Extraordinary Vision

The last, for now, in our “Common Senses of Caregiving” series.

Rita had come to the hospital to have her gall bladder removed.  It had all sounded pretty routine when the doctor explained it to her, and she knew many people who had similar surgery without complications.  But Rita developed an irregular heart beat in the recovery room after surgery and was transferred to the intensive care unit for more monitoring.  When she was fully awake, she was confused.  The room was darkened, there were wires all over the place, and she could hear alarms all around her.  The nurse came in frequently to check on her, but her manner hurried and abrupt.  Rita answered “no” to every inquiry about pain or discomfort, but in reality she was hurting badly.  She didn’t want to be a bother to her busy nurse.   She lay rigid, her hands clasped the bedrails tighter and tighter with each wave of distress, her knuckles were pale.  She was terrified.  Her signs of distress were visible; did anyone around her truly see them?

When my nephew, Jacob, was a toddler, he and my mother were looking at pictures of family members.  Upon seeing his older brother Daniel’s picture, he looked up and said as only a child can, “That’s my brudder. I love them eyes.”  Jacob’s own eyes were big, brown, and innocent.  Why would Daniel’s eyes evoke instant recognition and affection 
in Jacob?  

Each of us has heard that “the eyes are the windows to the soul.”  What do you see when you look into another’s eyes:  love, joy, fear, confusion, anger, loss?  Our eyes telegraph our emotions to others. 

Of course, our eyes do much more than that.  From the moment we wake up until the moment we go to sleep, our eyes are taking in information and relaying it to our brains to interpret. Sight conveys more information to the brain than hearing, touch, taste, or smell. 

Vision enables our daily functioning and plays an important role in memory development.  At times, our memories influence what we see.  When we look at old family photographs, our memories convey more than the photo actually shows.  Vision is important to the development of imagination:  a small child fears the dark because of what she cannot see and what she imagines to be there.  Our sense of vision helps us build important contextual cues:  we can tell by sight when things are out of order.  Rita’s confusion in ICU was caused in large part by her inability to find the contextual cues she expected to see:  Why was she here? What was all this equipment?  Why was it so dark? 

Infants are born with a complete visual system, but they must learn how to see.  They receive instruction and constant coaching to recognize (and make sense of) shapes, colors, and people. As we age, our sight diminishes, as our other senses do.  Those with limited eyesight or blindness learn to rely more heavily on their other senses and on the guidance of others. 

Caregivers must often learn how to see – to look at things in new ways and to make sense of all that they are observing.  They may have very few familiar cues:  when a loved one suddenly becomes ill, we struggle to understand what normal recovery should look like.  Over time, caregivers develop a mental “camera” to record their daily observations of their loved or patients, and to distinguish between developments that look serious and require action, or situations that may not be as serious as they look.  And caregivers must also be willing to rely on others for help seeing.  Healthcare professionals can teach caregivers how to look for important health cues.  So can our friends and other family members. Sometimes, our emotions can obscure our ability to truly see a loved one’s condition; that’s why a casual friend may notice a change in your mother’s appearance more quickly than you do.

Experienced caregivers use their extraordinary vision to look for subtle signals, such as those Rita was displaying, to understand more fully what is happening with a loved one or patient.  If caregivers are hurried or stressed, it’s easier than one might think to miss visual cues.

Caregivers also learn how to mask the emotions their eyes might project – such as fear or exhaustion.  In fact, caregivers learn this lesson so well that sometimes their closest friends can’t detect the emotional burdens they are bearing.  They fulfill their daily responsibilities so skillfully and efficiently that we might not see the unexpressed chaos they feel inside. 

We need to learn to look at the caregiver and truly see; we need to observe and interpret their body language and nonverbal cues.  In essence, just as caregivers learn to “listen  with their eyes,” we must learn to listen – with extraordinary vision – to the cues and signals of fatigued caregivers. 

Our power to see gives us extraordinary vision.  Perhaps the best way we can use it is to follow young Jacob’s example:  to see through eyes of love.