Just last week the sickest patient I’ve encountered this year (& for perhaps some time) asked me, if I ever see really sick people.
This 60 something-year-old farmer has a great sense of humour, so I immediately thought he was joking but as soon as I looked up from my notes, I realised my error. It kind of stumped me for a moment. I hoped he didn’t notice the gaping chasm between his question and my response as I quickly recalibrated my own internal compass… of course – our sense of our own heath is SO subjective – he is alive, he is upright & functioning and that means he is well & winning. Because it wasn’t so long ago that he was so very close to losing it all. That ‘note to self’ sent and received I replied, “No, they wouldn’t be coming to see me, they’d be in emergency.”
He liked this response – because I think he could relate. After all, when he was sick – he was in emergency & ICU. But now that he is home & free he is clearly ‘well’ again,
Back then he had had cardiomyopathy that was not picked up until he had just 20% cardiac function – underwent surgery, had a pacemaker put in and is now on the most incredible suite of meds for life. Over the interim 18 months, he has lost enormous amounts of muscle & weight and when I look at his labs I see effectively a multi-car-pile-up. He has CKD 4 that, of course, no one has mentioned, a homocysteine of 15, macrocytic anaemia, subclinical hypothyroidism etc etc And did I mention he’s a smoker, with a persistent hacking cough?
He tells me that his goal is to one day be able to come off ‘all these meds’🤯
Our sense of our own health is composed of many things – and objectivity is not necessarily one of them. But things like our expectations, our perceptions of ‘normal’ and the cultural, societal and spiritual influences upon these are big players. And of course it’s all relative – he is well; relative to how he was before. I just love working in this space – the learning goes on forever.
I read a great article recently called, ‘Is Hopefulness the Key to Better Mental & Physical Health’ and this ties in pretty nicely with this encounter, especially my favourite quote from this: “If resilience is the ability to bounce back, hope is the ability to bounce forward”🙌🤸♂️❤️