Sunday, March 29, 2020

"Bugle Notes" - A Silent Epidemic

She reached for my hand, her hands gnarled; the skin fragile, translucent, road mapped by bluish veins; hands that had done much in her 87 years. She looked at me from her hospital bed and with voice trembling, her eyes tearing, spoke words that penetrated my heart- “Can I stay here? Everyone is so kind. I am all alone now. I have no family, no friends left. I have no one to talk to. Please let me stay.”

Her severe COPD was taking a toll on her physically and mentally as the inevitable downward spiral continued. Despite this, she remained fiercely independent, tough, and resilient, so typical of her generation. Her toughness, though, was crumbling, and with it, her strength and will. She gripped my hand tighter, her eyes searching mine, pleading. The loneliness that now defined her life had become unbearable, painful. Its unwelcomed bed-fellows, despair and hopelessness, now resident in her heart, replaced any remaining hope and joy. Without hope she no longer lived life, she only existed, day by day. I reassured her that she would receive all the support and help she needed at home. With that, she asked me to pray for her. I did so and when I finished, she prayed for me – a precious reminder of the sacredness that is the doctor- patient relationship. She gave a nod of resignation, released my hand and, looked away. I placed the order to discharge her.

Her loneliness had become personal to me and in doing so, it became real. How many times had I missed the silent cries of others; cries from the depths of their loneliness and isolation; cries for acknowledgment, affirmation, for someone to hear “their story” and in doing so validate who they were as human beings? How many patients had needed more than physical healing? How many simply needed the warmth of love given through a human touch or words spoken with kindness and empathy?

Loneliness is a silent epidemic crying out to be heard. More patients to be seen, beds to free up, documentation to do, clicks on the EMR to make, families to talk to, the list goes on, all smothering the cry. We build walls, wear masks, and put on blinders to protect ourselves from the pain, suffering, and heartbreak inherent to medicine. In doing so, we can lose sight of the person in front of us, the humanness of that person. Relationships are an intimate human need, the absence of which creates an internal void needing to be filled. Loneliness, with its despair and hopelessness, waits to do that.

May we recognize the loneliness that envelopes so many. Even if words are not spoken, the message is still being sent – notice me, see me; I am alone, and I need that warmth of love….

Andy Lamb, MD

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