The Power Of Words: Private Conversations With A Patient

A patient today confessed to me the real reason behind his high blood pressure.

He presented to the hospital complaining of right-sided numbness over both upper and lower limbs. It was sudden in onset and occurred upon waking up in the morning, however it resolved spontaneously 30 minutes later. It was something he had never experience before. Upon arrival to the emergency department, his blood pressure was noted high: 160/101 mmHg. He was then treated for transient ischaemic attack (TIA), a type of stroke that happens briefly due to an intermittent blockage in the cerebral arteries, and as the name suggests, causes transient ischaemia in the brain.

Apparently, he has history of hypertension for the past 7 years and has been very compliant to his anti-hypertensive medication. But somehow, last night he forgot to take them. He claimed that last night’s missed dose was the culprit of his high blood pressure.

He was fit for discharge after we treated him with some anti-hypertensive medication.

As I was explaining to the patient about his discharge plans and future follow-ups, he finally spilled the tea.

“Actually ah, I know the real reason for my stroke. And it’s not because I missed the medication”.

I was caught off guard when he said this. He definitely had my attention now. “Why, uncle?”

“Well actually, yesterday I had a misunderstanding. It’s nothing serious, but I was really stressed out about it “.

He told me how the night before, he had an argument with his grand daughter, whom he loved dearly. Unfortunately, her father had just passed away a few months back. Her mother, on the other hand, is unemployed and a stay-at-home mum.

The day before the stroke, the patient and his granddaughter were out shopping for some school project supplies in a crafts store. In the middle of shopping, he warned his grand daughter not to buy anything expensive.

“We cannot afford much. Think about your mother. She is not working”.

The grand daughter immediately got defensive. “But how come everyone else could buy them, and I can’t?”

“It’s because they still have a father. Your father is dead”.

That statement hit the grand daughter hard. “My father is not dead, he is still with me in spirit”.

The situation got heated up. She was filled with emotions, and when she couldn’t hold it anymore, she started crying. It was a shopping-spree turned disaster. They went home feeling beaten down and the grand daughter refused to talk to anyone.

My patient explained how it was one of the most stressful moments in his life. With just one word, one sentence, and everything is flipped 360°.

Such is the power of words.

I was personally moved by his plight, because out of all the stresses he had ever faced, this was one of the worst. It just goes to show how much his grand daughter meant to him.

Unfortunately, the tension and stress from the event had a huge impact on the patient. Now he has hurt his beloved grand daughter. What could he do to fix the mess?

The incident left him feeling reckless. As a result, he forgot to take his medication pills, and then impulsively deleted all his phone contacts out of anger. 

The next morning, he started feeling numbness over his right body, which then led him to the hospital today.

After a few conversations, we have created a mutual bond which then led us to talk about more deep and personal topics.

 “Actually, I don’t really believe in God”, he told me.

In a country where religious ideologies override common sense, this statement intrigued me.

He admits that he doesn’t believe in God, but instead, he believes in the power of Mother Nature — the one universal law that governs the whole Universe, putting chaos into order. I told him I felt the same way too. He said the fundamental principles of life boils down to this one concept: respect. Respecting the environment, the animals, the planet, even the people living in it, in all walks of life. Behind all the prestigious titles and achievements, what matters in the end is respecting and treating everyone with kindness. Every action we take comes with a price, so think and choose wisely.

He talked about how he is from Penang, but lives in Puchong with his daughter. He asked me where I was from (“From Sarawak, uncle. Small town girl”.) and told me that I was a nice person (which was very flattering, not gonna lie). We continued chatting for a bit before his phone rang and we parted ways.

The conversation had a huge mark on me. Somehow, it made me wonder the number of patients in the past who did not disclose the full information of their illness. They’ve figured out the trick — to only tell what we want to hear.

But what if, we as doctors, make an effort to build rapport with our patients, and taking the time to discuss about matters of the heart: our concerns, what we want out of this illness, what we want out of life and how we can go about it.

The sad truth is, we just don’t have the time.

On a side note, it makes me realize that, some things are irreversible — every passing moment, every word we speak, or action we make. It takes a lot of courage to be grateful and to cherish each second, regardless of how hard life throws at you. You can’t control everything, but what you can do is work hard, improve consistently and let the results take care of itself. Being grateful doesn’t mean you are lazy. There’s a difference between being “passively grateful” and “proactively grateful”. That’s why I love the serenity prayer:

“God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference”.

Every day is a gift, it truly is. And we can only realize this when we change our outlook on life: by seeing the glass half full, as opposed to half empty. By focusing on our gains, as opposed to our lack. By letting go of control, and trusting in the natural flow of things.

Let’s make the most out of life and treat each day like it is our last.

“Stop asking what life can offer you, but start asking what you can offer life”.