Monday, May 12, 2014

Keeping Company With a Client With Depression

I first saw the patient at the front desk, trying to compose herself as she gave her insurance information and co-payments to the financial representative. Our center is always cold, an old house renovated with air conditioning that makes it either too hot or too cold. She was shivering from cold and crying, struggling to compose herself. I brought her a heated blanket and stood behind her gently rubbing her back as she did all the initial paperwork. It was the beginning of her journey of chemo, surgery and possibly radiation treatment.

As I waited with her, we talked about many things: about her occupation as a sales clerk in a store that I frequent, her upcoming wedding, family members who were with her. She confided in me that she had a long history of clinical depression. I thought to myself how cancer treatment alone puts people at risk of clinical depression; it had to be even harder, starting out with a level of risk. And so often, depression and anxiety appear together. I brought her something to drink and waited as she got her blood work taken. At times, she was tearful as she talked.

I asked her if I could give her a gentle shoulder massage while she waited to see the doctor. First I taught her a relaxation technique that I use with lots of patients, something to focus on while I massaged her shoulders. It is an easy one: Breathe in, think of a word, breathe out, think of another. Once she could do that, I massaged her hands for a few minutes until she was called into the exam room. I know the importance of patients telling their stories. So we talked. I listened.

A few days later I got a phone call from her. She wanted me there on her first day of chemotherapy. I was across the street at the other center, but told her to call me when they started and I would walk over. When I walked in and saw her face, her smile was so genuine, her eyes lit up, it amazed me how different she looked from a few days ago. I hardly recognized her.

To decrease anxiety in a treatment center, this is what I do: bring blankets and refreshments. Talk about our families and vacations and jobs. Share photos of grandchildren, commiserate over parenting challenges. Laugh. Give hugs for good news and extra hugs when the news is not so good. Depending on the patient, massage can also be done. It can calm someone's heart and put them on a beach someplace. When there is a lot of anxiety and isolation, the personal contact of massage can offer a simple, brief diversion.

I never forget that each patient may come in with a host of pre-existing conditions. In our work with people in cancer treatment, each patient comes in with a whole physical and emotional history. We can't forget or overlook those conditions. In the case of anxiety and depression, someone may need extra care. I am mindful of this as I work.

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