Tuesday, December 4, 2007

Focusing

Yesterday, I had an especially "difficult" patient. She was referred here for falling. She wanted to keep on talking about her stress. I usually can listen to patient's concerns. After all, I'm here for the patients. I am here to care for them. But with a referral for a particular problem, it seems that I should address that issue. She has fallen ten times in the past year. This is dangerous. She is elderly, and injury could occur. So I have to figure out why she is falling, and if there is treatment to improve her condition.
Her son had swindled her and her husband out of $100,000 a few years ago. He had stated that she had Alzheimer's, but an evaluation done by one of my colleagues revealed completely normal thinking. Now, he is apparantly trying to take advantage of them again. There are many details, but they aren't really that relevant here. She kept on telling me that she thought the stress she is under is the cause of her falling.
In order to figure things out, I do need some history. So I kept on trying to re-direct the patient; to find out more about this dizziness.
Now, I realize what the problem is. I wasn't really listening.
The problem with listening is remembering to hear what the people don't say. That's the tricky part. She wants this all to be related to the stress. That's because she can't handle anythying ELSE. There CAN'T be anything else. She doesn't have the ability to address another problem. She's here because her doctor sent her here. But in reality, she doesn't care about the falling. She doesn't care that she may fracture her hip. She doesn't care that she might hit her head. She only cares about the problems she's having with her son. So whatever is wrong, it HAS to be related to this stress.
I do think that there are stress related illnesses. I tell lots of my headache patients and my seizure patients about stress. I tell my back pain and neck pain patients about stress. I tell my obese patients about it.
But this balance problem was very clearly physical, and not stress related. So I was trying to explain that to her.
I missed the point entirely. There is nothing that isn't related to this stress for her right now. That's because this is the reality that she has created. So what am I supposed to do about this falling issue?

1 comment:

Anonymous said...

Merry Christmas Doctor, and all of the best to you and yours in the coming year.