Troubling: we know that health problems like high blood pressure and heart disease are on the rise alongside Diabetes. But this was news to me; combining those things WITH pregnancy and childbirth create an even higher incidence of stroke. Imagine being this young mom, having a newborn and then having a stroke. These are great reasons for young women to try to be as healthy as possible when thinking about motherhood!
So my awesome PA program volunteers at the Care Fair organized by the Junior League of Salt Lake City, a great women’s organization focused on:
The Junior League of Salt Lake City is made up of 555 women who are committed to building better communities. Our members are career women, working mothers, stay-at-home moms, and full-time and part-time volunteers. Although we may represent a variety of races, religions and ethnic origins, we are brought together by a common vision to identify the needs and create positive change for all women, children and families through collaborative programs and effective advocacy by providing time, money, volunteers and leadership for our community. We are a legacy of women making a difference.
The PA students alongside medical and nursing students did all kinds of stuff, from taking vitals to physical exams. And no, we didn’t just take care of women! Everyone was welcome. I was at the growth chart table, checking to see what percentile in height and weight all the kids fell into. I also got to shadow the second year PA students and third year medical students as they did exams and tried to figure out what was going on with patients! (shout out to our PA program- the PA student diagnosed a patient with a particular joint-pain problem that the medical students were clueless about…. the PA student had been in school 1 year,.. the med students were into their third year,… just sayin!) I spent some time finding out what the Early Head Start program is all about and what kinds of services they provide. If you don’t know about them, what a cool organization. They basically provide all kinds of support to low-income pregnant women and families in order to improve the outcomes of pregnancy, child development, and the health of families (parenting skills, father involvement, substance abuse help, job skills, etc.)
People who come to the Care Fair generally do not have health insurance, or the means to go to a clinic. For many, it’s the only time their kids will see a doctor that year to have an exam, get immunizations, dental, and eye screenings. I love that it is the result of dozens of volunteers providing an avenue for people to get care that they otherwise wouldn’t get. You can argue all you want about health insurance, and the burden of non-insured on the taxpayer, and all those crazy complex issues that we are struggling with right now, I get it, it’s complex, but you can’t argue with people who choose to give their time to serve. And, it’s clear that the hundreds of people that come appreciate the opportunity. No child chooses to be born into poverty, so it was my privilege to be involved in providing care! I was able to do something like this in Oregon too, I’m curious, who else has participated in free health and resource fairs, or conventions? What kinds of services were provided?
When you go to a doctor’s office and sit down with a physician/PA/NP, do you feel listened to? Have you ever walked out thinking to yourself, “Wow, they really took the time to listen and understand my perspective.” I’m learning more and more that the art of being a good medical provider is more about communication and listening skills, than it is memorizing drugs and diseases (that’s what we have iPhone apps for.) There are no apps for compassion, listening, empathy, and giving someone all your attention and enough time to be heard.
It is important to get diagnoses right: to recognize psoriasis and lupus, cancer and schizophrenia, AIDS and alcoholism. However, it is no less important to get the name of the illness right. It is no less important to recognize that for the sufferer, the name of the disease, spiritually speaking, is humiliation or fear or malaise or endless pain or loneliness or despair or the end of a career or the end of a life. It is no less important to recognize that this is a human being to whom a terrible thing is happening, and whatever other name this terrible thing bears, its name is tragedy.
One of the things we have talked about extensively in our courses is that being able to “take a good medical history” is everything. However, somehow you have to find a balance between allowing the patient to tell us THEIR story with the nuances, effects, burdens, joy, sadness, discouragement and perseverance that is their own experience, and the list of a gazillion questions we have to make sure we cover somehow. The dance between “tell me about why you’re here today” and “have you ever had cough? vomiting? heartburn? difficulty peeing? constipation? tremor? incontinence? colonoscopy? tetanus shot? tuberculosis? epilepsy? do you shoot up heroin??”
The truth we must bear as ministers of medicine, is that we must first see the suffering if we are to help relieve it, and that we cannot see it without in some sense experiencing it. To be transformed, to love with open eyes, is to join in the suffering of the world, as Jesus did.
By joining the sufferer’s story through listening and affirming, I can honor the fullness of their personhood, that they are the hero of their own story, that I am joining them on their journey but that they are the ones courageous enough to carry the suffering that they do. I must affirm that their experience and who they are is more than just an interesting diagnosis and a list of pertinent positives and negatives, that their story is much more complicated than merely the symptoms of disease, just as my own story is more than my own health problems. Who we are is a composite of all aspects of our lives, everything is intertwined, which is why working as a healthcare provider is a spiritual endeavor. To be truly compassionate we cannot stand at a distance. We have to find out what exactly that disease means to the sufferer- is it merely the annoyance of flaky skin? Or is it the identity as an outcast, a “leper,” unaccepted and uncomfortable out in our community? What does the disease mean for their personhood? Or have they been made to feel less of a person by impersonal healthcare workers and gawking society members?
I will never forget that scene in Erin Brockovich in which the cancer sufferer from the community Erin was advocating for asked if after having a double mastectomy and total hysterectomy, if she was still even a woman?
This is where I believe I have to be willing to go with a patient, in order to convey the depth of love, compassion, and care that I believe I am compelled to convey as a follower of Jesus. Yeah, it’s heartbreaking, but when suffering ceases to break out hearts, we have disconnected ourselves from the realities of this world in a way that reduces our ability to provide excellent care.
‘To be a patient is to be one who is patient, one who endures.’ ‘The Stoic ideal of patience is designed to result in resignation. In contrast, Christian endurance produces hope. The difference is crucial. The Christian virtue of patience is the power that looks suffering square in the face, sees it for what it is, and then decides what is to be done about it. It is in this process of clear vision, open acknowledgment, and careful decision that endurance produces character, the sort of character that is full of the hope that neither suffering nor anything else in all creation will ever be able to separate us from the love of God.’
I want to be the sort of provider that points patients toward hope. Not a fruitless, misleading hope that “everything is going to be ok” but hope in that they are worthwhile, their lives have meaning, they are loved by the God of the universe, and that at least someone, if only myself, is IN it with them, is willing to truly listen to their heart. I don’t want to be so busy getting through my questions and listening to their heart sounds that I miss their broken heart.
note: all quotes from Margaret Mohrmann MD “Medicine as Ministry”