Maroc - NEWSDAY.CO.TT - A la Une - 08/Sep 03:48

Old people know: Nobody cares

TAUREEF MOHAMMED “It is really hard,” the old man with Parkinson’s disease said, sobbing as he walked out of the examination room, shuffling with his walker, his son and daughter at his side like two bodyguards, there to prop him up in case he stumbled. He was looking toward the ground, perhaps to the exact spot where he would move his feet to next – this is how people with Parkinson’s move, step-by-step – then he paused, lifting his head for the first time in the appointment to acknowledge, also perhaps for the first time, that, “It is really hard.” The tears flowing were different from those that flowed steadily, like water trickling from a broken pipe, over the previous hour. Those trickling tears were a mere physiological reaction to his dry eyes, dry because Parkinson’s disease had taken away his ability to blink and moisten his eyes. These tears were more: these tears were accompanied by sobbing, a vocal expression of sadness; these tears were spilling, and gushing - not trickling; these tears were an emotional reaction, not merely a physiological one. His emotion-less, blank face – numb from a lack of dopamine – was now transformed, filled with emotion, albeit not the pleasant one. His face was overflowing with sadness. Although they perfectly summarised what had been discussed over the previous hour, the four words were unexpected. They broke the usual routine that I had grown so familiar with at the end of every appointment: thank you, you’re welcome, it was a pleasure meeting you, see you again in six months. None of that fake politeness this time. Just in case I had missed it – which I probably did because we doctors eventually become numb from the routine of seeing patient after patient, one tragic story after another – he had to make it plain and simple: “It is really hard.” Nothing was more factual than his parting words – perhaps not even the science of Parkinson’s Disease was truer than what he said. And nothing I would have said during the appointment could have made him change his conclusion, leave on a more positive note, or prevented him from sobbing. But yet, as truthful as his words were, I did not expect them. Patients usually tell us about their diseases, or we prompt them to tell us about their diseases: When did the shaking start? When did you start walking more slowly? Hardly, do they add a commentary of how they feel; numbed by science, we doctors are sometimes oblivious to how patients feel. Skill comes easy for us doctors; empathy is hard. And when it comes to old people, empathy, I have come to realise, is an alien concept. It is easier for us to appreciate the tragedy of a child getting diagnosed with cancer, a middle-aged person’s life being cut short by cancer, or the sudden death of a young athlete in a car accident. But the old man and old woman? They might as well be invisible aliens from another universe. Do we actually empathise with old people and their struggles? The simple answer is no. And old people, I believe, know this. Old people know that nobody cares, so they say nothing about how they actually feel. I think, this is why so many old people in the doctor’s office are quiet, passive, and say very little – it is not because of dementia. We know how difficult it is for the caregivers. Caregivers when given the opportunity do express their feelings and perhaps we empathise with them. And this is important. But it is also striking how little the patients themselves talk about their own feelings and how little we actually value their feelings. And this is unique, I think, to old patients. At times it feels like there is a silent collusion - not the least among us doctors - to look at old people as having old people problems and that is just life, which is perhaps why an old man with Parkinson’s disease saying, “It is really hard,” can be unexpected and discomfiting. And perhaps it is life. Getting old is life, and getting more medical problems as one gets older is part of life. It is easy to say that, and then look away – at the things, the people, that we believe are worth paying more attention to. Until the old man with Parkinson’s disease says in his soft, hoarse, tremulous, parkinsonian voice, “It is really hard,” then, and only then, do we stop, and look. Taureef Mohammed is Trini physician working in Canada. E-mail: taureef_im@hotmail.com The post Old people know: Nobody cares appeared first on Trinidad and Tobago Newsday.