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FEATURE:
cious and beautiful. It was as though a patient who had been in the
hospital many times had designed it taking into consideration not
only what the patient would prefer, but also the needs of the families
who spend long hours in the hospital with desperately ill patients.
In the midst of intense mental anguish, it is soothing to see an amaz-
ing piece of art work and for a few seconds your mind is uncluttered
and you are just with that moment. Did I just describe meditation?
My favorite is the ‘Blue Bonnet’ patch high up on a 40 feet wall just
outside the front entrance. I would stop and gaze at this beautiful
metal sculpture, a patch of blue bonnets by San Antonio artist Riley
Robinson. It is so important for the caregivers to take a moment to
recharge. I highly recommend reading the references I have given to
fully grasp the caregiver vulnerability, not just for dementia, but for nor did I make any announcement about the fact that he was hos-
so many other ailments that the spouse has to deal with.
Two of our friends had reached the University Hospital even be-
fore I did. A few more arrived with food for all of us. All of them
physicians putting their heads together to figure out what caused
N’s fall. The shoulder X-ray showed a fracture of the upper end of
the left arm (greater tuberosity of the left humerus) with the shoul-
der being pushed out of the socket. The orthopedic team came and
placed the shoulder back in position. N was restless and moved a
lot and the joint dislocated again and had to be repositioned. Those
two days when he was intubated and sedated were the most peaceful
days of the next three weeks he would spend in the hospital. As he
was being weaned off the medication N was becoming a difficult
patient, constantly demanding, and unreasonable. There was not a
moment of peace for the nurses. Now I need warm pads, more med-
ication, bed pan, water, breakfast. He was intimidating. He would
ask the residents who came by questions about pain medicines. One
night he made them break open 20 warm packs to place on his
shoulder. I discussed with the nurses for every shift his diagnosis of
FTD and the behavioral aspects of it and that they should treat him
and care for him like any other patient and not ‘Dr.N,’ the high-
functioning expert in pain management.
I must digress to write about this profession of health care and
the people who choose this as a career — the physicians, the nurses,
the nurse assistants, the social workers and even those who are only
cleaning the place. The professionalism, the tolerance, the under-
standing and the kindness that was shown to us just reinforced my
belief in this noble profession of health care and those who choose
to pursue it. People of my generation often complain about the next
generation and how that personal bonding and caring is lacking. We
had one-on-one caregivers who are ‘Sitters’ who help the nurses.
IN REAL TIME
Most of them were young men and women who were putting them-
selves through college. One was a medical student. N would not let
them sit, even for a second, demanding any number of things con-
stantly. I spoke to each one about N’s condition and that he really
does not know what he is asking and to use their judgement. In the
morning they would have bonded with N who was happy and called
them by their name and they will say goodbye and wish us well and
some would hug N before they left. All is well with our profession.
During this period, N hardly slept. They were trying different
medications to help with sleep. N complained about frightening
dreams. I stayed in the hospital every night. I did not restrict visitors,
pitalized. He had a constant stream of visitors from the anesthesia
department and my department. He spoke to them nonstop. Those
who visited N during that period saw him at the peak of his ‘Manic
Episode’ which was not considered at that point. It was masked by
the other medical interventions needed, such as pain management.
Seven days after the fall he underwent surgery for the shoulder in-
jury. The head of the humerus was fixed to the shaft of the bone
with a metal plate and about eight screws. Surgery was performed
by one of the best shoulder surgeons, Dr. Dutta, and anesthesia was
given by none other than one of N’s colleagues Dr. W. After he was
moved to the rehabilitation unit, N’s psychiatric care was attended
to by the psychiatry team that covered inpatients. The medications
he was on were not helping him. He was getting worse in not being
able to sleep and he had unending demands every two minutes to
eat, drink, use the restroom, re-adjust the bed, and he would get
into the mode of teaching. He made the caregiver sit and draw dia-
grams of brain or spine or formula and then would explain mostly
sensible things to these people who neither had the time nor interest
but were very patient.
His inpatient care was coming to an end, he was so unwell. Can
he go home in this state? However, the psychiatrist was unwilling
to admit him to inpatient psychiatry, not a suitable place for some-
one who is still high functioning. I made the decision. N needs to
be home. He needs his familiar surroundings, he needs Patch, his
dog, he needs home-cooked healthy meals, and he needs sleep.
Around this time for logistical reasons his psychiatric care came
under the guidance of Dr. Schillerstrom, someone N knew and
someone who had done research work with him. N came home after
three weeks of hospitalization. Our son was with us and also my sis-
ter. It couldn’t have been a better time for N to come home for I
had wonderful help. To be surrounded by family and friends is a
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