1.03.2016

Angels on the Roof

Heart Full of Wonder by Megan Leong


"I know you are busy..... but can I tell you a story?"

I was behind. As usual. It was time to go home, and I had (out-of-town) family waiting to start our New Years' Eve festivities.  I still had to call a newlywed and break the news that her culture confirmed genital herpes; change a toddler's antibiotic to one his insurance would cover; call Marcus and tell him the MRI showed 2 fractures in his left hand, one in his right knee and a torn right lateral collateral ligament from his motorcycle accident; and re-fill several medications before the long holiday weekend.

I didn't have time for anything more, but she seemed especially anxious to share something. So, hiding my impatience, I sat down, closed my computer and agreed to hear her story.

She always has one.

Vivian's chronological age is 64, but she is 88 by appearances and 97 if we calculate life-years based on accumulated hardship.  Over the last 2 1/2 years of overseeing her healthcare, she has frequently weighed heavily on my mind. Single, and abandoned by her children, she shares her small home with a grandson, who eats what little food she can afford, forcing her to often starve, but feels no compulsion to clean up his messes or help Vivian in any way. In factual tones, never dripping with sorrow or pity, Vivian often tells me about her challenges, especially ones involving her home's decrepit state of disrepair. Weighing less than 100 pounds and packing around a portable oxygen tank, she is tough and hard-working and does what she can to keep up on things such as trimming bushes, cutting down an overgrown tree with a handsaw, scraping chipped paint, and patching holes in the wall.

Which brings me to her story. I will relay it in first person, just the way I heard it.

My roof has leaked for a long time. In my living room, there is green mold where water drips down the wall. I couldn't afford a new roof, but I have been saving for many months to get some supplies to repair the leak. Two weeks ago, I had enough to purchase a bucket of tar. The cheapest one was $54.53 and I had finally saved $59 dollars. 

I was just about to buy the tar, when another customer standing next to me said, "I wouldn't buy that....it's not going to do a good enough job." He pointed to another bucket. "That's the one you should get." 

I asked the salesman the cost of the other bucket. It was $90. 

"I can't afford that one," I told the stranger.

"Who is going to be putting this tar on your roof?" he asked me. I said I planned on climbing up and doing it myself. 

"I'll tell you what...." he said. "I'd like to buy that other bucket of tar for you. And in fact, I'll come on over and put it on myself." 

He bought the $90 bucket, and carried it out to my car. I gave him my address and drove away feeling appreciative. But I didn't think I would ever see him again.

Three days later, on Saturday at noon, he showed up at my door. He went up on my roof, then came down and said, "it's kind of cloudy right now. I'll be back in a few hours to take care of your leak."

Two hours later, a beautiful pick-up pulling a large white trailer parked outside my house. Out of the trailer came six big guys who immediately climbed up on my roof and started going to work. I soon realized, they weren't there to just put down a bucket of tar. Six hours later, I had an entire new roof.  

The next Saturday, the man showed up again, this time with three guys. They said they were back to put on another layer and seal the roof.  They gave me what I could never, ever afford to do in my lifetime.

While they were working, I made them some of my homemade tortillas and really good beans. It was the best I could do to show my thanks. 

And you know what? I still don't even know his name. 

But I know he's an angel.

As she finished her story, we both wiped tears from our eyes. How grateful I was in that moment that I didn't hurry her out of the exam room. I felt gratitude that Vivian wanted to share this story with me. I was thankful for a profession that allowed intimate exchanges like this. I was thankful Vivian wouldn't have to worry about her roof anymore, and that---maybe--- her health and lungs would improve. I was thankful for miracles and kindness and character. And I was thankful to cap off the year 2015 believing in angels.




3.31.2015

Rhonda and the Aluminum Cans

It was the same story I hear at least once every single day.

Rhonda stopped taking her blood pressure and diabetes medicine 6 months ago because she couldn't afford them.

She shared her story... which sounded similar to so many others.

Rhonda is...
married
without education
without skills or training
can't get a job
in poor health
but not poor enough to be on disability

And then her story began to differ from the others.

Rhonda's husband is on disability and collects monthly disability payments. He makes it very clear to Rhonda that because HE is the one suffering from disability, HE is the one that gets all the money. She is not privvy to one cent of it, since she is 'healthy' and all....

The day I saw Rhonda in clinic, she told me her situation in a factual tone, without begging for pity. Then she got to her reason for the visit: she wanted a prescription refill.

"I have been saving aluminum cans for several months. I just turned them in at the recycle place and got $7.00 to pay for my blood pressure medicine this month."

"What will you do next month?" I asked.

"Oh honey, I don't have the luxury of thinking about next month, or even tomorrow. I just take my days one aluminum can at a time."












3.24.2015

The Fireman



There were three rock-solid hints right away that this was going to be a tough one.

First of all, there was a vague chief complaint. Whenever a patient tells the medical assistant they came for an appointment to "discuss an issue," it's a guarantee the patient isn't there for a sore throat or to check their blood sugar. This generalization usually means one of three things: either the patient wants to be tested for a STI (sexually transmitted infection), wants a narcotic, or is on probation and split their head open while intoxicated.

But it's mostly just the first two.

The second clue was that the patient, in this case a male, refused to allow the female student nurses to sit in on the visit. "That narrows things down a bit," I thought, pointing to a likely problem somewhere in the vicinity between the thighs and umbilicus.

But I was wrong.

The third and final clue was when the patient, someone I had never seen before, greeted me with "are you sure you want to see this?"

Now for me, especially since I chose a medical profession with all its grisly details, this kind of disclaimer is like dangling a penguin in front of a leopard seal. It's an open invitation to escape the mundane of hypertension and hyperlipidemia and feast on something atypical or cool or bizarre or shocking or grotesque or better yet----maybe even fixable.

So when the patient looked at me with apprehension and asked "are you sure you want to see this" I answered assuredly, hoping not to let the undertones of excitement jump the gun like an anxious girlfriend blurting out "yes I'll marry you" before he even pops the question.

"Yes, I am sure," I replied trying to sound safe and confident, and even though I was intrigued and excited, I was also nervous.

There is always that. Always.

Walking into an exam room, I am accompanied by my sidekicks: Inexperience & Anxiety. An undercurrent of worry weaves in and out of my day, popping up here and there like a silver thread woven among a tapestry of wool. Will I know the right diagnosis or the proper treatment? Will I recognize whether the problem is a danger or a diversion? Will I be able to make the best decision for the patient?

I remembered the last time a patient said those words to me --- "are you sure you want to see this?" A 30 year old man, who was lying (clue: not sitting) down on the exam table, proceeded to pull down his pants, and directed my attention toward "something" in his butt that had been causing him excruciating pain for 2 WEEKS.  This is an important point to remember --- two weeks, fourteen days, three hundred and thirty six hours!

I took one look at his backside, and instantly judged this guy as either a Herculean hero or a doltish Cronus. Perhaps he was a little bit of both. I assessed the situation stared and totally played it cool, swallowed hard, and calmly stated, "you need to go immediately to the hospital... you have about 8 inches of colon hanging out of your rectum..."

But I digress. (Like his colon.....)

So back to my story.....there I was in the exam room, ready to see what the patient wanted to hide from the student nurses. It was just me and him and his secret which filled the room like a hot air balloon. I was keenly aware of his vulnerability, and though I have realized this before, I was suddenly filled with marvel at the trust and privilege that patient's extend to health care providers. It is a curious phenomenon, that mere strangers, who within minutes of meeting one another, are exchanging one-sided, intimate details about a person's life and body. This is a precious right and responsibility that I hold sacred and hope never to take for granted.

Slowly, the patient rolled up his sleeves, revealing several scattered nodules the size of shelled walnuts up and down the front and back of his arms. Some were abscessed, others just nondescriptly sitting there, like a gopher in a hole---only the pest which had burrowed down in his skin was not a varmint, but misplaced heroin instead.

His story carved a deep inroad into my soul.

He had been a fireman for 29 years busting his butt and breaking his back, literally, for society. His aches and pains led him to prescription narcotics, which led him to street drugs, which led him to a stomach eroded and raw from the years and years of pain meds. Now at the age of 71, in a desperate attempt to control his pain, he started shooting the heroin to bypass his gut and give it a rest.

It wasn't for the high. It wasn't for the kicks.

He was a newbie to this brave rough world not usually inhabited by those with a pension and grandchildren, and he was scared and ashamed at what the drugs were doing to his toned and rescuing arms.

He had tried every conceivable way to quit drugs and manage his pain in productive ways. He looked straight into my eyes and pleaded, like a sinner asking God, "what else can I do?"

Oh Mr Firefighter..... I pray this is one rescue you will be able to make.



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