Sometimes I don't think about the fact that all of my patients are poor. I don't know if I've just become desensitized to having people tell me their total income is $800/month, or if it's because people tend to get somewhat dressed up to go to the doctor. Regardless, last night while I was interpreting for one of our doctors, the living situation of many of our Hispanic patients really hit me. This is only one example, and although each individual is different, I think it gives a good picture of the home and work conditions that make it hard to provide helpful medical treatment.
A Nicaraguan woman who I've been trying to get in touch with for the past few weeks finally showed up. Her and her husband just moved and changed their cell phone numbers. (Side note: This is pretty standard, but I usually end up calling every number the patient had ever listed and ask people if they know where said patient is. However, in this case, even when I got in touch with the couple's friends, no one seemed to know their new contact information.) The woman, who I'll call "A", presented with severe lower back pain. She proceeded to explain to me that she had come in August and was given 2 meds, but that her and her husband couldn't afford them. When the couple finally got work and could afford the meds, "A" was working such strange shifts that she was afraid of messing up the pill schedule. She goes to work at 5am, but she can't eat that early. One of the meds was supposed to be taken an hour before eating, but her break was at 9 and that was when she would eat breakfast (and she said she couldn't take the pill an hour earlier amidst working). Long story short: she never took the medicine she was prescribed. The doctor kind of rolled his eyes; after all, this is noncompliance. "A" then continued explaining that she used to sleep on some sort of "cushion" on the floor. However, now she sleeps on a blow-up mattress. The other night, she tried to get up to go to the bathroom, but her lower back hurt so badly that she ended up literally crawling out of bed. The next night, her husband pumped more air into the mattress so that it was a little firmer, and she said she felt a little bit better when she woke up in the morning. Additionally, though, her feet swell when she's working and become quite painful by the time she leaves to go home. The doctor said that she should try to alternate sitting and standing at work, and "A" looked bewildered. She works at a label-making factory, so she works 12-hour shifts on her feet with two short breaks. The doctor suggested that she wear compression stalkings (yeah, try explaining what those are in Spanish...) and that she put her feet up after work. He wrote her two new prescriptions of anti-inflammatory meds (from the $4 list) that she could take with food twice a day, and told her to make sure the mattress she sleeps on is as firm as possible.
The doctor was very nice. "A" and her husband are extremely sweet, so I guess it'd be hard not to be nice. But when I left the room, I couldn't help but wonder if the doctor had ever slept on the floor. As I lay down in my very comfortable bed last night, I tried to bring myself back to service trips where I've slept on the floor of a soup kitchen or YMCA gym for just a week at a time. I remembered the lower back pain as if it were yesterday, and then I tried to imagine doing that for years on end. That, coupled with 12 hour shifts working at a factory, coupled with struggling financially, made me feel depressed even thinking about it.
Wednesday, October 27, 2010
Saturday, October 23, 2010
La vida sencilla
Today it was 80 degrees in Savannah and there was not a cloud to be found in the sky. I went to the beach with my roomies, like I've done literally every weekend since I got here in August. Regina was holding a book and a towel, and as we got comfortable on the sand, she said, "This is what I call simple living."
Before I started MVC, I was under the impression that full-time volunteers lived in poverty. However, I've come to realize that, if you include the amount that is being paid for my housing, transportation, food, health insurance, telephone, cable, and internet, I'm making significantly more money than almost all of my patients. So although I only have $100/month as "spending money", I don't feel any type of need. To be honest, I don't think I've ever spent more than $100 in a month on non-necessities. Well, other than for traveling, but I can't really do that this year. (Unless you count the two conferences I've had in St. Simons and Atlanta, or my weekend visit to Hilton Head.)
Living simply has taken on a new meaning for me, though. I am perfectly satisfied just being. I don't feel the need to fill my schedule to the brim. I work hard during the week, but the weirdest thing has happened...I've found that my work has become a higher quality now that I'm not constantly exhausted.
I think the beautiful weather and scenery in Savannah is good for my soul. I'm so happy I'm here, even when I'm fighting constant frustrations with the immigration and health care systems. I know I'm in the right place, yet I'm also really content to know that it's only for a year.
So how is my life simple now compared to what it was in college? Now my weekend materials include a water bottle, running shoes, a towel, rice cakes, a good book, and my journal. No more note cards, laptops, heavy books, binders, etc. Everything I do that isn't in my work week feels like a treat. I'm not constantly surrounded by hundreds of people and countless activity possibilities, but walking around City Market or Tybee Island with a few close friends (such as my visitors) is the best thing I could ever imagine.
I honestly don't miss trying to fit as many meetings, meal dates, classes, labs, volunteer endeavors, etc. as possible into each day. I've realized that the quality of what I did was not what it could have been. And the overall quality of my life certainly was not its best.
I recommend that everyone attempt this simple living thing for at least one period of time. It's awesome.
Before I started MVC, I was under the impression that full-time volunteers lived in poverty. However, I've come to realize that, if you include the amount that is being paid for my housing, transportation, food, health insurance, telephone, cable, and internet, I'm making significantly more money than almost all of my patients. So although I only have $100/month as "spending money", I don't feel any type of need. To be honest, I don't think I've ever spent more than $100 in a month on non-necessities. Well, other than for traveling, but I can't really do that this year. (Unless you count the two conferences I've had in St. Simons and Atlanta, or my weekend visit to Hilton Head.)
Living simply has taken on a new meaning for me, though. I am perfectly satisfied just being. I don't feel the need to fill my schedule to the brim. I work hard during the week, but the weirdest thing has happened...I've found that my work has become a higher quality now that I'm not constantly exhausted.
I think the beautiful weather and scenery in Savannah is good for my soul. I'm so happy I'm here, even when I'm fighting constant frustrations with the immigration and health care systems. I know I'm in the right place, yet I'm also really content to know that it's only for a year.
So how is my life simple now compared to what it was in college? Now my weekend materials include a water bottle, running shoes, a towel, rice cakes, a good book, and my journal. No more note cards, laptops, heavy books, binders, etc. Everything I do that isn't in my work week feels like a treat. I'm not constantly surrounded by hundreds of people and countless activity possibilities, but walking around City Market or Tybee Island with a few close friends (such as my visitors) is the best thing I could ever imagine.
I honestly don't miss trying to fit as many meetings, meal dates, classes, labs, volunteer endeavors, etc. as possible into each day. I've realized that the quality of what I did was not what it could have been. And the overall quality of my life certainly was not its best.
I recommend that everyone attempt this simple living thing for at least one period of time. It's awesome.
Saturday, October 9, 2010
Lo normal no existe
I have no idea where October came from. My days pass too quickly, and before I know it the weekend is upon me. Suddenly, it went from intolerably hot weather to very beautiful "autumn" weather (and by autumn I mean that people from Georgia wear their boots and scarves while Yankees like me are still wearing shorts and flip-flops).
This past week was insane, but I'm starting to realize that every week kind of is at the clinic. That's one reason health care has always interested me I guess; there's no such thing as "normal."
A few updates:
-In regards to the woman with the ectopic pregnancy:
"R" called my supervisor on Monday morning and said that she hadn't had any type of surgery and that she still was in excruciating pain. My supervisor called a gynecologist who works within our hospital system and asked that she be seen immediately. It was 10am while all this was happening, and by 10:30 my supervisor and I were knocking on the door of R's double-wide trailer on the boarder of Garden City and Savannah. We then drove her to the gynecologist and interpreted for her. It turns out that she was, at one point in the last month, pregnant (according to 2 blood tests and 2 urine tests). However, despite claiming that she didn't bleed much since then, blood tests now confirm that she is not pregnant. (I asked the obvious question, "Where did it go?" but was ignored, so I still don't know.) They proceeded to do an ultrasound on R and discovered a 10cm cyst on her left ovary (that's the size of a newborn baby's head) and a hemorrhaging 4cm cyst on her right ovary. By the way, when she went to the gynecologist the week before without a translator, the nurse claimed she "couldn't see her right ovary". Maybe I'm a cynic, but I feel like they tried a lot harder with my supervisor and I sitting there watching the ultrasound as it was taking place. Anyway, the gynecologist said he would do an operation to remove the cysts. At first his nurse said that R should fast for the rest of the day in case they were able to get her into surgery that afternoon. R is diabetic and hypertensive, but she obliged. We brought her back to Good Sam and had her rest on one of our tables while we waited to hear back from the doctor. By 3pm, she was super dizzy, so I called the doctor's office and found out that she wouldn't be scheduled for that day or the following day. R and I then went to get some lunch at the sub shop next door. We had an awesome conversation about how the world would be a better place if everyone just helped each other out to the extent that they were able to. She told me about how she speaks a little English and has a car, so she drives other Hispanic immigrants to their appointments and helps them find the social services they need. It made me smile :)
R's husband came and picked her up around 3:30pm. The next day, I found out that the clinic that she officially is a patient at needs to send medical approval for her to receive the surgery. When I called her doctor, the woman's response was, "Why are you even involved?" I guess it's a fair question; R has never been seen by any practitioner at Good Sam. But the clinic she goes to in Savannah is huge and told her there wasn't much they could do for her. My supervisor and I had the Spanish skills, time, and hospital connections to help R out, so we did. She should be having the surgery sometime this coming week.
-In regards to my patient with breast cancer:
"N" thankfully had breast surgery yesterday. We were worried for a while because she had an abnormal EKG and her potassium levels were dangerously low. I spent a lot of time on Wednesday trying to schedule her a nuclear stress test and working with the nurse at the cancer center to up her dose of potassium. I'm really worried about N, and am looking forward to calling her on Monday to check in.
Funny anecdote of the week:
One of my patients called and asked how old I am. I told him to guess, and his response was "I don't know, but you have a sexy young voice." He's 38. Ew.
Crazy stories of the week:
1. On Wednesday I got a call from a guy who needed Lortab and Xanax. He's from somewhere in the middle of nowhere Georgia and said that his regular doctor is out of town for a few days. I explained that he needed to get his prescribing doctor to authorize the refills. He proceeded to explain that his ex-fiance picked up his pills from Walmart the week before and instead of giving them to him, she sold them. Evidently he had asked that no one except him be allowed to pick up his meds from the store, but she obviously knew his date of birth, address, phone number, etc. and the pharmacy tech at Walmart thought it would be fine. So now he's living with relatives in Savannah while he's waiting for the police in his town to deal with his fiance. Cool.
2. Yesterday a woman called to make an appointment for her boyfriend's "relative." She explained that he was in an accident in Louisiana but had no other relatives in the U.S. so her boyfriend took him in. He had 2 surgeries on his back in Louisiana about a week ago and is now in Savannah. It took me like 10 minutes to understand what she was saying (I'm not used to hearing the word "Louisiana", especially not in Spanish), but he's coming in Wednesday to get his stitches/staples out. It sometimes amazes me the things that people will do to help each other. I can't wait to hear how he got from Louisiana to Savannah.
Personal update of the week:
I applied to grad school! I applied to Emory and Tulane for a Master's in Public Health with concentrations in international community health development. Both programs also have a Peace Corps component. Hopefully I'll hear back soon!
This past week was insane, but I'm starting to realize that every week kind of is at the clinic. That's one reason health care has always interested me I guess; there's no such thing as "normal."
A few updates:
-In regards to the woman with the ectopic pregnancy:
"R" called my supervisor on Monday morning and said that she hadn't had any type of surgery and that she still was in excruciating pain. My supervisor called a gynecologist who works within our hospital system and asked that she be seen immediately. It was 10am while all this was happening, and by 10:30 my supervisor and I were knocking on the door of R's double-wide trailer on the boarder of Garden City and Savannah. We then drove her to the gynecologist and interpreted for her. It turns out that she was, at one point in the last month, pregnant (according to 2 blood tests and 2 urine tests). However, despite claiming that she didn't bleed much since then, blood tests now confirm that she is not pregnant. (I asked the obvious question, "Where did it go?" but was ignored, so I still don't know.) They proceeded to do an ultrasound on R and discovered a 10cm cyst on her left ovary (that's the size of a newborn baby's head) and a hemorrhaging 4cm cyst on her right ovary. By the way, when she went to the gynecologist the week before without a translator, the nurse claimed she "couldn't see her right ovary". Maybe I'm a cynic, but I feel like they tried a lot harder with my supervisor and I sitting there watching the ultrasound as it was taking place. Anyway, the gynecologist said he would do an operation to remove the cysts. At first his nurse said that R should fast for the rest of the day in case they were able to get her into surgery that afternoon. R is diabetic and hypertensive, but she obliged. We brought her back to Good Sam and had her rest on one of our tables while we waited to hear back from the doctor. By 3pm, she was super dizzy, so I called the doctor's office and found out that she wouldn't be scheduled for that day or the following day. R and I then went to get some lunch at the sub shop next door. We had an awesome conversation about how the world would be a better place if everyone just helped each other out to the extent that they were able to. She told me about how she speaks a little English and has a car, so she drives other Hispanic immigrants to their appointments and helps them find the social services they need. It made me smile :)
R's husband came and picked her up around 3:30pm. The next day, I found out that the clinic that she officially is a patient at needs to send medical approval for her to receive the surgery. When I called her doctor, the woman's response was, "Why are you even involved?" I guess it's a fair question; R has never been seen by any practitioner at Good Sam. But the clinic she goes to in Savannah is huge and told her there wasn't much they could do for her. My supervisor and I had the Spanish skills, time, and hospital connections to help R out, so we did. She should be having the surgery sometime this coming week.
-In regards to my patient with breast cancer:
"N" thankfully had breast surgery yesterday. We were worried for a while because she had an abnormal EKG and her potassium levels were dangerously low. I spent a lot of time on Wednesday trying to schedule her a nuclear stress test and working with the nurse at the cancer center to up her dose of potassium. I'm really worried about N, and am looking forward to calling her on Monday to check in.
Funny anecdote of the week:
One of my patients called and asked how old I am. I told him to guess, and his response was "I don't know, but you have a sexy young voice." He's 38. Ew.
Crazy stories of the week:
1. On Wednesday I got a call from a guy who needed Lortab and Xanax. He's from somewhere in the middle of nowhere Georgia and said that his regular doctor is out of town for a few days. I explained that he needed to get his prescribing doctor to authorize the refills. He proceeded to explain that his ex-fiance picked up his pills from Walmart the week before and instead of giving them to him, she sold them. Evidently he had asked that no one except him be allowed to pick up his meds from the store, but she obviously knew his date of birth, address, phone number, etc. and the pharmacy tech at Walmart thought it would be fine. So now he's living with relatives in Savannah while he's waiting for the police in his town to deal with his fiance. Cool.
2. Yesterday a woman called to make an appointment for her boyfriend's "relative." She explained that he was in an accident in Louisiana but had no other relatives in the U.S. so her boyfriend took him in. He had 2 surgeries on his back in Louisiana about a week ago and is now in Savannah. It took me like 10 minutes to understand what she was saying (I'm not used to hearing the word "Louisiana", especially not in Spanish), but he's coming in Wednesday to get his stitches/staples out. It sometimes amazes me the things that people will do to help each other. I can't wait to hear how he got from Louisiana to Savannah.
Personal update of the week:
I applied to grad school! I applied to Emory and Tulane for a Master's in Public Health with concentrations in international community health development. Both programs also have a Peace Corps component. Hopefully I'll hear back soon!
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