As I was totally feeling sorry for myself (oh, poor Dr. A), I was asked to see Isabel at the nursing home at the end of my morning. She has Alzheimer's which I would say is in the intermediate stages. She was having some arm pain and had a question about a cortisone shot for her shoulder.
I'm thinking to myself, "Oh great, just another thing that I have to fit in. How am I going to do that? I have to drive back and forth from there and make sure I'm not late for my afternoon office hours."
Following her exam, I thought she had a pulled muscle and prescribed some physical therapy and analgesics. She then asked me, "How long am I going to be here?" As I was frantically writing in the chart, "Well, we talked about this the last time I saw you. It is unsafe for you to go home because your husband has a lot of medical problems as well, and he cannot take care of the both of you."
"No, doctor," she looked right at me, "How long am I going to be here?" "Oh," I paused a long time before speaking again. "I don't have any idea on that. The Alzheimer's may slowly or rapidly progress. You're on the best medicines we have right now."
"What would happen if I wanted to stop all my medicines?" she asked. "Likely," I said, "this would probably progress rapidly for you." "I certainly don't want to live like this in a nursing home when I used to be independent, and yet I want to be around for as long as I can -- especially for my grandkids."
This is one of the tragedies of Alzheimer's -- when people are not mild, and yet not severe. They feel themselves slipping away as they forget more and more and, in addition, they start to lose their bodily functions.
If you know little about Alzheimer's, here is a link I want you to check out. It has a video clip that's about 3 minutes of a PBS program called, "The Forgetting." It really personifies what this tragic disease is all about.
Isabelle and I and a nice discussion and ultimately she made a decision that I went along with. Needless to say, after this humbling experience, I was brought back to reality and then went back to the office to continue my day....