I was dressed professionally with blue shirt, matching tie and crisp, clean, white lab coat. I had an ink pen in my breast pocket and name badge clearly displayed. There was no lint in my hair, no hint of the chocolate bar on my teeth. Having thus prepared, I stepped into her room and greeted her. The two children remained silent except for their coughing.
Good afternoon Ms. H. How can I help you?
I don’t remember much after this. It seems everything went downhill.
How long have you been coughing? Do you have a fever? Is anyone else at home sick? Are you taking any medicines?
She answered each of these in a monotone as if I was not asking the right questions.
Then, she went on to relate the multiple situations, signs and symptoms that had brought her to be treated today. I lost track after the first 6 or 7 complaints because they began to overlap.
‘Well, it all started when my boyfriend accused me of paying more attention to my other boyfriend’s children than his children. He screamed at me and would not let me get in a word. Then he raised his hand and struck at me. Luckily, I turned my head and he only got the back of it, but just enough to make me hit my head and mouth against the wall. My lip started bleeding and my front tooth came loose. Can you see it here doctor?’ She raised her upper lip with her fingers revealing the bruising and cut on the inside and a broken tooth.
She went on. ‘Then he grabbed me by my hair and threatened me that I better pay more attention to his two children than the other four or he would move out and leave me to pay the rent, lights and buy the food by myself. I don’t have a real job. I just take care of these babies. Then he left me and I started coughing and it won’t stop. The kids are coughing too, she said pointing to them. Both had running noses, and were coughing’
At this point, I am trying to figure out what does this have to do with her diabetes and hypertension. I can’t begin to address the smoking cessation that is obviously affecting the asthma and bronchitis of her children. I dare not go down the road of the necessity of immunizations. That only leads to a quarrel.
She is in the way of helping me tie all of these significant illnesses into a neat and easily treatable package. She is not making it easy for me. I face the computer and start my charting. Everything is in perfect order on the screen.
Unfortunately I don’t have the option of only treating the x-rays, lab studies or physical findings. The patient gets in the way of doing this. Their social comorbidities overwhelm the coding of the physical diagnoses and undermine my clean, crisp treatment plan.
Patients will get in the way of the treatment plans. I need to address their concerns and give them room so that with time, they will hear me. I must not be the help that hinders.
Jesus asked the man in John 5:6 ‘Do you want to be made whole?’ The man’s answer was not a yes or no, but a list of things that prevented his healing. The Healer of healers was there and this man was in his own way of being healed.
He did not condemn the man for his excuses or failures, He just healed him.
I must learn to address both their chief complaint with my chief concern. I know there are obstacles for their healing. I should not be one of those obstacles. She will return if I don’t stand in the way. And if she does, it gives me another opportunity to show compassionate care and help her get out of the way for her own healing to take place.