“You have two ears and one mouth for a reason.” Guest blog from Caprisse Honsbruch

My first home visit was to Palode. My group saw 10 patients with various conditions. There were people with cancer, amputations, stroke sequelae, paraplegia, diabetes, hypertension, and asthma. The age range of the patients were 23-90 years old, and there were 7 men and 3 women.

The experience was not what I was expecting. I was expecting more medical treatment and interventions, but these visits were more check-ups for chronic conditions. There were many social and psychospiritual interventions done, probably because there was a social worker on the team. Some of those interventions included setting a patient up with a way to support the family by raising chickens, making sure the patient’s child goes to school, helping a patient get a disability pension from the government, and taking steps to help the patient rehabilitate their house. That was really neat for me to see because that is not something that a pharmacist is usually involved in. It made me have a greater understanding and respect for what social workers can do. In the future when I’m hopefully a hospital pharamcist, I will go to the social worker because they seem to be able to work miracles for patients’ social needs. Even talking to the patients seemed to brighten their day. I found that interesting because in the USA a doctor’s visit is more like a chore, but in India we were welcomed into the house and treated with the upmost respect by the patient and their family. Dr. Raj said that doctors and health care providers are very well respected in India, and I definitely got that sense in the home visits. There was even an instance in a home of a patient who was very sick that the family insisted that everyone have a glass of fresh squeezed orange juice. I unfortunately didn’t feel comfortable drinking it, because it smelled amazing, but it was little things like that that made me feel very welcomed in the home.

The patient who I connected with the most was a women who was diagnosed with breast cancer 3 years ago, and has since been in remission after chemo and radiation. She has had 2 mammograms since that have been negative, but she is anxious that the cancer could come back. She really reminded me of my mom. She was diagnosed with breast cancer, but has since been cancer free for almost 5 years. Every time she has a mammogram appointment though she is very anxious that they will find a reoccurrence of cancer. She always tells me it not a question if the cancer will come back but when, which as a daughter can be hard to hear. The patient lived in a very nice house with a great kitchen and had a big flat screen TV. So I made the assumption that she was well off. But I learned that you can’t judge a person on material things like houses, clothes, cars, etc. because she was actually in debt. She was staying in her sister’s house, who lived abroad, because she had to sell her house so that her daughter could get married. Because even though dowries are illegal they are still common in Kerala. That took me aback because that is not the culture in the USA. In class we talked about how healthcare puts people in debt but not marriages, so I found that interesting. She was also nervous about her cancer coming back because her daughters are married which means they need permission from their husband to go and help their mother. That also took me aback because the culture again is so different from what I am used to. If my mom needed help because she was sick I would hate to not be able to go because my significant other said no. Finally she taught me that if all you can offer a patient is conversation then that is all right. I’m personally a fixer. If you have a problem, I want to be able to fix it. But sometimes you can’t make everything okay. If a person is dying from a terminal illness, you can’t wave a magical wand and make everything better. But you can listen to them and hear what they have to say. As a future clinician I will work on being better at that. My professors, in my other pharmacy classes have said, that you have two ears and one mouth for a reason. Let the patients tell you what they need. Don’t assume you know what is best based on your personal biases. 

Here are some of Caprisse’s favorite photos.

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