As the festive period approaches, The Lancet is publishing its winning Wakley Prize Essay together with an Editorial on the epidemic of loneliness, which is never more evident than at this time of year when many other families are spending time with their loved ones. The Essay is by Dr Ishani Kar-Purkayastha, UK Health Protection Agency, London, UK, who based her essay on a collage of encounters she had as a junior doctor with an elderly patient desperate to spend Christmas in hospital with fictitious injuries rather than return home to spend it alone.
The elderly patient (who is given the false name Mrs Doris Rafferty for the story) explains in the story that her husband died more than 20 years earlier, while both her children live abroad. She complains of injuries that a battery of tests cannot confirm in order to extend her stay in hospital, before briefly breaking down. "It's just that I'm all alone and there are so many hours in the day," she says, before letting out a forlorn noise that is neither laugh nor cry. "Doctor", she asks, "can you give me a cure for loneliness?"
Dr Kar-Purkayastha says: "There are probably thousands like her. Men and women who have lived a lot and loved a lot. Men and women who are not yet done with being ferocious and bright but for whom time now stands empty as they wait in homes full of silence; their only misunderstanding to have lived to an age when they are no longer coveted by a society addicted to youth."
She adds: "For now the ward is quiet. In the next 2 days there will be some celebrating, but there will also be some admissions—those who are really sick and those who are really inconvenient, usually older people, grandmothers and grandfathers who get in the way of the festivities. The hospital is the last minute resort for families that cannot cope or who do not want to. That is not to say that is how Doris sees her life, or her family, but she is nonetheless alone and it brings home to me the truth of this epidemic that we have on our hands—an epidemic of loneliness, insidiously affecting those among us who have seen the ebb and flow of countless seasons, seen the world grow smaller and then grow too large again."
The linked Editorial concludes: "Were we to revisit Doris a year later, with luck we might find her with more support. The absence of close family in old age need not be the end of companionship. There are many organisations who organise gatherings for older people who live alone, while social clubs and workshops can give people the opportunity to immerse themselves in something they enjoy. At the same time, it is important to recognise that loneliness can also be tackled by helping people to feel happier in their own company. For the rest of us who might have a little spare time on our hands over the holidays, a visit to an older neighbour who lives alone might be just what they need to make their holiday a merry one."
Dr Ishani Kar-Purkayastha, UK Health Protection Agency, London, UK. Currently in India. Please e-mail to arrange interview. E) ishanik@doctors.org.uk
The Lancet Press Office. T) +44 (0) 20 7424 4949 E) tony.kirby@lancet.com
For full Essay and Editorial see: http://press.thelancet.com/loneliness.pdf
For runner-up Essays and Comment see: http://press.thelancet.com/otheressays.pdf
Journal
The Lancet