Illness is not Only Physical

“Depression is a silent killer; physical illness is easily diagnosed, but depression can be hidden from even the most skilled of professionals.” (author unknown)

When I saw this picture and read its caption, I immediately thought of one of my patients at DP Marais. She had been diagnosed with tuberculosis, and had been in hospital for three months. This patient was a widow, with no children, or family, no one visited her and she spent most of her day lying in her bed away from the other patients. During my first week of trying to treat her she refused to get out of bed, I was warned that she might not co-operate and was told that I should try and ‘make’ her do activities because of the benefits that exercise has.

I was very hesitant to use this approach because I did not know if it was ethical or not, and I did not want to disrespect my patient. I decided that I would try and converse with her when she did not want to co-operate, instead of trying to force her and then leaving if she refused. She did not talk to me until the Wednesday of my second week, which was also the first time that she agreed to work with me; the sadness in her voice when she spoke of her husband and the fact that there is no one to visit her was heart wrenching. During our conversation I could see that this patient was suffering from the pain of the loss of her husband, which was not evident if you just looked at her.

This situation made me realise that just because someone is physically well enough to get out of bed, their mental health might not let them. A patient can be given the best health care possible, but if they have given up and refuse to help themselves they can not be fully rehabilitated. “Psychological depression symptoms include loss of motivation, loss of interest in things, irritability, and feeling hopeless.” (MacGill, 2017). I could sympathise with the patient because I suffer from depression and could relate to some of what she was saying. I was able to put myself in her position and handled the situation as if it was me who was lying in the bed, and I would want my physiotherapist to be understanding of the fact that I’m not refusing out of spite.

I could only use this approach due to the fact that a student only sees a few patient a day, so therefore I had the time to build a relationship with my patient. Health professionals who work in public healthcare facilities in South Africa have a very big patient load, with very little time to give each of those patients the individual attention that they need before they are discharged. (Statistics South Africa, 2019). They have to make the choice between spending the time to try and convince a patient to work with them, or spending that time helping another patient who will co-operate.

Every patient deserves to be provided with the healthcare that they need, but if a patient doesn’t want to be helped, is it right to let them take up time that could be used to treat a patient who is very motivated to finish his/her rehabilitation?

References:

Department of Statistics South Africa. (2017). Public Healthcare: How Much Per Person? | Statistics South Africa. [online] Retrieved from statssa.gov.za/?p=10548

MacGill, M. (2017). What is Depression and What Can I Do About It?. Medical News Today.

One thought on “Illness is not Only Physical

  1. Good day, I enjoyed reading this blog, however I do think a few changes can be made.
    There is no real link between your topic and text reflect.
    Have you considered to move the ‘Psychological depression’ definition to the end of the third paragraph, where you talk about the pain the patient is experiencing, ‘therefore you can take in consideration that she could suffer from depression due to the symptoms she is presenting.’ (unless she is diagnosed with depression, then you could mention it). Which also makes you realize the fact that some illnesses are not physical, but do need to be considered by health care professionals.
    I like how you related the reflection to yourself, which shows how you could empathize and sympathize with the patient.
    I would suggest that you get articles which support your claims: “Health professionals who work in public healthcare facilities have a huge patient load…” and your final paragraph.
    Thank you
    Janka Mathee

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