This One was Tough

I usually like to have a theme picture accompanying my blog, but I couldn’t think of a picture for this one.

In my career, I’ve entered people’s homes and their lives at very vulnerable moments. Every single person I visited left an impression on me. They taught me about chronic illness, disability, and death. They were my teachers and I respect them as I now face my own difficulties.

(I may get some of the details wrong here because this has been a while and it was a very complex case.)

Bethanne and Jamal were from the Midwest and retired in Sun City West in the late ’90s. They had a beautiful house on a golf course. Their eldest daughter was a doctor – a professor at Stanford. Their son had a very successful tech business in Silicon Valley. Bethanne was intelligent, witty, but very proper. Jamal was a chiseled retired businessman who now spent his mornings on the golf course.

One day Bethanne awakened in the morning and was speaking in an Irish brogue. Alarmed, Jamal called his physician daughter, Audrey. “What do I do? She woke up, came into the kitchen in her robe and started speaking to me like a leprechaun. She is only in her nightgown and robe and she never comes out of the bedroom undressed.” Audrey told her dad to take Bethanne to the emergency room, which he did. They went over to the ER at Del Webb where she was poked, prodded, and evaluated. She was given a diagnosis of dementia and bipolar disorder and was admitted to a nearby behavioral health facility.

In behavioral health, Bethanne declined. She refused to eat. Her behavior became more erratic. She made multiple attempts to escape through a window. She really wasn’t fitting the criteria for bipolar disorder. However, the medical staff maintained she had dementia. She would spontaneously roll around on the floor and act like an out-of-control child. Bethanne threw tantrums. She continued to speak in an Irish brogue.

Bethanne’s daughter, Audrey, flew in to assess her mom for herself. She was just puzzled. Then, the day after Audrey had flown in, Bethanne started having myoclonic jerking – these are shock-like, jerking involuntary movements. Audrey was stunned. She dug through everything she could, trying to find out how and why her mom went from healthy and normal to absolutely bizarre – and now the constant jerking movements!

By the time I saw Bethanne for her assessment, she had declined even more. She was being tube-fed, suctioned (as she had limited swallowing ability), and she could not open her eyes or speak.

Now this is weird…it was breast cancer.

Yes, it was breast cancer that caused all of this. Bethanne had undiagnosed breast cancer, which then spread. It is very rare to get personality changes and myoclonic jerking from breast cancer. But, Audrey’s research paid off. When I talked to Audrey on the phone, she went into great detail as to how she did her research and how she finally had her “Aha!” moment. By then it was too far gone, of course.

I don’t know how to end this…just that it is a strange phenomenon. And, I’ll leave this right here.