Along with the primary diagnosis of cancer, I remember when a hospice nurse quickly listed her patient’s other health issues at our team meeting. One of the patient’s concerns was a . . . “pathological fracture.”
To which I thought, “Huh? What?”
I first thought of pathological liar, a phrase I’ve read in novels and seen in films. Actor Jim Carrey’s Liar Liar from 1997 humorously came to mind. There he played a lawyer who frequently and thoughtlessly lied. Lying for Carrey’s character was no different than breathing. But did the familiar “pathological liar” have anything to do with “pathological fracture?”
In the realm of words, there’s a common ground because of “pathology,” or the study of diseases. Lying about everything, though funny for a movie’s plot, will hurt, and can be diagnosed as an illness. Lying can cripple a person and profoundly impact every relationship.
A pathological fracture literally cripples a patient.
When cancer and other diseases weaken the body, a costly side effect may include fractured bones. I’ve broken a finger, nose, and leg. Breaks are painful. But some kind of foolishness or unfortunate accident caused my problems. My bad bone history involved bike rides and a tumble down a mountain slope. From minor to major inconvenience, they were all part of an “Oops!” However, “Oops” doesn’t seem an appropriate response for a bone fractured because cancer has ravaged an arm or leg.
There is another, not-so-literal way to understand the secondary damages caused by insidious diseases. Bones aren’t the only things that could be broken.
Patients may begin to dread the next bad thing that will happen. He or she feels broken.
Families can experience turmoil. When siblings support (or don’t support) a dying parent, old resentments from childhood can resurface. They dread feeling broken.
In particular, caregivers are worn out and weary. He or she can break down.
Whatever was once perceived as normal at home or work seems like a different person’s different life. I wish I could wave a magic wand to make the caregiver’s life easier. I can’t. I recall my mother’s anguish as she supported Dad while he sank into dementia’s quicksand. He was unaware of his delusions or altered sleep patterns. But all of his disease’s twists and turns weakened Mom. Even after he was placed in a care facility, Mom’s support—and her “fractures”—continued. She slept fitfully, ate poorly, and rarely had time for friends.
In Katy Butler’s insightful, unsettling 2013 memoir, Knocking on Heaven’s Door, she wrote about her 83-year-old mother’s care for her husband following his stroke:
She put her hand, hard, on my arm. ‘He is killing me,’ she said. ‘He. Is. Ruining. My. Life.’ Then she crossed her ankles and put her head between her knees, a remedy for near-fainting that she’d clipped from a newspaper column and pinned to the bulletin board behind her. She was taking care of my father for about a hundred hours a week.
In 2015, the American Association of Retired Persons (AARP) estimated that:
43.5 million adults in the United States have provided unpaid care to an adult or a child in the prior 12 months. About 18.2% of the respondents interviewed reported being caregivers. The estimated prevalence of caring for an adult is 16.6%, or 39.8 million Americans. Approximately 34.2 million Americans have provided unpaid care to an adult age 50 or older in the prior 12 months. [Italics and bold font are mine.]
A 2023 report by the AARP indicated there has been little improvement to the literal and personal costs of unpaid caregiving. (See link here.)
I have no instant solution to the secondary bones and hearts that will break when a devastating illness impacts a person and their family and friends, but I do plea for compassionate action. I do plea for families to heal petty disagreements between siblings, to avoid the convenience of saying sorry-I’m-too-busy-to-help or to not claim ignorance about the burdens on an overwhelmed mother/father or sister/brother.
Seek ways to support the caregiver . . . now!
We are all fractured.
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Photo by Harlie Raethel on Unsplash
My book, A Companion for the Hospice Journey is available at Amazon.
Thank you Larry for your comments about supporting caregivers! Well written and I agree! Paula