One of my teachers once said, “Life is hard…especially when you don’t have resources. Not even money, but these patients don’t have cars, they don’t have mental health, they don’t have men in their lives to be a father figure or partner to take care of their children, they are socially isolated.”
And it shows in the coping mechanisms. I mean, everyone responds differently to hardship, but when you’re placed under the kinds of pressures that these people are, life is not about “living,” but rather becomes a struggle to survive.
When I was in medical school, I got to meet one of my teacher’s longtime patients. She had been having abnormal bleeding for the last 6 months, and no one knew why or cared to figure out why. She had high cholesterol was an adamant smoker, claiming it helped her severe back and neck pain. She had an alcoholic mother who was emotionally abusive.
When I saw her, she had just been diagnosed with type II diabetes. She was trying really hard to overcome it; she told me all about Living with Diabetes and how she is trying to educate herself about the disease. She told me about her teenage children are worried for her, and themselves, since her diagnosis. She showed me how she uses her glucometer, and we all cheered when the scale showed that she’d lost 9 lbs since her last visit.
But towards the end of the visit, when she started talking about her mom, she burst into tears. “I don’t want to be sick anymore,” she said. “I can’t deal with all of this. It’s just not fair.”
And you know what? It’s not fair. It’s not fair that no matter how good of a person she is, and no matter how hard she tries to manage her disease, her family situation and poverty and geography will try to suck the life out of her rather than giving her strength.
I’m trying to fight back tears as I write this, because I don’t understand what a doctor can do to actually make it better. I feel powerless to help her. And while this is her life, my life is about learning about which porphyrias are photosensitive, and how to become more likeable, and whether or not I should have a burrito for dinner tonight. What could I possibly understand? What help could I actually provide?