DR. HOOK- All relative: Estrangements complicate treatment

"We Are Family, I got all my sisters with me. Get up everybody and sing!" Go, Sister Sledge!! (Where are they now?) 

Family is something so powerful, so encompassing, so– ah, complicated. The Partridge Family never had major conflict even though the show started on the premise of the death of Mr. Partridge. Wait a minute, even on The Brady Bunch, at least Mike (and maybe Carol) was widowed. 

Good grief! The Courtship of Eddie's Father was based on the death of Eddie's mother. 

Oh, no! The Andy Griffith Show, My Three Sons, Eight is Enough, and Family Affair all involved a missing parent and spouse. Jody! Buffy! Cissy!  

You know, I never realized all of these favorite shows of mine were based on the death of a beloved family member. They're all comedies, so I never focused on the fact that the kids were missing a parent. Talk about a parent trap!

These shows demonstrate that family members stick together and move on. But do family members really stick together until the end?

I joke that I don't get older; I just get gooder. But the reality is that if I ever get to be elderly, I don't know who's going to take care of me should I fall ill with dementia or cancer. (I definitely don't want Anna Nicole Smith's mother or Britney Spears' mom to take over my care.) I have my advanced directives, power of attorney, etc. already taken care of at my tender age of 40, but who knows what lies ahead?

Some of my toughest cases with patient care deal with elderly folk who are estranged– or worse yet, who don't acknowledge they're estranged– from immediate family members.  

Patient: "Doc, I leave my kids alone, and they respect my privacy as well."  

Doctor: "When was the last time you talked to them?"

P: "When they were born."  

D: "Don't you think you should let them know you're in trouble with your health and can't live alone anymore?"  

P: "I can take care of myself. But can you get my groceries for me and do my laundry? I'm hungry and I smell bad."

Sometimes these types of patients won't even let me call their kids or other immediate family members, so I have to act like Rosanne Barr (i.e. nag, nag, nag) to convince them that I need to speak to family. Unfortunately, some people just don't have any immediate family.

In our lovely world of dysfunctional families, I sometimes regret being able to talk to the kids. I once had a demented and dangerous patient who needed to go to the nursing home, and the son did everything but buy his parent an AK47 and anthrax. He could not accept that his parent was ill, and he did everything possible to ignore medical advice.

I have had quite a few kids of patients act like Lindsay Lohan when I've been on the phone with them.  

D: "I'm sorry to tell you that your mother is on a ventilation machine and is not doing well."

Child: "Cool, so things are going well?"  

D: "No, things aren't going well. I think you should come here now because things are going poorly."  

C: "I'm so glad you're doing everything you can to help Mom. You're awesome." 

D: "Ah, do you understand what I'm saying? Your mom may not be around much longer."  

C: "You can email me on the cruise ship when Mom's better. Isn't it great what modern technology allows us to do?"

People need to think about who's going to be making decisions for them. I saw a bumper sticker recently that said, "Be nice to your children– they'll choose your nursing home."

Maybe I'll open up a new business, "Rent a Child"– for those in need of a healthy thinking (i.e. sane) next-of-kin. All my employees will be well versed in The Brady Bunch and The Andy Griffith Show.

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.