Unusual People: A Caregiver's Manual

By Alfred L. Anduze, M.D.

Un-Usual People is a
part-memoir, part-instructional manual consisting of evidence-based premises, patient
and caregiver stories, suggestions on required knowledge and skills, and
solutions used in the art and act of providing healthcare. The subjects are a
combination of regular and special-needs patients who seek and receive medical attention,
diagnoses and therapies and the caregivers and healthcare personnel who provide
the CARE. The ability to Communicate, connect, and cooperate, Accept and
appreciate, Relate and explain, Energize and encourage comprise the acronym of
effective healthcare. How patients are treated and behave, plays a major role
in the response to medical care and the final outcomes. Honesty, cooperation,
positive attitude, trust, adherence to the treatment plan and appreciation are
essentials for the patients. Open and sincere communication, hope, skill, and knowledge
are the working instruments of healthcare delivery. The basic premise is that
every human being has value and deserves to be treated with respect.

• Language: English
• Publisher: Yorkshire Publishing
• Release date: Mar 10, 2023
• ISBN: 9781957262864

Alfred L. Anduze, M.D.

Alfred Anduze, M.D. is a retired physician, ophthalmologist, Integrative Medicine Fellow, and diplomate of the American Board of Disability Analysts, and has an interest in the role of natural medicine in the prevention of disease through attention to the root causes and not just treatment of symptoms. He lives and works on an organic coffee and medicinal tea farm in the mountains of Puerto Rico. His other health-oriented texts include: A Practical Guide to Pterygium Surgery, An Integrated Medicine Approach to Modern Eye Care, Natural Health and Disease Prevention, In Search of a Stress-free Life, First Aid on the Farm, and Social Connections and Your Health. He can be reached at [e-mail].

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Un-Usual People is a part-memoir, part-instructional manual consisting of evidence-based premises, patient and caregiver stories, suggestions on required knowledge and skills, and solutions used in the art and act of providing healthcare. The subjects are a combination of regular and special-needs patients who seek and receive medical attention, diagnoses and therapies and the caregivers and healthcare personnel who provide the CARE. The ability to Communicate, connect, and cooperate, Accept and appreciate, Relate and explain, Energize and encourage comprise the acronym of effective healthcare. How patients are treated and behave, plays a major role in the response to medical care and the final outcomes. Honesty, cooperation, positive attitude, trust, adherence to the treatment plan and appreciation are essentials for the patients. Open and sincere communication, hope, skill, and knowledge are the working instruments of healthcare delivery. The basic premise is that every human being has value and deserves to be treated with respect.

ISBN 978-1-957262-86-4 (Ebook)

978-1-957262-62-8 (Paperback)

Un-usual People: A Caregiver’s Manual

Copyright © 2022 Alfred L. Anduze, MD

Izaak Rodriquez, Illustrator; Jaye Thompson, Creative Director

All rights reserved.

No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law.

For permission requests, write to the publisher at the address below.

Yorkshire Publishing

4613 E. 91st St,

Tulsa, OK 74137

www.YorkshirePublishing.com

918.394.2665

Printed in the USA

Dedication

This compilation is based on notes and stories about my last 45 years in the medical profession and is dedicated to all the responsible, cooperative people who sought care and knew how to be patient; and to all the healthcare providers who knew how to care.

Doctor’s Note

This book is not about the science of disabilities and geriatrics, but about the people I was privileged to have met and treated and about what I learned about the art of caring for and giving to seniors and those with special needs.

With a fresh diploma in medicine in my hand, and a rosy outlook on what life had to offer, I chose the specialty of ophthalmology because there were no limitations on who I could meet, examine and care for. I could see the entire range of humanity, from neonates and children of all ages to adults and centenarians and beyond; men, women, and everyone in between and at the sides, and both the sick and the well, at the same time. Over the course of 45 years of clinical practice, I am proud to report that I never missed a scheduled day and greeted every patient with a smile and a touch. With time came the realization that not every ailment could be cured, and some diseases had intangible roots. In trying to make every patient feel better on the way out than they did on the way in, I quickly learned that everybody had a story to tell, and everybody was worth something,

In this book, I try to share some of these experiences and shed some light on the amazing lives we sometimes downplay or miss entirely. In some cases, I have used only their first names or initials. I occasionally use the full names of highly deserving mention for their accomplishments, demeanor, and contributions. Complainers were not complimented by either.

Un-usual people attempt to showcase the best of ableism and ageism. My patients, their caregivers and fellow healthcare providers sometimes surprise me by being primary examples of the presence and wide range of human value. When we see the suffering of groups and individuals, ignore their mistreatment, lack of empathy, over reactions, and indifference or negligence of some healthcare personnel (home caregivers, nursing, physicians, ancillary care, anyone in contact with another person with concerns about health), we should react by questioning the whole art and science of healthcare. The fact that so many of our fellow humans are perceived as broken down people who are useless, worthless, expendable and are then discarded should raise our inner emotions to their heights. It could be me. Maybe they would better be addressed as exceptional people. That we should be aware when we say "Everyone scale that wall, except Billy and Sally here in the wheelchairs; Everyone run down to the lake and jump off the pier, except Sam and Agnes, because they are too old, that these excep-t-ional people deserve some recognition, is the theme of this book.

Every human being has value. *

Through interacting with my patients and their caregivers, I learned that all people are unusual in their own ways…all slightly different yet basically the same in human ways. There was always some redeeming value. For this reason, I found it almost impossible to ever tell anyone, that there was nothing I can do for you. This little smidgeon of concern in the middle of routine healthcare, can have profound healing effects.

In 45 years of active medical practice, some of my best work was done with infants, seniors and disabled patients, who also happened to be those human beings that few wanted to see or had given up on. Those who were deemed irreparable, people with severe traumas, babies with neurological dysfunctions clinging to life, kids with physical and mental disabilities, and those elders blind after four gallant surgeries and pounds of medications to repair what was irreversibly broken. Their lowest point always came when told that nothing further could be done, and there would be no need for follow up visits. I have seen many patients leave offices, clinics and hospitals with that Discarded stamp on their foreheads that contributed to further depression, despair and worsening of their conditions. Broken down, irreparable people, whether young or old, with any luck, may encounter a caregiver or healthcare provider who finds them interesting, different, un-usual, and takes the time to find that little something that can be done for them.

Often, some cannot or will not connect due to time constraints, lack of communication skills or other reasons. It is here that the introduction of an integrative medicine approach could help by addressing the causes and try to insert some of the aspects missing from a healthier life, by paying some attention to the social, spiritual, and common stressors and more enjoyable digestive issues that benefit the body as well as the mind.

Every little bit counts for something.

The disabled show their appreciation for simply surviving …and their fortitude, talents, and positive features should be applauded. The standouts, such as Helen Keller, Stephen Hawking, Stevie Wonder, Jose Feliciano, Andrea Bocelli, and Frida Kahlo, are all accomplished geniuses, who happen to be disabled in some way shape or form, have shared their enormous talents with the world. How many others not as famous have we turned away with those nothing-I-can-do-for-you tickets in their pockets? Wasn’t there something that could be done to alleviate at least some of the undesirable symptoms and make life a bit easier and more acceptable? Sometimes just a kind voice, a caring touch, and a slight aura of welcome, could impart a huge positive effect. I know you are here. You are important to me and to yourself.Likewise, the hug of a Downs Syndrome patient on being told he did a good job or the smile of a 99-year-old lady upon being urged to reach100, have profound effects on the provider and everyone else in the vicinity. How would you ever know what it was like to hold a baby who will never see your face or hear your voice or come running to be cuddled, since he has no legs, or who never hugs you since he has no arms? You know he will never feel the exhilaration of hitting a baseball past the shortstop and into left field for a double, then stealing third base, or making a jump shot from the corner, and worst of all, she will never smile or cry from experiencing the pangs of adolescent love for the very first time. With a deep-felt compassion, innate empathy, a basic sense of caregiving, and some experience, you can enable a reaction, a connection, and sometimes positive results.

The most important factor in patient care is maintaining some semblance of DIGNITY, a fundamental human trait required in every interaction. Any initial assessment of the patient/client/customer, should include functional level, expected results (outcome), how they are related and explained (in some cases to the accompanying caregiver). For extra perks, a satisfactory interaction is a remedy, and a continued satisfactory relationship is anticipated, expected, and rewarded.

How we treat each other, whether as patient or caregiver, should involve RESPECT, no matter what the condition (broken or whole) being addressed, age, gender, status, occupation, leaning, LGBTQ and ethnicity.

In my third year of medical school, the clinical years, contact with patients, learning knowledge and the scientific method were all intense, but we were short on basic people skills. To some of us, it was natural (Dr. Arthur Bradford excelled), some of us with good backgrounds in people skills handed down from our parents, siblings, and friends, learned quickly (myself), and others did not learn at all. Note that the six-year (instead of eight year) medical students’ capacity to interact was often limited and conversationally challenged. Many found more comfort in research labs. Three years in college studying science, and three years in graduate school studying medicine show how smart you are but do little to develop social skills. It shows. To fully interact with all patients, experience is the best teacher. In the Human Genetics Clinic: Making jokes about kids with syndromes, which and how many genes gave which and how many symptoms and how CRISPR gene editing could solve all problems or nothing you can do about it is plainly wrong! There are tons of things you can do. Begin with connecting with the patient and let them teach you what can be done to make their lives more comfortable.In a geriatrics clinic: Jokes about VOPs (very old people) with no money, nothing to fix, and an irreparable stamp on the forehead. Sit and listen to an old person sometime. He or she is a virtual library of wisdom and tales you’ll not find elsewhere. As an intern, one of my first patients was the Honorable Shirley Anita Chisholm, known as the first African-American woman elected to Congress, (from the NY 12th district, 1969-1983) and first to run for President of the United States (1972) on a major party ticket, orator, stateswoman, etc. I just knew her as Mrs. Chisolm, brilliant older person. On my night shift, I had to draw her blood samples at midnight, take them to the lab, pick up the results and report at 7 o’clock rounds. Miraculously she got better on my watch and was discharged home. Some years later, she came to see me at my office in St Croix while on a routine visit. What an honor! Respect the lesson learned. Everyone has value, no matter what the circumstances, even me. On ageism and ableism… how society has belittled, ignored, deliberately discounted and otherwise discarded or prepared to discard, the elderly and disabled, as otherwise unfit to participate in societal affairs. Treatment of dwarfs, people with different skin tones (albinos and dark-skin-toned people), anyone with extra-European features, and language differences (barbarians), gives rise to attitudinal biases that are evident in the level of care being provided and in outcomes achieved.

This book is for everybody, patients, potential patients, caregivers, and health providers at every level. Almost everyone alive either has an infirm or unstable family member or will have contact with those who are dysfunctional, disoriented or with