Medical Musings

So I have done a few shifts at the part time clinic downtown, and obviously I have lived to tell about them. So let me tell you about them.

My first day, I was early. That was good. Someone was waiting to let me in. That was also good. They showed me my very small office, and told me to settle in and explore the clinic. My sense of direction is lacking, so letting me explore is not such a good idea, even in a small clinic. Juan was my hero. Side note – his name is pronounced H-uan. Not W-aan, like us Texans pronounce it. So Juan was my hero. He showed me where the bathroom was. Most important.
I got to relax for a few minutes, then the crowd came in. One by one, they came in asking for healing. Most spoke English the first day, and most were acutely ill. I treated each as best I could, with the medicine they could afford. The doctor and I saw 82 (!) patients on the first day.
I didn’t write a single name brand prescription all day. I have literally never done that before. And it can be done. I didn’t feel like I had short changed anyone by substituting a generic medicine.

My Spanish was shaky the first day. I asked for Juan and Marta frequently, especially to explain the medicine.

My second day, clinic started much the same. Except. Juan and Marta and the rest of the nursing staff were discussing, get ready for it, How Many Times They Have Been Shot At. I had, of course, nothing to add to that discussion. So, I sat quietly in my office instead.

I had much the same experience the second day as the first day, except fewer patients spoke English. I am better at Spanish now than I was on day one. The doctor and I saw 40-something patients that day. Again, I wrote no name brand medicines that day. It still blows my mind.
The second day I was talking to a 217 pound 12 year old. I was discussing, in English, his weight and blood sugar. I was trying to discuss the urgent need for weight loss. The mom asked me which was better, diet or exercise. I answered that both would be appropriate for this young man. I urged the mom and patient to not think of it as exercise, but more like play. I instructed him to get out and ride his bike after school, to get out and skateboard more. Um. He doesn’t own a bike, or a skateboard. And his neighborhood isn’t safe enough to walk in, let alone bike in.
I accidentally wrote a prescription that was generic, but not on the approved Medicaid list. I overheard a man, the father of my patient, discussing the cost of this prescription with the pharmacist. It was $12. The man said to the pharmacist that the medicine was too expensive. The pharmacist offered to have me rewrite the prescription, but the man said that they would find a way to afford it, if the baby needed it.

These were sobering to me. I have never been in want, really wanted, that is. I have been poor, in graduate school, especially. But I have always lived in a safe enough neighborhood (except for when we got robbed at the apartment, and that was kind of a fluke.) I was really thinking about how much we, J and I, have. We’re so blessed. We have a full pantry, full freezer, full house, full heart. I can walk safely through the neighborhood. I have a bike I haven’t ridden in years. I have more friends than I can count. I am so blessed in so many ways.

I still have more clinic hours to do. I learn more Spanish every day, but I am really growing spiritually and emotionally. I plan on working there until I can find a permanent position. I really do enjoy it. As long as I leave before dark.