Unhappiness: When Those Closest To You Face Difficult Times and You Can't Make It OK

I had never heard of Jonathan Fields before I read Gretchen Rubin's interview of him in the Happiness Project on January 15, 2009.  His answer to her question about unhappiness got filed away in my brain.  And when I woke up this morning it was on my mind.

Gretchen: Have you always felt about the same level of happiness, or have you been through a period when you felt exceptionally happy or unhappy – if so, why? If you were unhappy, how did you become happier?

Jonathan: I’ve definitely run the gamut. Much of my unhappiness, when it’s been more present, has come from either an unwillingness to accept my lack of control over certain circumstances in life or seeing those close to me going through challenging times and being unable to make it okay.

Seeing Those Close to Me Going Through Challenging Times--Unhappiness is Viral

• After recuperating from major cancer surgery (and receiving a positive prognosis) last November my mother-in-law has landed in a small town community hospital in Florida--stuck there now for 6 days.  An uncomfortable chest tube stuck between her ribs.
• To catch up--read A Parent's Illness--Act Four  and What Your Doctor Never Tells You.  What He Really Thinks.  Maybe.  The November surgery was a success.  Her cancer was not ovarian.  All that was left was a follow-up regimen of what was supposed to be mild chemotherapy and 25 quicky rounds of radiation therapy that would be similar to a chest x-ray.  Side effects would be minimal.  Probably just fatigue.  Or so we were told.  After 7 days of treatment she felt like she wanted to die.  Worse than she had felt with powerful chemo or after surgery.
• 6 days in the hospital. Still no diagnosis.  Arrogant, uncommuncative doctors.  Lack of follow-through with lab tests.  Over medication.  A lack of confidence with the physicians in charge.
• Nothing is worse than seeing those close to me going through challenging times and being unable to make it okay.  My mother-in-law, my husband, my sister-in-law.
• All of this brings back my memories of the long slow declines of my own parents, and how going into a hospital just sets off a cascade of further decline.  Confinement to a bed, de-conditioning, medical errors & mishaps, over medication & the resultant confusion.
• Add all this to the continual barrage of bad economic news we read and hear about every day...

Dr. Jerald Winakur--The Dangers of the Hospital--an Insider's View

Dr. Winakur is a geriatrician, the director of a skilled nursing facility, and a son who cared for his own father.  With all his knowledge and savvy he knows the dangers that hospitalization holds for the elderly.
I've linked to his articles in Health Affairs in a previous post, but here's an excerpt from his 2005 Health Affairs article, "What Are We Going To Do With Dad?".  It explains my fears.

Hospital Dangers

"Three years ago my father, a longtime heart patient, had trouble breathing and complained of chest pain. He was admitted into the hospital with congestive heart failure. This is the hospital in which I have made rounds almost every day for the past three decades. Many of the nurses and therapists and I call each other by our first names. The CEO is my friend and patient. My father’s physician is one of my young associates, well-trained and eager. I was confident that my father would receive the best medical care he could get in America today. Yet I would not leave him alone in his hospital room. During the day, if I or my brother or mother could not be there, I had a hired sitter by his bed.

It’s rarely talked about, but acute hospitalizations are the most dangerous times for the elderly. Even if they have never before manifested any signs of confusion or disorientation, it is in the hospital—in a new and strange and threatening environment, under the influence of anesthetics, pain pills, anti-emetics, and soporifics—where the elderly (competent or not) will meet their match. Add to this the iatrogenic mishaps (caused by the "normally expected" side effects and complications of standard medical procedures) and the human errors (mistakes in drug dosing, the right medication given to the wrong patient)—now multiplying in our modern hospitals like germs in a Petri dish—and it is almost a miracle that any elderly patient gets out of the hospital today relatively unscathed.

I stayed with my father every night; I slept in the reclining chair by his bed. I got up when he did; ran interference with bedrails, side tables, and IV poles; guarded his every move to the bathroom; looked at every medication that was handed to him and every fluid-filled bag plugged into his arm. I was not afraid to question the nurse or even call his physician. Each day my father descended deeper and deeper into paranoid confusion. He couldn’t rest, he was intermittently unsure of who I was. At first I could calm him with my voice, talking about the old days, reminding him of our fishing trips on the Chesapeake Bay when I was young. Then he needed the physical reassurance of my hand on his arm or shoulder at all times. Finally, so that he could get some rest, I got in the bed with him and held him, comforting him as he once—in a long-ago life—did for me.

After four days and nights in the hospital, I knew I had to get my father out of there. His doctor came by and told me that his heart failure was better and that his dementia evaluation did not show a treatable or reversible cause. But he didn’t like the way my father looked—he was agitated and sleep-deprived and deconditioned, a perfect candidate for some time in the SNU. And, after all, here I was, his senior associate, the medical director of the SNU. Surely my dad would get good care there. 

I took my father home.  I knew if I didn’t get him home at that moment, he would never come home again."

Wisdom from Michael Kirk--the producer of the PBS Documentary: Caring For Your Parents

• I've watched caretakers take on so many burdens that their own health is jeopardized, and I've also seen wonderful transformations where children & parents talk, really talk, for the first time in their lives.
• I saw love in action.  I saw that the caregivers who could transcend their own needs (a lot of the time) were the beneficiaries of a very positive experience-and so were their parents.
• I also saw the effects of stress and emotional strain on the health of caregivers.  It is too big a job for one person. 
• Bring patience and your best self to the task.  Take care of yourself physically, don't believe a magical transformation is going to take place and start with the realization that as long as your parents are capable of making decisions they should be allowed.

When There's Nothing You Can Do, There's Always Prayer

Wisdom from Terry Pluto, sports and spirituality writer extraordinaire--what a combo!

"Someone once told me, "Prayer often does not change the situation, but it does change how we think and feel about it.  So keep praying."

I began to pray, "OK, God, get me through this."

It's a prayer I've heard from cancer patients, from parents of adult children who are having problems, from people who find themselves without a job, a spouse, even hope.

On the surface, nothing changed.  Inside, I did."

If you ever wondered why I was so passionate about eating right, exercising, staying positive and learning--well, when it comes down to it--they are all variables that we can control--that are in our hands--and they all help to bring us a Happy, Healthy, Long Life.

Comments

[Annie]

When my husband was ill and afterwards, my motto became "One day at a time...sweet Jesus! (thought the added part couldn't hurt)" and then I'd make sure I"d take a walk, exercise ....do something and eat right......because that's what I had control of! It helped me through some very tough times :exercising, eating right and thinking positive thoughts).

[Kairol Rosenthal]

My mantra is "everything changes". I stole it from Lao Tzu - the Tao de Ching. I was diagnosed with cancer at 27 and this phrase has gotten me through the last eight years. I love it because it doesn't deny reality, or even say that everything is going to be better. But if you are taking a stroll through hell, it lets you know that things will change. To me, this kind of reality equals happiness.

http://everythingchangesbook.com/

[MaggieM]

thank you for this post -- I needed it today!