May 15, 2014

The Physicians’ Silence Around Alzheimer's

I started my slow burn as I read the first words of the article.
“A fate worse than death,” my colleague muttered to me as we examined an elderly man admitted to the hospital with severe dementia.

Pamela R. Kelley
Alzheimer's Reading Room

It’s useful to know what others think and feel, particularly about matters that we also regard with deep feeling. It sometimes helps us understand why others relate to us and our loved ones in the ways they do.

The Physicians’ Silence Around Alzheimer's

So it was with interest that I read this article, The Silence of Doctors Around Alzheimer’s, in the New York Times.

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One doctor wrote about how doctors generally react to Alzheimer’s Disease. It got me all worked up.

I started my slow burn as I read the first words of the article..
“A fate worse than death,” my colleague muttered to me as we examined an elderly man admitted to the hospital with severe dementia.
Maybe I’m simply too close to the situation. l probably lost my objectivity when I took my seat in the front row, caring for someone I love who has Alzheimer’s.

No matter the reason, this article in the New York Times really irked me.

Written by a physician, the article explored the emotional terrain of doctors and attempted to explain why clinicians are largely silent on the subject of Alzheimer’s.

Apparently there’s not much shop talk among the physician class that touches on subject of dementia. They’d just as soon not mention it.

According to the author, Dr. Danielle Ofri, doctors who encounter patients with Alzheimer’s are buffeted by feelings that render them silent. What feelings does she name?

Shame and embarrassment for the afflicted patient. Unease. Reticence. Frustration. Fear. Discomfort.

In fairness, I think Dr. Ofri was bravely honest to reveal the emotional landscape many, probably most, doctors inhabit when confronted with a patient who presents with Alzheimer’s dementia.

Brave, because it sure doesn’t present her colleagues in a very good light.

There is a faint odor of “woe Is me” about those poor doctors who have to treat patients whom they cannot yet cure, whose disease does not offer them chances to boast about their clinical skills.

These are doctors who are so defined by their high octane brains that they’re frightened into silence in the presence of those whose brains have succumbed to the worst consequences of plaques and tangles.

I understand that the article was simply an insider describing the physician’s perspective. What disturbs me is how much the identified physician’s perspective is so opposite what I’ve sought in doctors treating my mother. After all, my mother requires medical attention from time to time – not to cure her diseased brain but to address the more prosaic medical matters of an octogenarian: osteoarthritis, urinary tract infections, a worrisome cough, skin problems and the like.

I don’t want some poor doctor’s discomfort to impede his ability to bring relief to my mom for one complaint or another. I don’t want the physician’s fear to blind him to the present needs of the frail woman before him.

After all, that frail woman had to surmount her own petrifying fear, and unease, and discomfort, and frustration just to leave the safety of her home and present herself to a stranger in a white coat.

I certainly hope these silent physicians find their words soon. There are an awful lot of patients with dementia in their futures, because that silver tsunami we’re warned about is coming quickly.

That means a future populated by a lot of care partners like you and me, too.

All of us will need medical professionals who are fully present and engaged in the treatment of all their patients, including our loved ones with diseased brains whose bodies continue to need medical attention.

So speak up, Docs. Start talking amongst yourselves about your experiences in treating patients who happen to have dementia. Talk about what you can do. Stop hiding behind the frustration of what you can’t. We can’t afford that indulgence.

That you can’t cure my mother’s Alzheimer’s doesn't concern me when I brought her to you with bronchitis.

It’s OK, Doc. If you’re having trouble handling it, we can talk about it. But you’re going to have to use your words.

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