It gets repetitive and dull. My first patient Ms. B complains of yet another self inflicted emotional and physical wound. The physical wound is the infected heroin injection site. I don’t have time to address the emotional wound. Mr. V is waiting.
Mr. V is bi-sexual. He, sometimes she or they, feels persistent societal and cultural biases which only worsen his, her, their attempt at keeping appointments and taking medicines on time. Add to that, all of them lack financial resources and feel unsafe at home. Their grandkids abuse them, taking advantage of their kindness and using the home as a place to host drinking, smoking and drug parties. It is an unsafe environment. This a toxic mix which is smothering them, and right now choking me.
I want to quit listening. I don’t even want to complete a thorough physical examination or discuss the implications of the multiple laboratory and imaging studies. I dare not address the moral issues if I want to keep them engaged enough to return for treatment. None of them understand the objective data and I will only have to repeat it again next week, especially when they return with interested family members or partners. Does it ever end? For them, no it doesn’t. But as for me, I get to go home.
I hurry up. I check all of the boxes confirming I have acknowledged the abnormal liver enzymes, bladder infection and pneumonia. I document that I have given them specific instructions, handouts to explain diet, smoking cessation, exercise and substance abuse. After that, I to go home.
I get to go home. The housing development is pristine. The lawns are manicured. The streets have smooth and the sidewalks are clean. My neighbors only ring my bell to tell me they kept the package that was delivered to me at their house because it was raining when it arrived. Other than that, I never hear from my neighbors. I get to go home.
I will never begin to understand how miserable and helpless it must feel for someone to leave my office, burdened down with all of the bad news I just offloaded. It does not matter that I gave copies of the most important studies or detailed instructions on what pill to take when, which doctor to see next week, and how to apply the ointments, appliances and dressings to the wounds, sprains and scars. They go home to the same challenges of limited financial resources, emotional support and unsafe living conditions.
Once I leave clinic, I go home where I have an unlimited supply of all of these things in a comfortable, safe and loving environment. I thank God and I dare not judge. After all, I get to go home.