There is a segment of the population whose suffering rarely ends. >20% of patients on a typical medicine service (personal observation) suffer from decubitus ulcers. I would have posted live pictures but we have our standards on this site. You can find plenty on google image...Decubitus ulcers are brought on by chronic inactivity/bed rest and the inability to apply proper prophylaxis. Patients are often paralyzed and don't have the social support to be rotated and moved regularly to keep pressure off points of greatest pressure. Once the ulcers form it is very difficult for them to heal because the circumstances that caused them are often unrectifiable. The pain of the ulcer is immense, the infections that brew to the bone are often uncurable and people pass in pain from this phenomenon. Every morning I see people with this problem and every morning I feel compassion, revulsion and sadness. I'm not doing much (consult wound care, iv antibiotics, softer bed, rotate and change dressings) and it's frustrating.
It brings out a thought. To comfort those that stand in need of comfort brings to the light the idea that members of our society suffer to an unnecessary degree. Without support, kindness and service many people will die in pain. Perhaps contact with that pain reminds us we are human, fallible and selfish in nature. Alleviating the pain salves their wounds and our souls.
9 comments:
Paul showed me some actual textbook pictures... let us all be glad he didn't actually post them.
Physical suffering like that seems inhuman. Without care and kindness, my feeling is that it would be easy for the people to feel inhuman themselves.
In such situations, emotional alleviation is probably just as important as the physical alleviation. I would hope that a good doctor would be able to pay some attention to both.
the bulk of these people's care comes not from doctors, but nurses, physical therapists, family and friends.
paul.
do you think your constant exposure to different areas of medicine redefines the reasons you are in that field?
Paul—very moving, thought provoking post. Having never suffered from, nor seen (first hand) decubitus ulcers, it is difficult for me to fully comprehend the severity of the pain, but my heart droops at the thought. My lack of experience with such pain pales the veracity of my comments, but it did being to mind Maslow’s hierarchy of basic human needs, and how interconnected our psychological needs are with our psychological, spiritual needs. If basic physical needs are not met, are we capable of serving the psychological, spiritual needs of those around us? Perhaps to Christ they were one and the same.
oops...Physiological needs are with our psychological...
petey: yes. attaching meaning to any event in life is tricky. why did we do it. why do we continue to do it. and will we do it till we die. daily i find new reasons why i like my job (kind senior resident) and new reasons why i don't (hospital beauracracy--stevie, you thought new york parking was bad). some of the reasons i went into medicine aren't actually experienced as a doctor.
mel: very interesting ideas. maslow's thoughts on needs are very applicable. i think it's one reason why it is so dangerous to judge others. take the person with chronic headaches--they are short with others more often than i am but they are probably better justified in their shortness.
your thoughts about spiritual and physical might go a step further. if our basic physical needs are not met are we capable of experiencing basic spiritual joys--probably. maybe the joy is more intense because the pain is more intense. but maybe spiritual joy comes less often--is less easily attainable. it might also be important to seperate spiritual feelings with emotional stability. someone in pain could be in emotional turmoil but experience spiritual peace?
paul,
thanks for suggesting i look up debucitis ulcers. a lovely time spent on google image.
Eeewww Stephen, you are so gross.
I had many a lecture on Maslow's hierarchy, and applied it often in social work practice. It is quite applicable when working within a social science context. However, the idea in its entirety never really sat well with me.
5. Self-Actualization
4. Status (esteem)
3. Love/belonging
2. Safety
1. Physiological (biological needs)
My thoughts always turned to Job, the extreme example, who was stripped of status, relationships, safety, health, etc. But he was most assuredly "self-actualized." Perhaps his self-actualization was formed in the comfort of 1-4, and was strong enough to last when they were taken away.
Perhaps my definition of self-actualization, which includes faith and hope, does not match the definition Maslow intended.
But I do think that self-actualization can come in the void of basic needs, relationships, security, etc. It is what makes faith and hope so powerful... the ability to look beyond a mortal life and yet find meaning in it.
i agree amy. i can think of both examples: those that never gained stability and those who were stable at one time and then maintained it through difficult circumstances.
i do think it is unfair not to give credit for a person's upbringing (or lack thereof) when judging their current abilities.
stevie: it's good to know i'm not dead to you. i'm glad you've been able to share in the lovely times i'm having in california.
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