Here I Come to Save the Day...

I've decided my job is exhausting - not so much physically but emotionally.  In a good way and in a bad... I had forgotten that my Texas City patients could get poorer until I went to Galveston on Friday.  I'm not complaining... just ever an eye opener.  The clash within me consists of wanting to give these people all that they don't get anywhere else in life - good medical care, someone to care and listen, time, and respect.... While in the meantime, I remember that they can't afford the treatment they most desperately need for the most part, and that even though UTMB is right down the street to offer them that, they can't pay and so probably will never be considered as a potential referral acceptance.  Wanting to spend time listening to them (whole-heartedly), remembering that I may be the only friendly face they see all week, but knowing that I can't spend a lot of time with anyone, regardless of how much they need me... cause I do have a job to do after all.

I find myself frequently frustrated.... I don't know if this has been scientifically proven or not.... but I'm pretty sure that the average weight of a population increases as their income decreases.  I have seen more than my share of 350 pound people in the last week...  With that comes all the medical conditions that go with that morbid obesity.  Arthritis of the knees, diabetes, high blood pressure, high cholesterol...  They need medicine badly, can't afford the medicine... but they can afford all the crap they eat that put them in that position in the first place... I think I'm gonna have to start implementing tough love.  One patient demanded that we give her permanent disability for her diabetes and it's complications.... for starters, it doesn't have to be permanent... and she did it to herself... and keeps doing it... not caring... Very frustrating when you step back and look at the situation to realize that you truly care more about that person's health than they do themselves.

Granted, a lot of them can't afford the supplies they need to monitor their blood sugar... or to eat a lot of health foods... but at least try!  Get off your butt and actually look for your insulin instead of just assuming it's lost and coming in with symptoms due to your high sugar level.

And then there are those that you really feel for... I've had several psych patients come in.  You can tell they are trying to turn their lives around, one was in rehab, one had been in prison.  And they're doing that with better control of their psych problems through medication... Medication that I have to tell them that not only do we not have to supply for them... but also that there isn't anywhere else they can go to get it... Do you realize that one month's supply of some of those meds is like $500-600... and that's just for one of the probably 5 or so they are taking... So what do you do? Wish them luck... and tell them to go to the ER (or come back) if the symptoms are getting intolerable... meaning they become suicidal... can no longer ignore all the voices they hear in their heads telling them to hurt themselves... can no longer ignore the bugs they feel and see crawling all over them --- though they say they can tolerate them for now.... To send out patients happy to finally have some control over their symptoms, knowing only that that control isn't going to last long since they can't afford the help they need...

Those are the patients that just really make you wonder how much good you are doing in the long run...

Are the patients who seem so eager to take my advice going to take it?  Are they actually going to make an appointment to come back and address the next issue?

Don't get me wrong, I love my job... but I wonder if there is such a seemingly high turnover because it just gets you down after so long... To long to work somewhere you can actually help people.. instead of just telling them there is hope but it isn't available to them... because they are poor.  Kind of like you wonder if providers who work with cancer patients eventually stop mourning the loss of the most recent victim... when they lose a couple a week... I don't want to become numb... hopefully, this will not be that for me...

Until then, I continue to think back to the cute little freckled girl who hurt her foot... or the severe insulin dependent diabetic who realizes we may be the only place available to get his supplies- granted not the ones he needs...  Not the 400 pound woman demanding that medicare buy her a motorized scooter since she can't get around anymore... instead of fixing the original problem..ug...

So my plea?  Care about your health!  I wish everyone could hear end stage COPD lungs as they continue to smoke... To talk to the now blind and amputated diabetic who didn't control their sugars as they should have... the cervical cancer patient who didn't get a pap her whole life until it was too late...  We like to see healthy patients!  Be our healthy patient before it's the other way around and we need you to be that example for the young guy who thinks it's cool to shove a stinky wad of chewing tobacco into his cheek... It's nice to have a tongue isn't it? :)

If you're still here.... thanks :)

And as for you Miss Kara... you're off for the summer, your mommy can come over and babysit, your hubby walks home from work to eat lunch with you two, and you only worked twice a week.... no more about me slackin!  :)