It's been a rough week, and it's not even Friday yet.
1. One of my favorite patients has breast cancer. She is Filipino and doesn't have any family except for her sister in Texas. She's already had a million other problems and has no income. On Tuesday night, she had to come get labs drawn at the clinic and she ended up sitting next to me and crying for almost an hour. She asked me if she was going to die and then proceeded to think aloud about how she shouldn't be afraid to die because God would take care of her. It was a heart-wrenching conversation made worse by the fact that since she'll get emergency Medicaid for the surgery and subsequent radiation therapy, she can't technically be a patient at Good Sam during the cancer treatment. When she asked me about this, she prefaced it with, "You all saved my life. I don't want to go anywhere else." Since we've also been caring for her fibromyalgia, carpal tunnel syndrome, etc., I'm hoping that we can sort of adjust our policy for her. After all, the minute the cancer treatment is done will be the minute that she's dropped from Medicaid.
2. Last Wednesday, a woman came in and wanted to see a doctor. She wasn't our patient, and we can't really accommodate walk-ins. When I explained this, she asked if she could talk to me somewhere in private. We went into the back and she told me that she had gone to the hospital a few days earlier with really severe abdominal pain. She has an IUD and an ultrasound suggested that she has an ectopic pregnancy. The hospital sent her home and told her to return if the pain worsened. So she came to Good Sam to find out if we could help her. The last I heard was that she was back in the hospital early this week so I'm hoping they'll remove her Fallopian tube (or that they already have). I can't help but wonder what would've been done if she had been insured and/or an English-speaker.
3. Yesterday evening, I went to a memorial Mass for the mother-in-law of one of the volunteer interpreters at the clinic. The family is Peruvian and the service was at the Hispanic church I wrote about recently. It was a beautiful ceremony but was also very solemn. However, I couldn't help but smile watching the family take random pictures of the church and assembly during the Mass. Plus, the last song was the prayer of Santa Teresa de Avila (which I said every day for most of high school)...so beautiful.
4. Today a woman and her daughter came to the door of the clinic. They are Puerto Rican and the daughter immediately started explaining to me in very anxious English that her mom had "serious health problems" and needed to see a doctor. I finally convinced them to tell me what was going on after some coaxing in Spanish, and it turned out that she has HIV and has been off all medications for at least 7 months. She went to the hospital a few weeks ago with severe abdominal pain and it turned out that she was having liver complications. She also has high blood pressure, high cholesterol, etc. The Emergency Department recommended that she follow up with the Good Samaritan Clinic. However, we don't have the capacity to deal with anti-retrovirals and the complications associated with HIV (which could be AIDS by this point, since she was diagnosed 13 years ago). The mother started crying when I recommended that she go to another area clinic that specializes in HIV/AIDS and its complications. She told me that people at the hospital were rude and that she's frustrated with everything. It was painful but I finally convinced her to try the other place and then to call me tomorrow to let me know if we can help her in any other way.
I love my job, but it's certainly not easy sometimes.
Thursday, September 30, 2010
Sunday, September 26, 2010
La justicia de comprar
I've been having a major ethical dilemma since before I even applied for the Mercy Volunteer Corps: for people who are living on limited means, is it better to spend extra on fair trade items or to leave that to people with disposable income? We talked a lot about this in my Food and Justice class junior year, but now that I am in the real world with a very small living stipend, it seems much more relevant.
Today, as I was standing in the grocery store looking at coffee, I had a very strong urge to buy a fair trade option. There were two problems with this. First, there were no fair trade options. Silly me, thinking a small grocery store in Georgia would carry such things. Secondly, how would I tell my roommates that I spent twice as much money as necessary on coffee, which only two of us drink anyway? I would want to talk about being at the cooperative in Monteverde, Costa Rica, and what a huge difference our purchasing power makes for people around the world. And then I would get all too excited and just make people not want to listen anymore.
It's kind of like the whole not eating meat thing. I don't want to be preachy, but I'm just not comfortable buying into the factory farm system in the U.S. There seem to be a large number of small, local farms that I might consider buying from, but I'm sure the costs would be significantly higher than traditional grocery stores, and $110/week isn't very much to feed four people when you start buying "fancy" stuff.
For some reason, this dilemma seems much more relevant with food than with anything else. But it's still in the back of my mind whenever we need to buy something for the house. Should we go to Walmart, where things are generally cheaper at the expense of millions of workers around the globe? Would we be wasting money otherwise?
I know that nothing will change in the world if only some of the most privileged people use their purchasing power to buy just products. But I also know that it's hard to justify spending more than the bare minimum on products when your budget is small.
The debate is endless in my head.
Today, as I was standing in the grocery store looking at coffee, I had a very strong urge to buy a fair trade option. There were two problems with this. First, there were no fair trade options. Silly me, thinking a small grocery store in Georgia would carry such things. Secondly, how would I tell my roommates that I spent twice as much money as necessary on coffee, which only two of us drink anyway? I would want to talk about being at the cooperative in Monteverde, Costa Rica, and what a huge difference our purchasing power makes for people around the world. And then I would get all too excited and just make people not want to listen anymore.
It's kind of like the whole not eating meat thing. I don't want to be preachy, but I'm just not comfortable buying into the factory farm system in the U.S. There seem to be a large number of small, local farms that I might consider buying from, but I'm sure the costs would be significantly higher than traditional grocery stores, and $110/week isn't very much to feed four people when you start buying "fancy" stuff.
For some reason, this dilemma seems much more relevant with food than with anything else. But it's still in the back of my mind whenever we need to buy something for the house. Should we go to Walmart, where things are generally cheaper at the expense of millions of workers around the globe? Would we be wasting money otherwise?
I know that nothing will change in the world if only some of the most privileged people use their purchasing power to buy just products. But I also know that it's hard to justify spending more than the bare minimum on products when your budget is small.
The debate is endless in my head.
Friday, September 24, 2010
Estoy enojada
I'm angry.
On Tuesday, the Grand Old Party in the Senate decided it'd be fun to block the National Defense Authorization Act. This act contained two very important things: the DREAM Act (which would allow immigrants who came to the U.S. illegally as children to gain legal citizenship if they met certain requirements) and a repeal of the "don't ask, don't tell" military policy (which currently bans openly gay, lesbian, or bisexual individuals from enlisting in the military).
The current political state of affairs in the United States is making me feel nauseated.
Stephen Colbert brought a smile to my face today though. http://www.cnn.com/video/#/video/politics/2010/09/24/bts.colbert.testifies.cnn
On Tuesday, the Grand Old Party in the Senate decided it'd be fun to block the National Defense Authorization Act. This act contained two very important things: the DREAM Act (which would allow immigrants who came to the U.S. illegally as children to gain legal citizenship if they met certain requirements) and a repeal of the "don't ask, don't tell" military policy (which currently bans openly gay, lesbian, or bisexual individuals from enlisting in the military).
The current political state of affairs in the United States is making me feel nauseated.
Stephen Colbert brought a smile to my face today though. http://www.cnn.com/video/#/video/politics/2010/09/24/bts.colbert.testifies.cnn
Sunday, September 19, 2010
La misa buenísima
Finally! I have found a parish in the Savannah area that I actually enjoy! It took several weeks of sitting through stuffy Masses, but today I was rewarded with feeling comfortable at church here.
The parish is called Our Lady of Lourdes and it's located in Port Wentworth (where a lot of my patients come from). It is a small wooden building that was literally teeming with people this morning. I was one of five white non-Hispanics present, so at first I felt a little out of place. People looked at me funny, but I guess many of them receive unwelcoming looks on a daily basis in southeastern Georgia, so I sat between a family and two young guys and just soaked in the awkwardness I felt.
Mass was pretty hilarious. The music was absolutely incredible but the priest spoke terrible Spanish (he was one of the other four white people). His homily was really good, but he mispronounced a lot of words and he was reading directly from a piece of paper with the type of intonation that made everyone aware that he had no idea what he was saying. He was obviously beloved by the community though; after all, it's not like there are priests lining up to serve in rural Georgia for Hispanics. Amidst the usual Mass verbiage, babies were crying and small children were playing/eating/whining. Most of the parents were more concerned about their children than what was going on up at the altar. It made me feel so joyous- it felt like a big family party where everyone could just be themselves.
Communion was kind of awkward. Despite the fact that there were probably 200 people there, I think maybe 30 of us went up to receive. I've noticed this a lot in Central America; my host mom in Costa Rica said Latinos don't generally go up for Communion if they feel like they're "living in sin" (which can be translated to being divorced, having sex out of wedlock, using birth control, etc.) So basically only children and old people go up. I had to climb over like 5 people to get to the front of the church, and on my walk back to the pew I felt like everyone was looking at me with confusion.
Luckily, at the end of Mass, Jeannine, who is in charge of Hispanic ministries at the parish and who also serves on the steering committee at my clinic, introduced me to everyone. I didn't know she was going to do that, so I was obviously super awkward when she asked me to stand up, but then she told everyone about what I'm doing this year and everyone clapped.
After the service, several people welcomed me, which was really nice. I feel like I've gained a sort of automatic trust within the parish community now, similar to the one I received when Sr. Maria Lauren introduced me in South Philly last summer.
Before I came home, I had some mini tacos and a coconut popsicle outside the church, which were being sold to benefit one of the parish groups. I also gathered information about upcoming parish events, including the vigil for comprehensive immigration reform. I am geeking out :)
The parish is called Our Lady of Lourdes and it's located in Port Wentworth (where a lot of my patients come from). It is a small wooden building that was literally teeming with people this morning. I was one of five white non-Hispanics present, so at first I felt a little out of place. People looked at me funny, but I guess many of them receive unwelcoming looks on a daily basis in southeastern Georgia, so I sat between a family and two young guys and just soaked in the awkwardness I felt.
Mass was pretty hilarious. The music was absolutely incredible but the priest spoke terrible Spanish (he was one of the other four white people). His homily was really good, but he mispronounced a lot of words and he was reading directly from a piece of paper with the type of intonation that made everyone aware that he had no idea what he was saying. He was obviously beloved by the community though; after all, it's not like there are priests lining up to serve in rural Georgia for Hispanics. Amidst the usual Mass verbiage, babies were crying and small children were playing/eating/whining. Most of the parents were more concerned about their children than what was going on up at the altar. It made me feel so joyous- it felt like a big family party where everyone could just be themselves.
Communion was kind of awkward. Despite the fact that there were probably 200 people there, I think maybe 30 of us went up to receive. I've noticed this a lot in Central America; my host mom in Costa Rica said Latinos don't generally go up for Communion if they feel like they're "living in sin" (which can be translated to being divorced, having sex out of wedlock, using birth control, etc.) So basically only children and old people go up. I had to climb over like 5 people to get to the front of the church, and on my walk back to the pew I felt like everyone was looking at me with confusion.
Luckily, at the end of Mass, Jeannine, who is in charge of Hispanic ministries at the parish and who also serves on the steering committee at my clinic, introduced me to everyone. I didn't know she was going to do that, so I was obviously super awkward when she asked me to stand up, but then she told everyone about what I'm doing this year and everyone clapped.
After the service, several people welcomed me, which was really nice. I feel like I've gained a sort of automatic trust within the parish community now, similar to the one I received when Sr. Maria Lauren introduced me in South Philly last summer.
Before I came home, I had some mini tacos and a coconut popsicle outside the church, which were being sold to benefit one of the parish groups. I also gathered information about upcoming parish events, including the vigil for comprehensive immigration reform. I am geeking out :)
Thursday, September 16, 2010
La gente amable
Reason #3409851 why I love the Good Samaritan Clinic:
Last night, the neurosurgeon who volunteers at the clinic was supposed to come by at 7pm to see two patients who have bulging disks. However, he had two emergency surgeries and didn't know what time he'd be able to get to Garden City. He ended up calling and saying he'd be there between 9 and 9:30pm. I called both patients he was supposed to meet with; the first, who lives over an hour away, said he couldn't make it because his headlights don't work and then the second, who lives about 15 minutes away, said she couldn't make it because she didn't have a ride. So at 9pm, when the regular clinic ended, the two women I work for got in a car and picked up the latter patient. They arrived back at Good Sam at 9:30, just a few minutes after the doctor began reviewing her films. I didn't get home until 10:30 last night, but it was well worth it. I love being part of an organization that cares so deeply for its clients.
Last night, the neurosurgeon who volunteers at the clinic was supposed to come by at 7pm to see two patients who have bulging disks. However, he had two emergency surgeries and didn't know what time he'd be able to get to Garden City. He ended up calling and saying he'd be there between 9 and 9:30pm. I called both patients he was supposed to meet with; the first, who lives over an hour away, said he couldn't make it because his headlights don't work and then the second, who lives about 15 minutes away, said she couldn't make it because she didn't have a ride. So at 9pm, when the regular clinic ended, the two women I work for got in a car and picked up the latter patient. They arrived back at Good Sam at 9:30, just a few minutes after the doctor began reviewing her films. I didn't get home until 10:30 last night, but it was well worth it. I love being part of an organization that cares so deeply for its clients.
Tuesday, September 14, 2010
La reforma
Today was the primary election in Massachusetts, which I technically voted in last week (fun fact: I have voted absentee for every election since I turned 18). I'm not going to lie: I'm starting to get nervous about the political state of our country. More specifically, I'm worried about health care and immigration. I guess that should be of no surprise, since I'm working in a clinic that tries to provide better access to health care, predominantly for immigrants.
Health care reform passed on March 21, which was conveniently the day after my birthday. I was super excited because it was the result of several decades of debate and it gave President Obama a lot of momentum. However, at the time, the most obvious flaw in the plan to me was that undocumented immigrants would be completely left out. I hoped this would be addressed if comprehensive immigration reform was brought up, but that still remains to be seen.
Living in Georgia has opened my eyes to another glaring problem with health care reform: providing more people with Medicaid is not going to help people living in rural areas. In a lot of places in this state (and many others around the country), there simply are not enough doctors. And the doctors that are in the most remote places often will not accept Medicaid or Medicare because the reimbursement is slow and the rates are extremely low.
I heard this criticism while I was in Philadelphia and in southeastern Massachusetts, but I kind of ignored it. I just assumed the doctors were being greedy. After all, I've spent my entire life living in areas that, quite honestly, have more doctors than we know what to do with. On my Appalachian Experience trips in college, I learned about lack of access to medical care in rural West Virginia, Kentucky, and Virginia, but I didn't realize that the problem went beyond having a large number of uninsured people.
Now I hear people in this area who have good, private health insurance complaining about a lack of doctors, especially a lack of specialists. I also have many individuals call me who have Medicaid but who can't find a doctor to see them. In most rural sections of Georgia, the majority of people are poor and will probably qualify for Medicaid in 2014 (if they don't already have it), but doctors often cannot even "break even" if the majority of their patients have government-sponsored insurance. I have no idea how more doctors will ever be enticed to set up practices in these places, either. At least the funding for the National Health Service Corps has increased...
To be honest, health care reform really only affects about one-third of the patients at Good Samaritan. Other free clinics around the country are worried about having to shift to serving the "underinsured", as well as covering eye and dental services (which were not included in health care reform at all but are very severe needs for many). But at my clinic, I just pray that some of our patients will get better access to health care as the years unroll, and that the election in November doesn't set us back anymore.
Health care reform passed on March 21, which was conveniently the day after my birthday. I was super excited because it was the result of several decades of debate and it gave President Obama a lot of momentum. However, at the time, the most obvious flaw in the plan to me was that undocumented immigrants would be completely left out. I hoped this would be addressed if comprehensive immigration reform was brought up, but that still remains to be seen.
Living in Georgia has opened my eyes to another glaring problem with health care reform: providing more people with Medicaid is not going to help people living in rural areas. In a lot of places in this state (and many others around the country), there simply are not enough doctors. And the doctors that are in the most remote places often will not accept Medicaid or Medicare because the reimbursement is slow and the rates are extremely low.
I heard this criticism while I was in Philadelphia and in southeastern Massachusetts, but I kind of ignored it. I just assumed the doctors were being greedy. After all, I've spent my entire life living in areas that, quite honestly, have more doctors than we know what to do with. On my Appalachian Experience trips in college, I learned about lack of access to medical care in rural West Virginia, Kentucky, and Virginia, but I didn't realize that the problem went beyond having a large number of uninsured people.
Now I hear people in this area who have good, private health insurance complaining about a lack of doctors, especially a lack of specialists. I also have many individuals call me who have Medicaid but who can't find a doctor to see them. In most rural sections of Georgia, the majority of people are poor and will probably qualify for Medicaid in 2014 (if they don't already have it), but doctors often cannot even "break even" if the majority of their patients have government-sponsored insurance. I have no idea how more doctors will ever be enticed to set up practices in these places, either. At least the funding for the National Health Service Corps has increased...
To be honest, health care reform really only affects about one-third of the patients at Good Samaritan. Other free clinics around the country are worried about having to shift to serving the "underinsured", as well as covering eye and dental services (which were not included in health care reform at all but are very severe needs for many). But at my clinic, I just pray that some of our patients will get better access to health care as the years unroll, and that the election in November doesn't set us back anymore.
Sunday, September 12, 2010
El Nuevo Sur
This past weekend, I went to a conference for the Georgia Free Clinics Network on St. Simons Island (which is about 70 miles south of Savannah). The resort was absolutely gorgeous, and I certainly did not mind missing a day of work to look at the ocean. However, it was kind of a strange experience because the event was only intended for clinic directors and the person in charge made it very clear to the Executive Director of Good Samaritan that I wasn't welcome. Oh well- I'm glad I got to learn more about Georgia laws and about how free clinics operate here.
To me, the most fascinating thing about the conference was the discourse that was used in our little retreat room. There were only 25-30 people present, so I expected everyone to want to really get to know each other and listen to each other as a way to learn new ways to advance every one's own clinic. After all, people came from all parts of the state, with many driving over 5 hours to attend the weekend.
What ended up happening was an overabundance of ego in a very small room. Maybe people have become so used to defending their clinic against critics that they don't know how to communicate with people who have similar missions. But everyone was constantly interrupting each other and trying to make themselves look best- it reminded me of something in a bad high school movie.
It was also strange to me because I assumed that everyone would also be nice and caring; after all, they have all given their lives to provide health care for individuals who are uninsured. So it especially shocked and angered me when someone asked "How many of ya'll accept illegals?" Calling individuals without social security numbers "illegals" is extremely disrespectful and completely minimizes the fact that they are people. They may have done something illegal, but gosh, who hasn't?
And I know I have my own biases, but I didn't really expect to be chatting with people who are die-hard Republicans wearing Army T-shirts.
So I guess I'm learning a lot about the south. I discovered a drive-thru liquor store last night. I constantly hear about states' rights and how the government shouldn't be involved when discussing health care. I now know that Newt Gingrich is from Georgia. I'm living in a state whose flag from 1956 to 2001 looked shockingly similar to the flag of the Confederacy. People are still adjusting to racial integration in rural areas and don't quite know what to do with Hispanics. To be honest, the only thing that seems to unite people is their love for UGA football.
Georgia is foreign to me. But at least it's interesting.
To me, the most fascinating thing about the conference was the discourse that was used in our little retreat room. There were only 25-30 people present, so I expected everyone to want to really get to know each other and listen to each other as a way to learn new ways to advance every one's own clinic. After all, people came from all parts of the state, with many driving over 5 hours to attend the weekend.
What ended up happening was an overabundance of ego in a very small room. Maybe people have become so used to defending their clinic against critics that they don't know how to communicate with people who have similar missions. But everyone was constantly interrupting each other and trying to make themselves look best- it reminded me of something in a bad high school movie.
It was also strange to me because I assumed that everyone would also be nice and caring; after all, they have all given their lives to provide health care for individuals who are uninsured. So it especially shocked and angered me when someone asked "How many of ya'll accept illegals?" Calling individuals without social security numbers "illegals" is extremely disrespectful and completely minimizes the fact that they are people. They may have done something illegal, but gosh, who hasn't?
And I know I have my own biases, but I didn't really expect to be chatting with people who are die-hard Republicans wearing Army T-shirts.
So I guess I'm learning a lot about the south. I discovered a drive-thru liquor store last night. I constantly hear about states' rights and how the government shouldn't be involved when discussing health care. I now know that Newt Gingrich is from Georgia. I'm living in a state whose flag from 1956 to 2001 looked shockingly similar to the flag of the Confederacy. People are still adjusting to racial integration in rural areas and don't quite know what to do with Hispanics. To be honest, the only thing that seems to unite people is their love for UGA football.
Georgia is foreign to me. But at least it's interesting.
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