Posted by: Ade Williams30 AUG 2019
Source: JL / The Pharmaceutical Journal
He was my patient who never made eye contact, yet he would teach me how caring is not just the application of knowledge and expertise — it is also time and attention that heals.
‘Barry’, as I will call him, was a very broken man. He had received residential mental healthcare when he was younger and the experience scarred him, but also left him very untrusting of others. He would later recount his experiences and vivid nightmares.
He had later lived with his mum. She protected him and isolated him from the community that avoided him. The idiosyncratic behaviours, not uncommon for his condition, left them bewildered.
She had helped him to manage his medications and had prepared his meals. Her advancing age brought limitations in her mobility, but her death, though not untimely, left him a with a broken heart and a dysfunctional life. He just did not know how to cope, and as his medication compliance deteriorated, his paranoia and unpredictable behaviour became more commonplace.
His weekly visits to collect his medicines were part of an arrangement set up before my time — a plan to create much-needed structure. With his social awkwardness and extreme anxiety, he came across as a person who just wanted to be left alone.
Then one day, I asked him about his plan for the rest of the day. He paused and smiled.
So our rapport started. He loved singing and painting — both with much panache.
His mum had always been very appreciative of and entertained by his gifts and now so would others. I spoke about joining a local choir and a painting class. He declined repeatedly but, surprisingly, one day asked for the details.
He went and enjoyed them both. He now agreed to talk to me about his health and medications.
His problems with uncontrolled eating were likely side effects of his medicines. He was at risk of developing diabetes, a problem not helped by his lack of engagement with healthcare professionals. Lack of trust was a significant barrier, but it wasn’t insurmountable.
A meal plan and cooking classes were real game changers. I was happy to help organise both.
Soon enough, he was just another patient seeking advice from his local pharmacy.
He always brought paintings along to show us. Now we could all support him not only to get the most from his medications, but also to champion his wellbeing.
He felt more confident to live a life that many of us would take for granted — he radiated and shared his joy. His paintings were now exhibited in local libraries and care homes too.
Time and attention seemed to be healing old wounds — we had opened a gate that allowed us to follow a path together of improving his health and wellbeing.
Kindness, when married up with knowledge and expertise, enables pharmaceutical care but builds rewarding relationships too.
Everyone needs a pharmacist to dispense kindness. I am happy that Barry taught me how.
Ade Williams, lead pharmacist, Bedminster Pharmacy, Bristol
Ade’s piece placed second in the pharmacist category of our 2019 writing competition ‘The Patient Who Changed My Practice’. Read more entries here.