Wednesday, March 3, 2010

LA Traffic, I do not love thee...

I shadowed the MT at our office in Los Angeles County today, which means driving past LA to get there... it's like China -- too many people for too little area of land. But anyway, that's another story...

It was a bit of an off day for the office in LA due to people having the day off, etc., so the MT was asked to do a sign-on for a new admit, which is something MTs don't really do on a regular basis. But anyway, we only got to see one pt together, but still, it was a valuable learning experience. How often do you get to see two different people do the same exact job in two different counties with different pts? I was able to observe how different the MTs styles are, and yet how both styles work for each therapist. The pt we saw today was residing at a board and care in a town about 20 some miles from the office. She was in her 70's and has suffered multiple strokes. She seemed severely depressed and had a flat affect. The MT asked if she wanted to hear some music today. The pt initially refused (kindly), but the MT continued to talk to the pt, letting her know she was there to help her and be there for her. The pt eventually agreed (without coaxing) to hear a song. The MT sang "Sentimental Journey" at a nice relaxed pace, not too slow, but not upbeat and uplifting. The MT attempted to delve more into the lyrics of the song, but the pt didn't have much to comment. She did however allow the MT to sing another song. The MT said, "I know you know this one!" and played "Home on the Range." The pt had no real response to the song, no indication that the song was familiar, even though we can safely assume she had heard the song before. The MT then asked if she wanted to hear a mellow song or an upbeat song. The pt requested the song to not be upbeat, so the MT chose a nice laid back rendition of Bob Marley's "Three Little Birds." I thought it was a good song to pick -- not upbeat and obnoxiously happy, yet simple, to the point, and just nice. With still no real emotional response, the MT asked if the pt wanted to hear another song. The pt responded, "I think we should wrap it up." The MT kindly obliged, but asked if the pt wanted her to return for another visit sometime in the future. The pt agreed.

The MT said that during her first visit with the pt (this was only the second time seeing her) even though it was also brief, the pt's eyes remained closed most of the time, and she only sang one song. Progress has been made! The pt opened her eyes, allowed the MT to sing three songs, and agreed to another visit!

I think the pt was in a state of defeat, and felt that help of any form was a lost cause. However, I also think she enjoyed the music (and the company!) and that's why she agreed to another visit. I feel bad that the pt was just laying in bed with nothing going on... the mind can be a dangerous thing... we are capable of good and bad thoughts... sometimes, isolation frees up the mind, allowing it to think outside of the box or arrive at long sought realizations -- other times, being isolated allows for the mind to focus on any negative aspects of a person's current state, with no one there to rebuttal or dispute, leaving a very desolate, defeated pt with no real desire ensure any quality of the life for the time remaining here on earth... hopefully, if a pt is at least open enough to allow the MT to be present, we can start pulling down that white flag and leading the pt to a realization that being alive even at this last stage of life is meaningful, important, significant, worthwhile... there are people here to love and care for you, and life is still life, whether you know when it's about to end or not.

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