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lessons learned from this profession


ok, I'm not the guy from SNL,
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No matter where you go . . .
So I wander into this nuclear
        reactor . . .

Thoughts on This Day
The Power to Forget
Announcing:  Alwyn!
Martyr Complex
The Call
The Reality of the Situation
Comforting Presence
Guilt & Redemption


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2 March 2005

Martyr Complex

Many people who believe in reincarnation say that in each life you have lessons to learn, and that any lessons you fail to learn must be faced in another life.  I think that perhaps I've finally learned a lesson assigned to this life.  We'll see.

All my adult life I've had a martyr complex.  In work, in volunteer activities, in my personal life (even in recreations, for crying out loud!) I've always been the guy to do the hard thing that needs to be done but that no one wants to do.  Granted, we all have to do our share of onerous jobs now and then for the world to work.  That's fine.  But sometimes I'll take on a responsibility which becomes something more like an obsession.  Without really meaning to, I'll find myself sacrificing myself (my health, my finances, my enjoyment of life) in order to attempt to meet that responsibility.  I've long understood this about myself, and try and moderate it, but it is a recurrent pattern of behavior.

Why do I have this tendency?  As a child I was always considerate of the feelings and needs of others.  I was raised Catholic, steeped in that moral obligation of self-sacrifice.  And my dad was a cop killed in the line of duty just as I entered adolescence.  While I know I will never live up to his sacrifice, part of me feels that I must somehow try.

My wife and I care for her mother, who suffers from senile dementia and memory loss.  It's not Alzheimer's, thankfully, so we don't have to contend with the personality change which accompanies that disease.  But still, as her primary care physician constantly reminds us, being a care-giver for a loved one with dementia is the most chronic, stressful thing you can do.  In terms of stress levels, it ranks right up there with the loss of a spouse, or going through a divorce . . . but lasts longer.

I have been the primary care-giver most weekdays for my mother-in-law since last summer, allowing my wife to return to her architecture practice.  It's a situation which works fairly well for me:  I do some conservation work, I write, I have the luxury of time to think.  Well, taking into account the fact that I must be attentive to the needs of my mother-in-law.  She naps, she reads, sometimes we play cards.  I fix her lunches and her snacks, make sure she gets her meds and exercise, help her with the routines of life.  In the evenings and weekends, my wife and I share the responsibilities, one of us always "on call" to help with bathroom runs in the middle of the night, preparing meals, and so forth.

As I said, my mother-in-law's memory is failing.  Short-term memory is always the first to go in these situations, and that is true in this case as well.  As we age, we tend to rely more and more on those long-term memories we have, slowly losing the middle parts of our lives.  Because of her memory loss, we have to remind her of things the doctors say, repeatedly answer her questions, remember ourselves that she's not being ornery or cantankerous but just forgetful.  Her memory has now deteriorated to the point where she doesn't always remember that it is faulty.  And her cognitive faculties are spotty, so sometimes the conclusions she comes to about things are rather, ah, creative.  For the most part, this is harmless.  It doesn't matter if she mis-remembers why she stopped going to Sunday School classes, for example.  But occasionally, she'll get something into her head that goes contrary to what the doctor (or common sense) tells us she needs in order to remain safe and healthy.

And there's the rub.  I'm used to having people understand and cooperate in matters pertaining to their own self-interest.  I tried for months to reason with her on these matters (that she needs to eat more, that she has to have someone with her when she wants to get up and walk somewhere, etc.), to explain why it was necessary for her to do the things we were telling her she needed to do.  But it was about as useful as arguing with a drunk.  I tried begging, pleading, cajoling, even shaming her into doing these things.  Some efforts would work - for a while.  And in the meantime I was increasing my stress levels, pushing my blood pressure up into the danger zone.  I knew this, but figured that it was necessary in order to get her to understand and cooperate for her optimal care.

Then I recognized that I had once again fallen into the martyr trap.  I was slowly sacrificing my own health and sanity in an effort to keep her "perfectly" healthy.  When I realized what I was doing (again!), I took a step back and asked if it really made sense for any of us for me to do this.  It didn't.

So now, while I will do what I can to get my mother-in-law to abide by the guidelines set down for her, I realize that there is more than one way to skin this particular cat.  If she refuses finish one of her meals, I tell her that she needs to do it for her own health, I show her the note the doctor wrote in her "memory book," but then I leave it at that.  There is literally no point in trying to convince her that I'm right and shes wrong.  Instead I'll supplement her other meals and snacks in little ways that she won't notice.  Rather than debate whether she needs to have someone with her when she gets up to go somewhere, I just make it impossible for her to try to do so without my being aware of it.  And so forth.

It's not a perfect solution.  Sure, I'd rather that she understood and cooperated, making these stratagems unnecessary.  But a perfect solution isn't what's important; her health and happiness is what matters.  My mother-in-law is happier being here in her own home, and for now we can provide her with a better level of care and quality of life than she would get in a nursing home.  And to do that, I have to remain happy and healthy myself.  There may come a point when she needs real medical supervision, but we hope to delay that eventuality until the final days of her life.  And maybe, just maybe, I've learned my lesson about being a martyr.  We'll see.

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