Tuesday, May 30, 2023

Bon Voyage!

Bon Voyage!
A very sweet elderly lady departed.
She was a very sweet lady with very advanced disease. She had only her niece to take care of her who tried her best to help out.
At her 2nd and last visit, she could manage only a phone call and she could not get any labs or imaging and follow ups and consults. I tried to educate her only to realize that poor lady had so many limitations. She was dependent on others for her care.
Sometimes, life situations tie the hands.
May she rest in peace.

I remember her first visit. The gangrene that she had wasn't looking good but she didn't want aggressive care. She was planning to move to assisted living.

Having seen so many patients through their journey, what I have come to realize is that the best companion in the life is self. We meet several people in our journey but we board and depart alone.

On the other hand, no one is alone because everyone boards and everyone departs.

We should make the most use of the time while we are here.

We keep worrying about gathering and planning a lifetime without realizing that the life experiences are worth much more.

Everything else will stay back on this earth. Even the body and mind and skills stay back. The life departs without anything but experiences and learning.

Welcome to the world of Medicine! These experiences are very soulful and teach a lot.

We just need to keep grasping these learning nuggets, stay happy and healthy and live each moment because each moment that goes will never come back. 

We should always strive to make a significant and positive difference in people's lives.

And these people are humans.
All good work done makes us feel lighter and brighter.

The lighter we are, the easier to depart. After all, while likes to carry a lot of baggage lifetimes after lifetimes!

Dr. Jaya Sonkar MD MPH
5/30/2023

©All rights reserved . Copyright 2023

Sunday, May 21, 2023

Abhi To Main Jawan Hoon

Abhi to main jawaan hoon!
(I am still young.)

"Hello Doctor": comes a very sweet sound when I entered the exam room.
A very beautiful lady in her late 70s was sitting elegantly on the exam chair. She was very well-maintained and her body language was as nimble as of a little girl. She was full of life and grace. She was hurting in her joints.
She felt like she still had so much work to do but her joints and muscle strength were limiting her.

She was very well aware of her health but I could see the spirit in her eyes that she could still do so much to make a difference.

I introduced myself to her and we worked on making her feel better and more mobile and help her complete her goals.

This reminds me of a gentleman who was in mid 80s and he was worried bout the way the arm muscles were lax and he was losing his strength and was unable to do the yard work so well. He was fully functional with intact executive functions and very tech savvy that was impressive.

He had a very good sense of humor and in his mind he was still young and could move mountains. He wanted to do a lot more in the years to come. He had an autoimmune disease that manifested very late in his life.

Seeing geriatric population is very insightful. I have realized that the age is in the heart and it is what you feel it is. 
Dedicating this song to all my very sweet, energetic , motivated elderly patients.

Dr. Jaya Sonkar MD MPH 
5/21/2023
©All rights reserved . Copyright 2023

https://www.spreaker.com/episode/53952399

Thursday, May 4, 2023

The gem of the patients! Lets fill our treasure boxes with pleasantness!

Disclaimer: The names of the characters have been modified. Ms. Brittany: "Doctor, two months ago, I was driving. And now, I can't even sit up. I had breast cancer several years ago. I survived that, and had all kinds of surgeries, but never knew that someone can have so much of pain and yet be alive. My eye is hurting as if it will burn away. My back is hurting as it will burn away. I believe Jesus is there and he resides in me and he will help me." I held Ms. Brittany's hand and tried to comfort her with the fomentation that she was struggling with and adjusted her posture to make her comfortable. Me: Ms, Brittany, please continue to have this faith and have strong willpower. I have seen patients improve. We will try our best to ease your suffering with the help of medications. Please continue with physical therapy. Long Pause while she looked me in the eye and attempted to speak more and tried to hide her tears... Ms. Brittany: Thank you, doctor, for your positive words.  Ms. Brittany was an active and independent woman leading her life. She had a stroke that took her left half away.  Me: Ms. Brittany. Have you been seeing a neurologist?  Ms. Brittany: No doctor, And I don't think I can see one. I think it will be a while before I can drive again. Me: Would you have anyone who can help you? Ms. Brittany: I won't know until I ask. I guess, my family will. But everyone works, except me. Me: Dear Ms. Brittany, you have worked hard all your life. It's your turn to get care. Ms. Brittany: I guess, you are right, doctor.  You see, I lost my husband a year ago. Now, I am glad for him. He is in a much better place. I never knew someone could be in so much pain and yet be alive. It would have been traumatizing for him to see me this way. I am glad he went before he saw me in this condition." Me: I am sorry to hear about your loss Ms Brittany. I can only imagine the pain and sadness that you must be going through. I will say that I agree he is at a good place and I hope things get better for you. Nothing lasts forever. This, too, shall pass and things will hopefully get better. Ms. Brittany looked into my eye and said, "Thank you, doctor, for your positive words." ms. Brittany must be a very kind soul. I have seen people get delirious and unpleasant when in so much pain and suffering. She had maintained her kindness and was not complaining much despite being in so much pain. It was saddening to see her lying on the bed like that. I did whatever I could to give her some comfort and came out. Life is so unpredictable. Would she have ever imagined the morning that this will be the last morning when she can walk out of the house? The only thing that was giving her some relief was that her beloved husband did not suffer this way and also did not suffer from the pain of watching her suffer. Just the same day, I met another very pleasant patient, Ms Stacy, she was independent and was enjoying cooking her meal in her house. She was worried about her posture that she was bending forward and this was getting worse. She had severe spinal stenosis and she did not want to go through any surgical intervention.  She mentioned that she lost her spouse 3 yrs ago. She got married to him at the age of 13 yrs and they never dated anyone else. They created a big family. She was proudly mentioning that her grandson-in-law was an Indian just like me and then she told me stories about India that she heard from her grandson-in-law who she was very fond of. She was very satisfied with her life and just wanted to maintain her independence until she was alive. Both the patients were in their 80s and 90s A few days ago, I saw another patient, Ms Katie in her 80s, for whom, mobility and being pain-free were very important. She responded great to the knee injections and was mobile again. She gave me a very precious hug and called me her daughter.  As we age, what is important. Almost everyone wanted independence and mobility. No matter how much one is loved or not, no matter how much wealth or knowledge the person has, no matter how big a family someone had, in the end, your own hands and feet and brain matter, and people don't really want to stay in their body if the body limits them. The body in itself is limiting. We are not able to see, hear, or feel a lot of things. We are limited in our knowledge and reach. We are part of mother earth and are protected in her womb and we never take off. We stay in her womb from birth to death. Until a few days ago, I could say that the memories of good times stay and all the life experiences result in fond memories that stay forever. Only to realize that memory fades away too.  I saw a very sweet elderly man, Mr. Alan today, whose wife lost her memory to the point that she didn't recognize him and could not tell a difference between him and another man. He was shattered that the love of his life couldn't even recognize him. He was trying to hide his tears when e said that they were planning to move to assisted living and place his wife in memory care while he lived near her as he didn't have the physical capacity to take care of her and was very sad of losing the cohabiting with his wife of several decades. He was very thankful that he was able to use his shoulder again and manage quite a bit but his wife's memory loss was the most painful thing for him. It will hurt only until he has his own memory. Memory fades away too and so does the mind. It's not just the body but the memories get lost too. What remains then? Nothing? Or is there still some learning that we carry forever. And who is this We or I? In the end, it is a lone journey of social animals. Even if you love someone from the core of the heart, that someone will not wait for you to be ready to say goodbye. When the time comes, that someone will go or that someone will not accompany you when you go. It's a "bhedchaal" i.e. walking behind the sheep and cattle in the direction where they go. It just seems right to continue the life cycle and learn and earn and create a family and enjoy the time. But what is the purpose? No idea! I just know that holding Ms. Brittany's hand and comforting her and placing her in a comfortable position, wiping her tears, listening to the stories from Ms. Stacy, being hugged by Ms. Katie, and comforting Mr. Alan made me feel really good. That gave me a feeling of pleasantness and I was able to close my eyes for the night peacefully and calmly. One day someone asked me why I like to go out to the Assisted Living facility. It is for this vast knowledge that I gain from the gem of the patients who have collected wisdom for almost a century and who have lived the history, is why I don't mind driving 100 miles. Yes, that does make me think of my elderly parents with whom I would like to spend more time and take care of them, and also think of all the other elderly people who have ever seen me as their daughter. My heart goes out to them and I pray that everyone ages beautifully and keeps collecting wisdom points of pleasantness in their treasure box. We are all following their footsteps from the day we were born and we will continue to follow till the end. Let's fill our treasure boxes with pleasantness!
 Jaya Sonkar MD MPH 5/4/2023
 ©All rights reserved. Jaya Sonkar  2023 

 A song dedicated to all the elderly love birds! Please click on the link below to listen. Stay tuned! https://www.spreaker.com/episode/53747096