On the value of drawing from past experiences to establish a relationship with an elderly patient.
Photo by Aaron W. Haney, MD, 2013. Cathedral of the Annunciation, Columbus, Ohio.
They are an adorable elderly pair with their white hair pulled up in buns, green button-down sweaters, and long skirts, or at least that is what I imagine the hospitalized one would be wearing too if not required to wear a gown. The sister lying in bed has a deep V in her brow, like a bird frozen in flight, her eyes lost in the distance. The face of the sister sitting at the bedside is more pliable and relaxed, but still full of concern. They are siblings living out their latter days together and I get the feeling my presence is an intrusion.
The sister in bed tries to give a polite smile but only the corners of her mouth move, the rest of her face strangely unchanged. I introduce myself and wonder how I might gain access to their insular world.
On some level I feel like a child again at church camp surrounded by those sweet old ladies who in appearance and mannerisms were very much like these two. Early in the interview I notice a Bible lying on the bed and try to open things up a bit by making reference to it. The supportive sister responds positively, and the subject of God and prayer weaves its way into the mix. It feels somewhat like a ruse, but I am not a reluctant participant in thinking and talking about such things.
A small opening begins to form in the circle where I gently set my foot as a place marker. The sweatered sister mentions taking “one day at a time” in regards to the daunting medical challenges facing her sister. The patient chimes in with, “It’s like that song says, ‘one day at a time, sweet Jesus,’“ and I add the next line, “That’s all I’m asking of you.”
With that little bit of gospel music knowledge from my youth, I find myself as much in the circle as can realistically be expected in so short a time. They both appear more relaxed and talkative after my unexpected lyrical intervention which makes things easier in figuring out what is at issue and how I can be of help. It is a 3-way dance in this particular psychiatric consultation and another gospel song sings its way out of the depths of my memory, “Will the circle be unbroken, by and by, Lord, by and by,” as the little boy inside taps his foot to the beat.