Lo difícil

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.