hard to hear about the physical ailments of my senior patients—all of them over sixty-five, all homebound due to mobility impairment from a serious illness or injury. “I could never do it,” she says. “With my patients, I help them create new beginnings. For yours, there are none.”

I’m offended by her view, partly because it paints my primary-care job as less than desirable, but even more because I don’t see it that way. In my humble opinion, my job is to help my patients see each end as a new beginning. This shift in perspective can be the difference between suffering and peace. It’s a difference illustrated by two patients of mine.

One has chronic fatigue syndrome and won’t engage with home-health physical or occupational therapy because of debilitating depression and anxiety, issues that started years ago when a hysterectomy and bilateral mastectomy took a toll on her sense of self.

The other one, a former elite athlete and scientist whose peripheral vascular disease led to a leg amputation and phantom limb syndrome, asks fascinating medical questions out of curiosity and offers me oranges from the trees he encourages his wife to cultivate in their backyard.

The latter is more mobility impaired but feels less so than the former. He views his condition as a challenge, one he doesn’t like but must accept and find ways to meet if he is to live as well as he can. Such perspective is no small feat. It wouldn’t be reasonable to expect everyone to be able to achieve it. When physical health declines, it’s more than understandable for mental health to suffer an even greater blow. Yet hope is an important albeit unmeasurable vital sign.

How do I keep on visiting patients in their homes as they endure so much suffering? Like the patients I admire, I do my best to find a new beginning in every ending, even the end of life.

Sara Lynne Wright
Mountain View, California