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We spend so much time worrying about our patients. Are they going to be compliant? Do they understand the treatment we're proposing? Will they really stop smoking before the surgery? So much goes into caring for the sick.
But what about the significant other? What about the other half?
 Clinically, it's been a rather busy and challenging week for me. I've been in the hospital, clinic and operating room most days (and I'm not even on call). My clinic has been particularly busy, with some highly complicated patients. However, during some of my most difficult patient interactions, the energy, the stress and the hard work don't even hold a candle to what the other half – the spouse – experiences. It's time to take a moment and recognize just what it means to be the husband or wife to a sick patient.
Let me tell you about a particular patient's wife. Patient John Smith (no real names here to protect the innocent) fractured his ankle. Before barely getting to know his wife, one of my residents and I repaired his traumatized limb. For us, it was about an hour-and-a-half of time. We worked hard and felt satisfied when the case was done. After that, we left the hospital and went home.
A week later Mr. Smith and his wife came back for a follow-up visit. While speaking with the couple, I noted that Mrs. Smith was wearing a short-sleeved shirt (it was a warm day in Southern California). This shirt was significant because it revealed a bandage on her forearm covering her hemodialysis fistula. You see, Mrs. Smith has end-stage renal disease and dialyzes three times weekly. As I'm sure many of you know, hemodialysis is often very draining for the patient, leaving them tired and temporarily weakened. The bandage was on her arm this day because she had just finished dialysis before coming to my office for her husband's appointment.
What I'd like to show you is that Mrs. Smith is a small woman, and despite her height and her own health issues, she actually pushes her husband on a roller cart. I watched her do this. She looked like Sisyphus, pushing the boulder up the mountain only to have it roll down again. It was quite a sight. When I asked her if we could make Mr. Smith's next visit on a non-dialysis day to make it easier for her, she – incredibly – thanked me with open gratitude.
She thanked me.
It should have been the other way around. I should have thanked her for the selflessness of taking care of her husband despite her own illness. It was an hour-and-a-half of time I put into taking care of Mr. Smith, yet Mrs. Smith must spend most of her day taking care of him, cleaning, cooking, driving and pushing him where he needed to go. Think of the strength that must take.
We should also remember that she didn't choose any of this. She married this man, became sick herself and some time later, he just happened to injure himself. Now, sick and weak as she was, she still managed to get her husband to his appointment. It's truly amazing.
Mrs. Jones has a similar story of struggle with a sick husband, except her plight is in some ways worse. Her husband lost a leg to diabetes and while we try to save the other side, she quietly performs daily dressing changes, helps her husband in and out of a wheelchair and handles a household with children. It's no wonder she sometimes comes to my office with a grim and serious look. And yet she smiles when I take the focus off her husband for a moment to ask how she is doing. How much stronger could a person be?
Mrs. Duchenne has been taking care of her husband through literally years of ulcerations, amputations and complications. Mr. Duchenne had almost no left foot after his last osteomyelitis bone debridement, subsequent to a Lisfranc amputation. We brought him in for an ankle fusion as a final limb salvage attempt and the hospital admission after recovery must have felt like a vacation for her. She'd been fighting with and for her husband – his depression at losing his health to diabetes, his noncompliance and the many complications – all the while working full time. She'd spent so much time and energy taking care of her husband that her own health was starting to suffer.
I point out these three women because I've been working with them recently and sometimes you just can't avoid the universe showing you a theme. It was like a small parade of women walking by and letting us glimpse their love and strength. It doesn't often seem like a gift while we're in the middle of the literal blood and guts of these situations, but that's just what it is: a gift. To witness the strength of these patients is a gift. I described three women, but while sitting here thinking, I could come up with a score of other examples of quiet strength, beauty, and love and I'm certain you could do exactly the same. Keep this in mind the next time you're in the exam room with the other half.
Best wishes,
Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]
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