FMM 7 13 18 The Damage Done

“In a time of universal deceit – telling the truth is a revolutionary act.”~ Unknown.

One of the challenges of becoming a nurse is learning the language.  First there is the medical terminology – many words are derived from Latin, so if you know any French or Spanish that may be a little helpful. But there are also words of Greek origin – a confounding collection of consonants – think of the word ophthalmoscope! The words are combinations of building blocks, if you know some of the pieces you may be able to guess the rest – prefixes, suffixes, stems and roots come together in challenging chains.  I love to teach students the language using words like esophago-gastroduodenoscopy, which merely means they are going to pass a tube down your throat, through your stomach and into your duodenum to have a look! Or as a patient who was going for a colonoscopy once told me, they are going to ‘shove a camera’ up a place I won’t repeat here!

But it is not only the language that can be challenging, there are often at least two names for any given object in the body.  There are also names – structures or conditions named for the person who first identified and wrote about them – the sphincter of Oddi near the gall bladder, Broca’s area in the brain,which controls speech, and oh so many more.  It helps once you can associate the condition or structure either with a mnemonic or a person.  If Broca’s area is damaged (by stroke), your speech is broken.  There is a condition associated with long-term alcohol abuse and a deficiency of thiamine (Vitamin B1) that goes along with it, named the Wernicke-Korsakoff syndrome.  Once you have taken care of a patient with this syndrome, you never forget it. The damage to the brain leads to an interesting symptom known as ‘confabulation’. The person has huge gaps in their memory, and so they just ‘make stuff up’.  When they see someone they know (usually a family member) but have no idea how they are supposed to know them, they make up a whole story about when and how they met.  It can be quite amusing or extremely distressing, depending of course on your relationship to the person with the syndrome.

Some syndromes have names that sound like a character in a Disney movie – like the Munchausen syndrome, or the related syndrome, Munchausen by proxy.  Many years ago in South Florida there was the distressing story of a mother and child.  The child was so sick that she had to have a feeding tube for nutrition, and was in and out of the hospital.  The mother was always by her side, and impressed the hospital staff and all who came across her with her caring, her dedication to her child, her knowledge of the ins and outs of caring for the child, and her self-sacrifice.  For quite some time the physicians were not able to pinpoint the underlying cause for the child’s illness.  I don’t recall now how all was eventually revealed, but it turned out that the mother suffered from ‘Munchausen by proxy’.  She had manufactured symptoms, actually caused harm to her child so that the child would be sick and need attention.  In gaining attention for her child she gained attention for herself- she was the hero, until she was arrested.

Every once in a while there will be a scary story in the news of a healthcare worker who will do something similar – they manufacture medical emergencies in an ICU so that they are the first one on the spot, and are seen to be the hero, saving the day. Unfortunately, it may be some time before the person is identified as the common causative factor, and many people will have been harmed.

I have been reminded of the Munchausen by proxy syndrome recently, as I observe the leader of the USA creating crises that did not exist, then present himself as the savior.  So many of our headlines are due to the distressing policies of this administration.  It was hard not to compare the two gripping stories that unfolded on our TV screens and on social media recently.  On the one hand there were the poor boys stuck in a freezing cave, trapped by rising water, with heroes who risked their lives to save those of the boys and their coach in Thailand.  Of note is that many of the boys are ‘stateless’, belonging to undocumented minority groups that were fleeing persecution or gang activities in their country of origin.  The cave trip was of their own doing, foolhardy and poorly timed, but they had entered the caves voluntarily.  Meanwhile, back on the USA-Mexico border, children (also stateless and undocumented) are lost in the caverns of US bureaucracy, torn from their parents through a man-made disaster.  And instead of cave divers with oxygen tanks, we have lawyers and activists trying to find their way through this mess to the scared children.

And those are the stories making the headlines. Meanwhile, in the halls of the United Nations, at the World Health Assembly, the US opposed a resolution to ‘protect, promote and support’ breastfeeding, choosing to side with the formula manufacturers, going against all of the research and evidence in favor of breast milk.  What other potentially life and health threatening policies are being enacted and lost among the weeds as we are distracted by the headline grabbers?

It is up to us the populace to keep our eyes open and keep ourselves informed.  We have to stay healthy and strong by finding ways to oppose those policies which harm the vulnerable in our society.  We have to keep focusing on the positive and exposing the negative.  Bob Marley sang ‘soon we’ll find out who are the real revolutionaries’ and it is incumbent upon us to keep singing the truth, keep calling out the policy makers who think only of the interests of the wealthy.

On this Friday morning, as we celebrate the happy ending to the Thai cave adventure, let us not forget those who are suffering quietly and beneath the radar.  Let us find ways to be involved and informed, to fight back against these forces that want to carry us backwards. And may you learn at least one new word a day! Have a great weekend, Family!

One Love!


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