Happy Thanksgiving

I received a call at home Sunday night. It was the sister-in-law of the young woman with the Glioblastoma. She called to let me know that her sister-in-law had surgery. They removed a golf ball sized tumor from her brain.

She is home now. Home for Thanksgiving.

The family wanted us to know that they would be celebrating Thanksgiving because of the clinic; because we had sent her to have the test that found the tumor.

Good health, when we are lucky enough to have it, should be at the top of our gratitude list this Thanksgiving.

UGH.

UGH.

That seems to be my tag line lately. Ugh. I am so tired on NOT being able to help people.

We seem to have more and more complicated issues each week. Remember the young woman I told you about – the one needing an MRI? Well, the MRI was negative, but her issues continue. She has headaches that are debilitating, yet she works full time. She keeps a complete headache diary – the headaches sometimes come 6 to 8 times per day. She suffers from memory loss, she is sometimes unstable walking. She is scared, and frankly, so am I after hearing her symptoms.

The doctor that saw her last night wrote for referrals to ophthalmology, hematology and neurology. I laughed – not because it was funny, but because I know that other than ophthalmology, there is very little chance I can get her seen by the specialists she needs.

The woman with the glioblastoma was transferred from the local hospital to a regional center where she was scheduled for surgery. I may or may not ever hear the outcome. At least I know she is getting care.

Today, I get a call from the health department. A young man seen here last night was there today trying to get help. We were not able to make the referral he needed. He works full time as well, for a large local company; one that hires full time help through a temp agency. That way, they don’t have to pay for benefits. Yes, I am bitter and angry. If we expect employers to provide insurance, why don’t we make sure that they provide insurance? And, if it is each person’s responsibility, why don’t we make it possible for them to GET insurance?

I had to tell one of my nurses last night to instruct patients to use the insulin syringes we were able to provide for a couple of injections. I thought she was going to be sick – physically sick – when I said that. As nurses, we teach people to never re-use their syringes. But, since I don’t have enough to ensure that all of my diabetic patients have enough syringes for all of their injections, it is better to give them what I can and have them re-use them than it is to not have any syringes to give some of the patients. I can do a half-assed job for more people that way.

Yup, I love our healthcare system.

Gratitude: Pass it On

Last week I received a card with this note in it:

Hello,

I just received some great medical news and I wanted to pass this blessing on. I hope this donation helps. Thank you.

Enclosed was a check for $500.

Yes, it will help. Thank you for making your good news our good news.

100

This is my 100^th blog post.

Wow. I am so awed by all of you that take the time to read what I write. I never anticipated being a writer of any sort, so this is such a stretch for me. I have to thank my amazing daughter for all of her assistance and support. She proof reads everything that I write so that I don’t embarrass myself. Any and all mistakes are mine.

This has been such an amazing journey for me; it has been so important for me to share the stories of the people that I serve. These are our friends, our neighbors, and the people that work in the establishments we frequent: grocery stores, restaurants, nursing homes, many of the businesses in our community. Their stories are important; they say a lot about our society and how we treat people. Their stories also tell a great deal about the real values in our country today.

We proclaim loudly that we are a Christian country, that we live by Christian values. But, that is not what I see. To me, living by Christian values would mean that we live out the words of Jesus from Matthew 25: The Judgement of the Nations

 “When the Son of Man comes in his glory, and all the angels with him, then he will sit on the throne of his glory. All the nations will be gathered before him, and he will separate people one from another as a shepherd separates the sheep from the goats, and he will put the sheep at his right hand and the goats at the left. Then the king will say to those at his right hand, ‘Come, you that are blessed by my Father, inherit the kingdom prepared for you from the foundation of the world; for I was hungry and you gave me food, I was thirsty and you gave me something to drink, I was a stranger and you welcomed me, I was naked and you gave me clothing, I was sick and you took care of me, I was in prison and you visited me.’ Then the righteous will answer him, ‘Lord, when was it that we saw you hungry and gave you food, or thirsty and gave you something to drink? And when was it that we saw you a stranger and welcomed you, or naked and gave you clothing? And when was it that we saw you sick or in prison and visited you?’ And the king will answer them, ‘Truly I tell you, just as you did it to one of the least of these who are members of my family, you did it to me.’”

When we refuse to take care of people because we don’t think that they are worthy, we are not living our lives as Christians; when we refuse to provide equal access to quality healthcare to everyone, we are not living our lives as Christians.

We are ALL better off when everyone has access to healthcare.

And, that is my sermon for the day. Thank you to all of you who care, all of you who donate your time, talent and treasures to this clinic or wherever your passion leads you. Thank you for letting me tell the stories.

Crazy Night

I know that there was NOT a full moon on Tuesday night, but… oh, my. It was a crazy night.

So, first of all, we were short staffed. That happens sometimes, and we can usually make it work. Well, actually, we always make it work – we have no other choice.

The symptoms people were presenting with were crazy – things way beyond the scope of a free clinic, or so one would hope.

The first patient I dealt with had come in with a compliant of headaches. We had ordered an MRI – which, I have to tell you, usually I say no. What are we going to do with the information once we have it? Is there anything we can do? We don’t have access to a neurologist, there is no neurosurgeon, so… what can we do with the information? But, this gentleman had the MRI – which showed “his brain was shrinking.” Honestly, I have no idea exactly what that means. I am sure there must be a real diagnosis in there somewhere, but that is what he heard and what he shared with me. Understandably, he is scared. He didn’t know what to ask the doctor, and I didn’t know what to tell him. We are working on getting him seen at one of the larger medical centers in the state. It is a slow process.

Then, there was the young woman with headaches, memory loss, and some other vague symptoms. We made the decision to have an MRI done on her; we are still waiting for those results.

The third person I met Tuesday night is 39 years old, which means she is just a little too young to qualify for the Breast and Cervical Cancer Screening Program. But, she found a lump under her arm, near her breast. She is terrified, in tears, and I have very little to offer her. But, I tell her we will get the ultrasound, if there is anything suspicious, we can get her into a surgeon, and we will go from there. I know a little bit about her fear; I found a lump near my breast when I was about her age. I was lucky – it was nothing. I share that with her, but am not sure if it helps or not. When it’s your life, other people’s stories don’t really help.

And, then there was the patient I didn’t see. But, I saw her test results today, and my heart sank. She too presented with headaches, memory loss, some balance issues. Her diagnosis: Glioblastoma multiforme (GBM), which is the most common and deadliest of malignant primary brain tumors in adults.

Holy crap. I envisioned a clinic where we would take care of people with minor issues – colds, asthma, diabetes, high blood pressure. Not where we are having to tell people that the diagnosis is going to change their life forever… and we have almost nothing to offer them. Healthcare reform is not coming soon enough for some of these individuals.

What do I tell them?

On a lighter note, I did get a marriage proposal on Tuesday night. Well, sort of. He wants to run off with me – or would if I weren’t married. I told him THAT would be the biggest mistake of his life.

At least there is something to make us smile!

A better way? I sure hope so......

I tend to be a “cup is half-full” kind of a person. I am usually optimistic and I like to believe the best about people and things.

So, it has been difficult for me to receive criticism for my championing of the Affordable Care Act. I have never intended to hurt anyone’s feeling or step on any toes. But, I am very passionate about the work that I do, and the population that we care for. I am anxious for people to have access to healthcare – real, meaningful access.

The work of the clinic, while it makes those of us doing it feel good, it is not what is best for the population we serve, or even what’s best for our community. Month after month I see hundreds of uninsured, low-income individuals walk through the door of the clinic. They are sick, they are vulnerable, and they are tired. And, we do the best we can to put the pieces together for them. They see a healthcare provider, they get their medications, someone listens to their story (hopefully) and they go on their way. God forbid that they end up sicker – because then their only choice, at least until the next Tuesday night, is to go to the emergency room or go without care.

I love these people. I love that they trust us enough to come here. I love that I get to do work that has meaning. And, believe me, I am not a saint, I am not even always a nice person. I am just incredibly fortunate to be here, now, and to get to do this work.

So, I apologize for feelings that I have hurt. I am sorry that the clinic has lost your support. But, I do not apologize for how I feel, for the passion that I have for this work and my belief that there is a better way.