It’s not that we aren’t aware of it. But it happens all around us. Every day. People come to us with this jambalaya of emotions. We apply our heart and our head and then our heart again (thanks, Wendy Leebov). The expressions come in all manner. Weeping, sighing, cursing, praying, growling, questioning, surrendering, fighting, and more. There are the quiet signs that we might not get at first, or maybe even ever.

The caregiver said to this dear old woman that she needed to change her blouse because of the heat outside.

“You are going to burn up.”

“No thank you. I’ll be just fine.”

The caregiver persisted with a kind of Nurse Ratched scolding, condescending, “Bless your heart…you just make me crazy.” The woman smiled a half smile and finished getting dressed. Once at the doctor’s office the medical assistant continued the chiding as if a baton being passed.

“Darlin’, you need to get you some lighter clothes. These sleeves aren’t gonna keep you cool and they sure don’t make my job easier.” Again, a half smile and an, “I’m sorry. I just like this blouse.”

I stepped in and asked if I could speak to the caregiver. After all, this was my mother.

“You see, it’s not about her liking the blouse. She is embarrassed. Her skin bruises easily as a result of the meds and when you add that to her age spots she just feels…ugly.” I went on to say, “My mom was, and is, a beautiful woman. Not one with too much vanity, but clearly aware that her days of skirts and sleeveless gowns and heels are behind her. Her smile is as vibrant as ever. Her wit will shake the best of them. Her curiosity and zest for life is inspiring. But her skin, once a source of such pride, will not return to its pearly color and smoothness. It is a daily optic of mortality’s twilight.”

Darya teared up and apologized. I said there was no such need. These are the subtle and deeply personal attempts at preserving dignity. They can go unnoticed without experience and practiced empathy.
I thanked her for her care of my mom and for choosing this noble work. We hugged. She walked back into the exam room and you would have thought mom was Cinderella at the Ball. The next few moments were all about her. I smiled. This too is healing.

Our patients come to us vulnerable and unsure. Their information, their cover, and their life’s story is lassoed and leased for a time. Strangers see them at their worst—even if only in their own mind. The long sleeves are simply there for preservation of a time when they felt…better.

This is where the natural science and the social science coalesce. It is where humanity meets medicine. It is where we can be a better part of ourselves in this good work.

My question for the empath’s out there—what are the signs…what are the “long sleeves” we must watch for? Talk to me.

P.S. Mom, thank you for your quiet reminders that make us better.