Lesson from a Doctor

Lessons from a doctor

On Thursday, a client had two doctor appointments.  I brought along my knitting so I could knit as we waited. Unfortunately, for my knitting, the first appointment was with an eye doctor who kept turning off the lights as I was trying to pick up stitches around the neckline. The doctor told my client his eyes were as good as they could be after the surgery to repair the damage from diabetes, My eyes widened when I heard that, the client had told me his eyes were damaged during the Vietnam War from Agent Orange, so he was “owed” treatment. After we got into the car my client asked me what the doctor had said about his eyes improving. I repeated what the doctor had told him,  his eyes would never improve; they’d been too damaged by his diabetes. He wistfully replied that he had hoped to ride his Harley again, but now he couldn’t. He’s been a difficult client to work with, but he looked so crestfallen I felt sorry for him. I suggested that he could still ride behind someone, would that be all right for him? He said it would be okay, but I knew it wouldn’t be. He didn’t want pity so I let him be with his thoughts.

We got to the second appointment twenty minutes early, I pulled out my knitting, but before I could set up, the nurse was ready for us. Who ever heard of doctors being early?

I’ve been frustrated with the health care system and the way some people abuse it. I suppose in part because I haven't had health insurance most of my adult life so I can't afford to see a doctor often. I have elderly clients that go into see doctors whenever they want. This client decided he didn't like the wait at Interfaith Community Clinic so he made an appointment at the Senior Health Services to get a new primary physician. He went on a day I wasn't there. But I picked up the phone for a reminder call for his follow up visit. So I told them I would talk to John to see if he really wanted to change physicians. He didn't so I canceled the followup appointment. When I first started working for him, I found a stockpile of pills that Medicaid had paid for. I took more than 25 bottles of outdated pills and dumped them at the drugstore bin. Despite his protests, I scooped out a cupboard full of lancets that he never used to check his diabetes and took them to the community health clinic for other patients to use. But the doctor at this appointment, a diabetes specialist, upended my thoughts.

After looking at the results of his tests showing that his blood sugar had way up, he talked to the client for twenty minutes trying to figure out how the client could remind himself to take his medication, even asking me put red balloons above his bed. Suddenly, the doctor said, “ I’m resigning from your case. I like you, but I need to be treating people who I can help. Unless you go into an assisted living situation, I can’t help you.” He told the client that he could come back if he went to an assisted living facility. The doctor said he would notify the primary physician of his decision as he walked out the door. I was astonished. Most doctors just let him keep coming. As we walked to the car, the client scolded me for telling the doctor that he wasn’t taking his medication. I told him it wasn’t fair not to give the doctor the correct information. If he let the doctor think he was taking his medication, the doctor might prescribe the wrong dosage. The word fair hung in the air. What is fair about life?

When we got back to his trailer, he asked me to show him what medication he was to take.  So I explained the Mediset to him, again. I asked him if I could put up a sign to remind him, but he told me he didn’t need it. I wondered what he’d remember over the weekend. He hadn’t eaten breakfast, but he didn’t want me to fix him anything. I checked the refrigerator, he had a Meals on Wheels meal, I didn’t know how old, and a dried up pizza. He had hamburger patties in his freezer that I knew he would cook so I left.

The doctor’s straightforward statement has stayed with me. I was as dazed as my client walking out of his office. The directness was powerful. Of course life isn’t that clean, the primary physician still has to deal with him not taking his medication. I keep reporting the irregularities and neglect that I witness with the client. One day after washing his clothes, as I pulled out his clothes, I found at least 15 wet, one hundred dollar bills in the washtub. After scooping up the money and placing it on the shelf above the washer to dry, I was shaking to have that much money in my face. I called my supervisor, she called his case manager, he is not to have that much cash and be on the program that pays for my services. I've filed his bank statements showing that he has enough money in Canada to disqualify him from Medicaid, but after I call my supervisor, and she calls his case manager, nothing happens. I don’t know what else to do. He needs help, I need work, so I show up.