The frailty continues…

Is this something I should leave-alone?

Since I wrote about frailty last Friday, there have been suggestions as to alternative names –

Vulnerability Service

Mature Medicine

I’m afraid neither of these seem right.

On the ward this week I re-introduced the subject; that is, during Rod’s frailty ward round, with the frailty nurse and trainee doctor and the computer called ‘frailty’ I suggested that the name wasn’t right.

I was subsequently accused of being a stirrer, that and the assumption that I wasn’t being serious.

But, I am.

This whole thing troubles me.

You could tell me to ‘get a life’ and find something important to worry about – but, as Frankl says, worry is subjective – my worry is my worry, just as my fear, anxiety or obsession.

This was followed yesterday by a fantastic presentation by one of the junior doctors (another dodgy tame) in the department about the relationship between weight-loss, malnutrition and dementia.

I’ll come back to this, but first was the terminology – he kept saying ‘elderly’ – as I mentioned last time, some of us, those with autistic tendencies like me in particular, struggle with this word.

Last night I tried to explain this to a group of people at the B:Friend training in Doncaster College – I think most were puzzled; aren’t there more important things to worry about? Climate Change/Social Isolation/Nuclear War (Megan Markle)?

Yes – I’m not saying that these aren’t important; it is just that this for me is one of those things; think Sheldon’s spot in The Big Bang Theory. It is just a place on the settee, but it is his place, no other will do.

Suffice it to say there are four ways of looking at elderly – those who think, What is his problem? Those who don’t see a problem, those who adamantly stick to elderly because that’s how it has always been = ‘department of elderly medicine’ and the final group; my enlightened bedfellows who have transitioned to older.

Why make such a fuss?

Why not?

NAMES MATTER.

(See, ‘Tradition’)

This takes me to the presentation from the doctor yesterday.

One of the aspects of nutrition in supporting people living with dementia, either in hospital, at home or care settings is communal dining, which increases wellbeing, the amount people eat and health.

Yes, sitting round the table with family and friends is something that has evolved over the past four million years; get it right!

The irony however was the doctor’s assumption that staff sitting and eating with the patients would be frowned-upon, considered poor etiquette or illegal.

I advised that this wasn’t the case – from my experience, there is nothing nicer than snacking or chatting over a cup of tea with someone you are treating.

(This is within the realm of imagined rules and regulations that stop good things happening) – it is also within the Gestapoism sometimes demonstrated by doctors and nurses in hosptials ‘It isn’t visiting time – come back later,’ or, ‘Watch!!! Remove that from your wrist… the policy says…’ – Bruce Lee would call this looking at the finger and missing all the heavenly glory (See, Enter the Dragon, Shaolin scene).

Bringing these disparate thoughts together…

Well,

First, let’s look at the word thing.

This blog, almondemotion has its name from the source of much of human behaviour, emotion, creativity, passion – almonds, named for the amygdala, the ancient (present in reptiles, canaries) mid-brain segment which controls primitive emotions, most notably fear.

Activate the amygdala and we shut down – we take to the mattresses (in Corleone style) – reflexively, fearfully look for an escape-mechanism, how to avoid future harm or injury. This is the inverse of care, compassion and creativity, all of which thrive in situations of safety, security.

It you are worried about the sky falling-in, you won’t be dreaming about clouds.

Fear (anxiety) and names (nomenclature) are intimately related.

We fear the unknown, the unnamed, beyond this, when we assign a name to that which we fear, the threat increases. See Kthulu.

Naming and symbolism, like the Gestapo idea; before you know it, you are wearing a Swastika and goose-stepping along the Champs-Élysées.

Names are powerful and can create magic or terror.

Think Obama’s use of ISIL – attempting to undermine the enemy by manipulating their name.

Have I justified my thing about frailty? Perhaps elderly?

I just don’t see people as elderly and frail.

Sure, I can identify someone shloorying down the road with walking-stick, stooped, arthritic, perhaps underweight (one of my patient’s yesterday, her weight had dropped from 84Kg to 49 Kg over 20 years; part of ageing, senescence, deterioration – that is frailty), but, still the word. The damn word!

Sitting typing I look at the world, my vision perhaps not what it was 20 years ago, my muscles weaker, joints less flexible, neurones not as efficient. Yet, I don’t see it, I don’t feel it. I am still seventeen, or, perhaps 20. I don’t need someone to remind me I am middle-aged, that just reinforces society’s stamp.

Hey you, old guy, bald, belly, breathless.

Just because I see you a certain way doesn’t make you.

Some people see the sunrise and are overcome by beauty, others close the shutter and curse the morning. We all see the world differently; we don’t need to imprint our perceptions on others.

That is perhaps my point.

The search continues.

Thinking again of Bruce Lee – back in the 60’s he was aware of the potential harm of naming; the risk of distortion, perversion, narrowing our horizons.

He sometimes described traditional martial arts as being a ‘classical mess’ – I don’t want to be the guy who creates a classical distortion of health or wellbeing.