Tuesday 5 February 2008

"Missing you"

I spoke with a lady today, in her late 70's, who I've been seeing for a few years now.

She suffers with several painful conditions, a fair bit of infirmity, a lifelong legacy of self doubt and anxiety, she'd lost her confidence and is troubled by F41.1 Generalised anxiety disorder. Has been for many many years.

I've seen her in out-patient clinic regularly (but not that frequently) over the last three or four years, once I offered her in-patient care when things were fraught after her husband died, episodically I meet with her in the day hospital, but overall I must confess it's the case that, as better folk than I convey, the doctor's the drug.

Decades with others have shown, and after rocking the boat I've realised too, that all that really helps her is seeing someone, and time's shown that someone has to be a psychiatrist, to review things and chew the cud with her once in a while. So over the last few years I see her every 3 months or so, it takes half an hour of my time and keeps her well. She now feels she's coping, she's going out, she's shopping, she enjoys time with others.

On getting folk well I'm invariably discharging them from regular follow up and offering open appointments, partly so I'm seeing folk who need seeing, partly so folk can then see me when they want to (rather than after an arbitary time I choose), but there are probably some half dozen patients who I'm seeing 4 times a year to simply see them. It's what they ask for, the GPs love it as it's stopped them visiting their GP frequently, it's the best thing I can think of that contains their ill ease and keeps them well.

So after 20 minutes of reviewing how she's been over the last copule months, what's gone well, what's been trying, what's changed, she spoke of her late husband and how when she get's home she'll apologise.

"Apologise for what?" I asked.

"For being late, getting back," she said, smiling weakly. "I always do it. Whenever I get home, I speak to him, still. I tell him when I'm going to sleep, too."

I could have hugged her, then.

It was so endearing, he lives on with her, her relationship endures with him despite his death, in a healthy and charming fashion that she lives each and every day. It's not just GPs who are fortunate men :-)


Vicky Pollard said...

My dad still speaks to my mum, every day, even though she's no longer with us. I talk to her too, occasionally. As far as I'm concerned, she's still around, even though she's not here physically.

Elaine said...

I am so pleased to hear that you, along with Dr Andrew Brown , are a fortunate man.

It is a good turn of phrase.

Disillusioned said...

Lovely to knwo she still feels her husband is there.
Good too to read of your understanding that some of us need the reassurance of talking to someone - that can be enough. I'd love to be able to continue my monthly sessions with my wonderful counsellor when I am "well" - because it helps to keep me well, reflecting on how things have gone, having her help me to reframe things. The view of the system seems to be that I shoudl be able to mange without, so instead of being willing to pay the £45 or so monthly fee to her they would rather prescribe me masses of expensive drugs to do the same thing. Sad, isn't it?

Anonymous said...

My Dad doesn't speak to my Mum. Wouldn't be so bad if they weren't still living together.

Katie! said...

That's a lovely story. I am glad to know that some relationships go on, unaffected by the limitations of human life. Thank you for sharing.

I've just discovered your blog and am looking forward to catching up on all I've missed!

Am Ang Zhang said...

I found this tale moving. I have tons of patients or parents of patients like that when I was still with the late NHS, the one with no guidelines -- not NICE to say that really. One mother in particular used to have her hair done and really look like she was going to a party when she came to see me once a month. It took me a while to realize it was her only outing.

I mentioned this in my book ”The Cockroach Catcher”, and shall also talk about this more in The Cockroach Catcher Blog.

A retired Consultant Child Psychiatrist

Milk and Two Sugars said...

I've a great aunty who suffered terribly when her husband died following an operation she had encouraged him to have: she blamed herself. We knew she had accepted his death when, years later, she told us that "I go to his grave and talk to him, but the bugger doesn't answer me back". There is something very good about it all.

Dr Andrew Brown said...

That sounds a very GP thing to do. I still have a few people that I see every couple of months for no very obvious reason. I think these consultations support both doctor and patient - you clearly got something positive out of it. There's a quote I can't quite remember along the lines of "reaching out across the infinite distance between two human beings" that describes the dynamic of the best consultations.

Your blatant flattery is noted - shall I leave the bundle of tenners in the usual place? :-)