REFLECTIONS
REFLECTIONS: ISOLATION
AUTHOR Teresita Bacani-Oropilla, MD
I
solation – what a lonely word! Various
definitions by Webster include “to set
apart, to cut off from a group or a whole,
to quarantine.” The images they conjure
are less than heartening.
Isolation can be self-imposed or the
result of circumstances beyond one’s con-
trol. Some are life saving, others designed
to break one’s body or spirit. History and fiction are rife with exam-
ples that make survivors either heroes or victims.
The Duke of Windsor and his American duchess missed the royal
pomp of the kingship that he renounced. Napoleon, the conqueror
of many lands, must have been lonely when exiled to Elba. Father
Damien, however, chose to administer to the lepers of Molokai,
becoming one of them until his demise.
The fictional Robinson Family triumphed over the disaster of
shipwreck to demonstrate courage and the make-do spirit until
rescued at last.
Like many of the prisoners of wars of recent memory, Nelson
Mandela suffered isolation, severe punishment and privation, but
survived to change history.
Closer to home however, are the ordinary widows and widowers
among us who have lost spouses. Having bonded and circulated
together with couples they befriended for years, they suddenly
become third wheels.
What about older parents and relatives who have outlived their
usefulness or capacity to live alone in a vibrant, busy world? Al-
though still loved, the sandwich generation can hardly cope with
its own activities, much less assure the safety or comfort of their
elders. The latter might indeed feel they have been cut off from their
world when they leave their homes for safer abodes.
Isolation for supposedly incurable diseases has been practiced
through the ages, with shattering emotional devastation. Biblical
stories tell of shunning lepers who had to cry out their condition
so no one would come in contact with them. In our own lifetimes,
family members had to be torn from their kin to live in leper colo-
nies until a cure was found for Mycobacterium leprae. Tuberculosis
patients suffered in sanatoriums until mycobacterium tuberculosis
was controlled. Modern experts remain on alert to find new cases,
treat and isolate the infectious terror, Ebola. Public health and
community doctors all over the world work to find and treat people
with HIV and hepatitis A, plus the latest worry, new cases of measles
due to the stubborn idiocy of the anti-vaccine parent.
At the same time, reversible isolation has saved millions of the
immune-suppressed from preventable infectious harm and death.
Medical isolation therefore is a necessity. The aim is to be a step
ahead of all threats and put up a strong barrier to new infections.
Unfortunately, it seems society and the medical profession has
been challenged with a new and growing threat. Extremely sad
and frustrating is the increasing number of the young who try to
find answers and solace with drugs and alcohol. Eventually boxed
into a corner, they may find themselves so desolate, so alone and
so hopeless that they kill themselves. That is the acme of isolation.
As physicians, are we willing to corral this threat to life in the
future? We have beaten back others before - it can be done again.
Dr. Bacani-Oropilla is a retired psychiatrist.
SEPTEMBER 2019
29