Unseen Wounds

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It was late in the afternoon when the caregiver stormed into the OPD, visibly agitated. 

He raised his voice, frustrated that his father’s tremors hadn’t improved despite weeks of medication. The room became tense with his tone of voice and my staff became quiet. 
 
I gently asked him to come inside and sit down and he did so. After couple of seconds without raising his head in a quiet tone he said “Everything is the same, nothing is helping” 

He had nothing further to say no further questions. No anger. 

Just exhaustion. 

Unlike this gentleman. There is this lady, a woman in her early 50s taking care of her mother with Alzheimer’s came to me, not for her mother’s treatment, but for her own migraines, sleep issues, and unexplained palpitations. 
As we spoke, it became clear: she was carrying more than physical strain—she too was drowning
 
Just exhaustion. 

As a neurologist, I have seen this pattern far too often. While we focus on the patient—and rightly so—the caregiver begins to crumble in the shadows.

Both of them needed help. In his anger and her silence, I recognized the signs not of anger and silence, but of compassion fatigue. 

Compassion fatigue is not just burnout. 

It is the emotional wear and tear from prolonged caregiving, especially when there’s little improvement or hope 

Compassion fatigue should be recognised as this will help in ensuring the care to the patient as also improve the quality of care of the caregiver. Compassion fatigue can be recognised when you find the person getting easily irritated, angry, or even bursting into tears, feels emotionally numb and worthless, and has associated headaches, sleep disturbance, and unrecognised sustained fatigue. 

In our country, the caregivers, predominantly women, are expected to be tireless, patient, and composed—even as they silently fall apart. 

I quietly validated the efforts of both the caregivers and gently urged them that while they are doing their best, they should have their own space to breathe. 

Because I believe that sometimes, the one who isn’t in the wheelchair is the one who’s hurting the most.


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