Abstract
To most people, technology and older adults don't mix well. Being a therapist in the age of telehealth amidst a global pandemic means I was not only a therapist, but an information technology (IT) technical support and leader of a game of charades teaching patients how to unmute their phone. Telehealth can feel cold, distant, and often impersonal.
When a man in his 80s recently diagnosed with an advanced cancer presented for an initial psychology telehealth appointment he was angry at the technology for being so challenging to navigate. He worried about seeing a “trainee” without life experience who couldn't possibly understand what he was going through. With a 50-year age difference between us he feared I couldn't understand. I suggested he give therapy a three-session trial run and he reluctantly agreed.
He joined the subsequent session late, with his arms crossed across his chest and a laundry list of complaints about video lag, robotic audio quality, and choppy Wi-Fi connection. Our relationship changed when he told me how afraid he was to undergo risky surgery and to endure a week-long hospital admission without visitors due to the risk of contracting COVID-19. When I asked him what would offer him comfort he jokingly replied, “someone to hold my hand.”
Because his angry exterior was challenging, his team rolled their eyes when I showed up after his surgery in the inpatient unit and told them I was going to visit him. He lit up with enthusiasm to see me behind layers of hand sanitizer, gloves, mask, and goggles. I sat with him in his pain and held his hand; after our in-person encounter, he never missed a session.
Similar to clockwork, weekly sessions usually started out grumpy due to his frustrations about telehealth or concerns about new aches and pains. As the angry exterior melted and furrowed brows softened, I saw how vulnerable and afraid he really was. Beneath the anger he was fearful of dying, leaving his loving wife behind, and not having accomplished everything he wanted to in life. Similar to a dropped Wi-Fi signal, feeling disconnected was threatening to him during a vulnerable phase of life. Even after 80 years he still had life left to live.
The next phase of each session he mesmerized me with stories of past accomplishments, a career he was proud of, travel adventures or mishaps, appreciation for nature, and creating films that won awards at film festivals and his one true love, surfing. He could recite every famous beach break he surfed, the quality of the crashing waves, if the wave broke to the left or right and the names of locals he met in the lineup. Over months on telehealth he shared old photos, his favorite surf boards, gave tours of his “man cave,” and even once played an Australian didgeridoo concert for me. I watched him transform from an old grumpy man to playful and youthful surfer dude with zest for adventure in life. Despite layers of protection from masks, to video screens to an angry exterior, I tried to see him how he saw himself: full of life, accomplished, adventurous, and with a good sense of humor.
Sitting with him offered me perspective and wisdom on living a meaningful life. As an emerging psychologist I'm at the beginning of finding my professional identity and purpose in my work. However, listening to this patient's regrets of not spending more time with family, appreciating youth, and traveling, I see the benefit of living a well-rounded life. This year I've learned to hug those I love a little tighter, call more frequently, and to prioritize connecting to nature on a surf board.
I know he's frightened to die but he will live on. For the next 50 years his legacy will carry on with me and with all the patients who I will comfort through suffering. Anytime I surf, I think of how appreciative I am for my body, current health, the importance of family, vulnerability, and the healing power of simply holding hands when in need. I am the future of the adventures he has lived in the past and I will always carry him in my heart on my surf board.