Wednesday, July 31, 2013

The Chicken Soup Element

This post is dedicated to my Grandma Sue, who is so patient with the long periods of time where I neglect to keep in touch with her.

I have been thinking a lot about the importance of the concept of family lately. My mother-in-law wasn't feeling well yesterday, so after work I headed over to her house with a tupperware of soup my wife had made. I texted my best friend and let him know what I was up to, and he made a comment about how nice a thing that was. My response was, "What are family's for?" and then I really started thinking about all the situations I've had in the last few weeks where I have sharply noticed the importance of family.

I am in the middle of my 6th week now as a resident psychiatrist at my county's mental health facility (apparently we can't technically call it a psychiatric "hospital" for some bureaucratic reasons, but that's essentially what it is). During my time so far, I have really come to see how important families are for the patients who come through here, and the devastating consequences that come when someone either doesn't have any close family or they are no longer involved, for whatever reason. In my first week, I met a young Hmong man in his first presentation of schizophrenia, who had been found on the edge of a bridge, experiencing voices in his head telling him to jump off. I remember meeting his family for the first time- he had gone missing days earlier, and his mother had no idea where he was or if he was even still alive. When his symptoms had improved to the point where he was able to be discharged, his family welcomed him home, with a strong plan in place to help him make sure he received the care he needed.

As encouraging as it is to see people rallying around their family member in need, unfortunately I have seen the opposite end of the spectrum much more often. Much too frequently, I have seen people depressed to the point of contemplating or even attempting to take their own lives, and there are no family members who are around to support them. I recently called the family member of a young patient on the unit who likely has schizophrenia, and when she answered, she said, "She's always getting herself into trouble. I don't want to deal with it anymore", and hung up. As understandable as those sentiments can be, it leaves me in a situation of trying to arrange a homeless shelter for this person, when her symptoms are sufficiently treated that I can no longer keep her against her will. Similarly, consider another man I recently cared for, who has dealt with psychotic illness and drug dependence for decades, and at this point his intellectual function has declined to the point where he hardly knows where activities of day to day living are nearly impossible for him to do on his own. Before he came to our treatment center, he had fallen in with a woman who convinced him to sign over his disability check to her, and was making him live in a slovenly house and barely providing food to keep him alive, before he escaped and walked into an emergency room. I'm sure he "burned his bridges" long ago, but it's difficult to think that, if he'd had some family involvement, he never would have ended up in that sort of situation. The best we could do for him, after redirecting his disability check and filing an Adult Protective Services report, was link him up with a reputable Board & Care facility.

I'm not saying that only people who have a certain percentage of genes in common are able to help care for each other. I have had the privilege to work with so many physicians, clinicians, and other health care workers who are incredibly compassionate; alternatively, I have certainly come across family members who only seem to exacerbate existing problems. But overall, there is something unique and powerful about the relationship between family members. They just bring something special to the table- call it the chicken soup element, if you will. To all you people out there who have loved ones struggling with illness, whether mental or physical, kudos to you. You are an irreplaceable element of their care, even though your contribution often goes unnoticed and underappreciated in the background. Power on, and make sure to take some time for your own wellness, too!

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