If you're living with a chronic illness, you're in the right place.

Saturday, November 10, 2012

NHBMP #9: Losing a Client

5:28 AM Posted by Tiffany Taft , ,
Today's topic (Ok, yesterday's but I think it's still yesterday in Hawaii so I'm getting in just under the wire) for NHBPM is to post a detailed description of a memory.  Since Steph and I are writing about our experiences as people who work with those living with chronic illness, our entry is a little different.  When I thought about what memory to write about, 2 of my previous clients came to mind - those who had died either while I was seeing them or shortly after we'd finished.  I'll call them John and Joe.

When you learn how to do therapy, you study different theories and do some role playing in your classes.  You sit in and observe your mentors doing initial interviews and maybe a session or 2, but overall it's like being thrown into the deep end of the pool when you're 6.

John was maybe my 2nd therapy client.  He was in his 60s, in a tenuous marriage, had a daughter who he was estranged from, and a former oil rig worker.  He came to me after he'd had a liver transplant due to Hepatitis C, and the 2nd liver was starting to fail because he'd had very little follow-up care.  John was a no-bullshit kind of guy.  He kind of reminded me of George Carlin, but not quite as funny.  I was a budding CBT therapist and I gave John a homework sheet from a workbook I had of CBT homework sheets (because that's what you do, right?)  He took it and when I spoke to him the following week he told me I could shove my worksheet up my ass.  Rather than being off-put by John, I learned several valuable lessons about my job very early.  I really enjoyed working with him.

After seeing John for about a year and a half, he went into the hospital around this time of the year and he never came out.  I heard from his wife via email that he'd passed away in early December.  It's pretty rare to have a client die as a therapist in general, let alone this early in your training. I had such a flood of emotions.  And I wondered if it was appropriate for John's therapist to show up at his funeral.  The #1 tenet of this job is you always protect confidentiality.  If I showed up, his family and friends would ask who I was.  I could lie, I suppose.  I talked at length with my supervisor about all of this, and I decided not to go.  I did email John's wife and let her know what an impact he'd had on me, but she never replied.

Joe was one of my clients who I worked with at the Veterans Administration (VA) hospital during my internship year (5th year of graduate school).  Joe had paranoid schizophrenia since he was in his early 20s and was in his early 50s when I saw him.  We worked together for a year and he taught me more than any book could about life with schizophrenia.  Joe was well known at the VA since he went there most days for classes in the program they had for people with more serious mental illnesses.  I'll never forget how he described life with his condition:

It's like living in a dark room, all the time, but there's this dim light in the corner that you reach out to...and sometimes you can get to it, but usually it's just out of your grasp.

I learned that Joe passed away about 8 months after I'd finished my year at the VA from a brain aneurysm.  The doctors had missed it when he went to a non-VA emergency room because they assumed his symptoms were due to schizophrenia (something that  happens more often than it should).  This time, I did attend the funeral service as several people from the VA were going.  It still felt strange to be sitting there in the church with Joe's family up ahead of me, but I was glad I was able to pay my respects to my client this time.

“Through others we become ourselves.” ―Lev S. Vygotsky