Column
How do you live a life more ordinary?
When a ‘broken’ man came to Dr Hester Wilson, she was faced with the limits of what medicine could offer.
Can people press the play button on an ordinary life?
In our first consultation, Gene described to me what his life used to be like.
He’d been a surfer and musician, travelling around Australia as a drummer in bands. He loved drugs and the muso lifestyle. He was building up a collection of tattoos. He told me of his leather jacket collection, black jeans and chunky silver jewellery – the full muso look.
Life was perfect.
These days, Gene still has the tattoos and jewellery, but that lifestyle is gone forever.
To supplement his freewheeling life, Gene had been working as a labourer whenever he returned to Sydney – when he wasn’t chasing waves, of course.
That was fine until, suddenly, it wasn’t.
Gene’s first life ended abruptly when he slipped and fell two floors to the ground on a building site.
Rather than taking him to hospital, the building contractor dropped Gene at his mother’s front door. She describes coming out and finding him as being like a horror movie.
‘He was broken – covered in blood, incoherent and unable to move,’ she told me at one of our joint consultations.
As she called an ambulance, her son lapsed into unconsciousness.
He had severe facial injuries, head injuries, and had fractured his pelvis, ankle, right hand, left wrist and multiple ribs. He spent months in hospital and rehabilitation.
Gene returned home to his parents and tried to restart his life.
And now he was here in my consultation room, accompanied by his mother.
It had been 10 years since the injury. The Gene who was once the life of the party was not the same one sitting before me.
Now in his 40s, Gene was living with his elderly and ailing parents, who both played a big role caring for him.
Gene had come out of rehab, but would never fully recover. He told me of his grief at finding he couldn’t play his beloved drum kit. His physical pain and limitations, coupled with his brain injury, meant it was impossible.
‘I couldn’t move in the same way. I couldn’t think how to put it all together,’ he explained.
Gene told me his pain was severe, his sleep poor and his mood miserable. He used cannabis, opioids and benzodiazepines to try to manage his suffering.
But nothing was improving. He told me of withdrawing into his room.
Now, his only human contact came from his loving and worried parents, his GP for repeat scripts, and his friend and cannabis dealer who would visit him at home.
Gene had been referred to me by his GP, who had tried many options to help him with his pain. Adding medications. Reducing medications. Ceasing medications. Specialist referrals. Nerve blocks. Botox injections.
Gene found his psychology appointments left him feeling worse and he refused further offers of help for his mental health.
Gene has been living like this for 10 years.
‘It’s like I am in a permanent revolving, repeat state,’ he said.
‘All day I long for the end of the day, and all night I long for the morning.’
Over a number of appointments, Gene and his mother share their experience. I slowly learn his story and begin to understand his experience.
But while I feel great empathy and a desire to assist Gene and his family, I find myself torn. Because I know there’s not much I can do to change the real problems of his chronic pain. He’s already tried everything.
So what do I do now? There are no easy answers, no quick fixes.
Gene is not alone, of course. This is the reality for so many of my patients. Deep down, I know there is very little I can do to change the materiality of his life.
For Gene, though, even this precarious existence will not last. His parents are getting older and frailer. His father recently had a mild stroke. His mother – who is in her mid-70s – tells me she knows that a time will come where her son will either need to care for himself, or be placed in care.
She asks me if there’s anything new we can try.
I ponder it. Here we had a man in his 40s, incapacitated by a serious injury. The pause button has been pressed on his life. He is in a state of suspended animation. The truth is he’s the only one who could press the play button – and I’m not sure he’s physically able.
But I see her desperation and I vow to try.
So we start tinkering around the edges. His mother comes in with him for the first half of every consultation, leaving for the second half so Gene has space to talk about anything freely.
It is a therapeutic intervention – Gene attends the appointments and he talks freely.
Over time, we dial down his dose of diazepam. He limits his use of cannabis to bedtime. I flag the fact that his opioid use is unlikely to be helping much with his pain. He says he will think about changing it.
A real strength I see is the connection within this family. Their deep love and concern for each other is palpable. Gene tells me he feels lucky to have a family like his.
Slowly, slowly, there are small signs of improvement.
Gene gets a little more active as his diazepam and cannabis doses decrease. He helps his mother with shopping, chopping veggies for dinner. He’s talking about getting into the gardening. In one consultation, he tells me of his plans for his own veggie patch.
I am pleased that his life has improved a little. But I know, still, that we will never get his old life back. And even as I help and encourage him, I wonder how much more can change. I feel I’m doing talking therapy by stealth.
His life can never return to the first one he had and loved – that free time of music and surfing.
In his mind, that first life has become mythical, a wonderful time before what he saw as the sad limited reality of life ‘after’ that fateful fall.
But I do wonder whether the real change might be still to come.
I wonder if, over time, he will start to see that an ordinary life can be lived even with these limitations.
I hope he can choose this path. That he can press the play button on an ordinary life, rather than mourning the Gene he used to be.
Login below to join the conversation.
chronic pain dependency mental health
newsGP weekly poll
In the past year, have you seen an increase in the number of younger patients asking about vaping?