Optimist, sunshine, nature, apples, clouds, animals, walking, being me, air-rifle, sketching, music, laughing with friends, reading, living each day to the fullest
'On ne voit bien qu'avec le cœur. L'essentiel est invisible pour les yeux.

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This video captures what an elderly woman does at home, alone. It is quite sad actually.

This post comes after I have lost my EZ link card, feeling really stressed + annoyed at myself for not realising how it got missing :/ (I've searched thoroughly all the places I could have placed it!) wasted brain cells and energy from stressing out and worrying about the possibility it have been misused. Also, that I have recently topped-up my student concession, and the day starts tomorrow. ): Oh well, I ought to channel this energy into more productive things because I will be heck busy next week. If I keep procrastinating, I'll be so so mad at myself.

I find that my neurology placement has one that helped me learn not only about clinical-related interventions, but also in terms of being a more humanised person. This is because of the nature of the cases which you get to see at the ward - strokes, TBI, parkinsons disease, cancer, and the other variations which present as co-morbidities. It is sad, or sadder than those you see at MSK because people still can walk and communicate/ interact, and be independent most of the time. However, in the neurology setting, many of them are unable to manage their disabilities independently, and many a time requiring maximal to total assist for basic functions like bed mobility. It makes me feel more for them after realising that they may not have caring family members, friends to want to help them too, or they may not have the financial resources to make their lives easier.

However, you don't want to pity them and really let them wallow in their situation. Because, my role here is to maximize their function and enable their lives (hopefully, and with hope+++).

I would like to share part of my recent experience with a minimally conscious patient, who is a middle aged man (Ranchos Los Amigos Scale: L3, GCS 11/15) suffered from TBI had and a bifrontal craniectomy. On first impression, he was emaciated, not verbalising (you don't know even if there was a Being inside him), not even responding to an auditory startle or visual reflex, he had no useful function on a hemi-side of his upper and lower limb and was basically very weak and bony. He didn't look "cute", and had few visitors.

short of time, keep it in point form :)

- Previously, my end goal was to just get him to be able to assist the carers at the nursing home with turning.
- My supervisor taught me to look at the bigger picture and to put him in the ICF model
- I realised that although minimally conscious, I should have taken more into account that living inside that person is a Being, and not just a shell
- Despite being hard of verbalising and communicating, he would be like any human and would definitely crave for human affection, and socialisation. I felt that this was a major realisation to me, for leaving out such an important human need. In addition, I have also missed out the part where he would probably require financial support, and ideally with long term rehabilitation and neuroplastic changes, and hope, he may recover and find alternative employment. I realised that I have already put the consideration for his future employment outside of my initial goals for him. For that, I felt guilty because there was already a limit that I have set for him.
- although I understand that his prognosis is poor, having communication, an enriched and stimulating environment would often be helpful to the recovery of the patient. and also as a Human with needs
- On a separate patient, I felt a little upset with the doctor who have already brushed off the patient. We wanted to get his help to coax the patient to get out of bed and get moving with us POST OPERATION because it would be essential to his recovery. (the patient was mentally subnormal, and had lots of anger management issues). If we are trying our best to try to maximise function of the disabled, and to enable them, it is not very nice that the people in your team doesn't try to facilitate your effort and replied saying "aiya, nevermind. he is going to the  nursing home anyway, nobody wants to take him home." yes, he is going to the nursing home, but he can probably be able to do more there rather than rot away like those old, and forlorn. those who are more able than others can at least get their butts out and watch television during the day. but if you don't help those who are disabled and unable to do so by themselves independently, do you think the nursing home staff would waste their time to bring them to watch television? sit out of bed to eat when they are already on a nasogastric tube? Chances are - NO. They would be upset and miserable staring at the ceiling fan, the dirty walls and the noises made by their cranky neighbours would probably be the source of auditory stimulation they get.
- I wrote in my personal statement some years back when I was at a nursing home doing research on incontinence management systems, and i'm sure that my experience there was an actual depiction of what it really was there. (basically it paints a not-so-happy picture)
- just like the lady in the above video, im pretty sure that these people crave interaction, and affection - we are all human beings


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