Skip to main content

Sport - A Poem on Frailty



An extremely pleasant 89 year old patient of mine has recently been struggling with functional decline.  She has developed some new swelling in her ankles and has not been able to get around like she used to.  She is still active and at her most recent visit, she brought in a poem that she wrote with her poetry group. She was flattered that I wanted to post her poem but she did not want me to say anything else about her.  The fact that she participates in a poetry group should tell you a lot about the type of thoughtful person she is.

Sport 
Not jumping broad nor high
Not running fast nor straight
My only sport is reading fate
In dramas now and late 
My body’s strength
Is measured by painful pressure
on delicate vessels a high systolic measure 
Oedipus gave us edema in ankles
While all humans
sport their pulses and crankles 
sport can be used as ridicule
by those who lack the tool
of coordination

There is a tension between respecting frailty and preventing frailty.  One of the recurrent themes of this Geripal blog has been to highlight how important it is to respect frail patients.  Her last paragraph in particular captures this perfectly. 

Curated by: Dan Matlock



Comments

Anonymous said…
Beautiful. It is clear that while physically frail she is versatile and even robust in her cognitive/linguistic skills. Frailty has many domains and deserves a preface.
Dan Matlock said…
Great point - she is definitely cognitively intact. When I used "frailty" I was really referring to physical frailty. You are right though, frailty has many domains.

I guess that gets to our challenge as a community in agreeing on a unifying definition of frailty.
Arden said…
That was a very nice poem. I could imagine the frustration of not being able to do the things that writer used to do during the younger years.

Popular posts from this blog

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …

Dying without Dialysis

There is a terrific article in this weeks Journal of Pain and Symptom Management by Fliss Murtagh of King's College in London about the epidemiology of symptoms for patients with advanced renal failure who die without dialysis.  This study is important because while we know that patients with advanced renal failure have a limited life expectancy and the average age of initiation of hemodialysis is increasing, we know little about the alternatives to hemodialysis.  Specifically, we know nothing about symptoms affecting quality of life among patients who elect not to start dialysis (so called "conservative management" - is this the best label?).  This article provides a terrific counterpoint to the article in last years NEJM showing that nursing home residents who initiated hemodialysis tended to die and decline in function (see GeriPal write up here). 

The study authors followed patients with the most advanced form of chronic kidney disease (the new name for renal failu…

Does “compassionate deception” have a place in palliative care?

by: Olivia Gamboa (@Liv_g_g)

There is broad consensus in the medical community that lying to patients is unethical.  However, in the care of patients with dementia, the moral clarity of this approach blurs.  In her recent New Yorker article, “The Memory House,”  Larissa MacFarquhar provides an excellent portrait of the common devices of artifice, omission and outright deception that are frequently deployed in the care of patients with dementia.  She furthermore explores the historical and ethical underpinnings of the various approaches used in disclosing (or not) information to patients living with dementia.

Ms. MacFarquhar introduces the idea of “compassionate deception,” or the concept that withholding truths, or even promoting outright falsehoods, is a reasonable and even ethical choice for those caring for patients with dementia.  To the extent that it helps a person with dementia feel happier and calmer, allowing them to believe in a gentler reality (one in which, say, their spo…