Remembering Barb: Caregiver shares memories with palliative care students

Plaster molds were made of Seiler's and Zimmerman's hands.

As a longtime nurse, Katherine Zimmerman worked with patients of all ages in hospitals and with children in all grades of Texas schools. The experience prepared her in some ways—though not all—to be the caregiver for her special, lifelong companion, Barbara Marie Seiler.

Zimmerman spoke about her loved one and the highs and lows of Seiler’s closing years during the March 5 session of MEDI 4115, the palliative care didactic elective for fourth-year medical students.

Seiler was a dental assistant and took courses in emergency medical technology and dental hygiene. She was also in the military as a physician assistant and received a degree in sociology. She and Zimmerman met four decades ago in a church choir in San Antonio.

In December 2014, Seiler checked into the hospital for a hernia repair. “The doctor came out and said she had some tumors in her intestinal area. It turned out to be pancreatic cancer,” Zimmerman said.

The two ladies had seen this form of cancer before. Three of Zimmerman’s family members had died of the disease, each within six months of diagnosis.

“Barb went through with the chemotherapy,” Zimmerman said. “She didn’t want any extraordinary means. We went to a palliative care group and they were very supportive.”

Twenty-five million caregivers deliver care at home to seriously ill relatives in the United States, said Sandra Sanchez-Reilly, M.D., course co-director and associate professor of medicine in the Division of Geriatrics, Gerontology & Palliative Medicine at UT Health San Antonio. She cares for patients at the South Texas Veterans Health Care System.

If the time of Zimmerman and other caregivers were averaged at $10 an hour, the cost equivalent of uncompensated care would reach $450 billion, Dr. Sanchez-Reilly said.

“We were in and out of the hospital for two and a half years,” Zimmerman said. “Sometimes we were out for only six hours before returning, and other times it was three to six weeks.”

Seiler’s favorite physician was Jeanette Ross, M.D., associate professor of medicine at UT Health San Antonio, who also cares for patients at the South Texas Veterans Health Care System. One time during her illness, Seiler had a panic attack when she couldn’t remember Dr. Ross’ name, Zimmerman said.

“Barb wasn’t open at first to hospice,” Zimmerman told the students. “She would go to the hospital to get stronger, not to die.”

Palliative care group members brought plaster to Seiler’s room toward the end of her life. Molds were made, one of Seiler’s hand and one of Zimmerman’s. Rings that Seiler had made in a class were placed on the plaster, which sits on Zimmerman’s mantle today.

“I was used to taking care of patients,” she said. “Barb was different; this was a person I loved and admired. We went to Europe together five or six times. We had a good, full life.”

Small things matter. A palliative care fellow at the VA stayed with Seiler and Zimmerman for an hour and a half one day. “That was a lot of time for a doctor to do,” Zimmerman said.

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