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  • Writer's pictureDonica Baker


I have a whole category of patients who are grandparents who have needed to take custody of their grandchildren. They came to me because of arthritis and joint pain. Inevitably it comes up in the conversation that they are trying to stay healthy and active because they have to take care of their grandchildren—because the parents could not—often due to drug abuse, incarceration, alcoholism, severe mental health issues, or a list of other problems that makes someone unable to be there for their children. What happens when you have arthritis and chronic pain, but you have to be a caretaker for someone else and others rely on you?

One of my patients who left the deepest impression on me was an 80-year-old elderly gentleman with severe arthritis affecting his hands, knees, spine, and throughout his body. One time we were talking about taking one of his medications early in the morning on an empty stomach for best absorption. His response blew me away. “That’s not a problem,” he replied, “because I have to wake up at 4:00 am every morning to take care of my 6-year-old grandson with cerebral palsy anyway.” He went on to explain how his grandson is in a wheelchair and requires total care, including diapering, tube feeding, and bathing.

“Where are his parents?!” I asked naively, only in my rheumatology fellowship training at the time. “His parents are divorced,” he said, “and the mother left the picture a long time ago. She lives in a different city and we haven’t seen her for years. Our son, who is the father, visits once in a while but he works a lot.”

I was shocked that this patient who had severe rheumatoid arthritis had to do so much in his retirement years to take care of his young grandson, and that the parents were so uninvolved. Suddenly, I felt so honored to be taking care of the hands of the man who was taking care of that helpless and vulnerable child. I couldn’t help that child myself directly, but in a way I could help him by taking care of his caretaker. I still remember that patient as someone I deeply admire, who inspired me so much during fellowship training.

Back in medical school, I was initially hoping to become a pediatrician. I loved kids and felt like it would be a good fit for me. My pediatrics rotation in medical school turned out to be more difficult than I thought it would be. It turned out that I loved kids so much that it was difficult to see them suffer from difficult situations like childhood cancer and chemotherapy, abusive situations, congenital abnormalities, or other tragedies that they had no control over and no escape from. As an empath, it became too difficult to see that suffering on a daily basis so I decided to choose a different career path.

Later, I decided to become a doctor for adults because I realized that in order for children to have a happy and healthy home and upbringing, they first need to have happy and healthy parents and caretakers. Taking care of adults would likely cause a ripple effect to help with other people around them, especially their children. This ripple effect was clearly reflected to me that day when my patient told me all about his grandson. That’s why I love hearing stories about my patients’ inner lives. You get a glimpse into a world that you would otherwise never get to see.

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