My office schedule was packed with patients one day when a colleague called me in to an exam room to see her patient. The situation was urgent, and I tried not to think about the delays our patients would experience because I was making time for someone else.
This patient was a thirty year old woman who had been bleeding heavily for almost two years. Her pain had increasingly become worse, so severe that today that she had arrived at the office without an appointment, insisting on being seen. Our nurse practitioner had made time for her, but it turned out her problem was complicated, too complicated to be diagnosed without a surgical perspective.
I could clearly feel the large mass in her pelvis: it was obvious she needed surgery. We performed the ultrasound and necessary biopsy to line her up for the help she needed.
Unfortunately, the patient didn’t have health insurance.
For a doctor or anyone in the healing profession, it’s heartbreaking to see patients who need help but can’t afford care. The patient glared at me with a mixture of pain and anger, and asked what she was supposed to do. I suggested going to the health department to see if she was eligible for Medicaid – or perhaps to the hospital, to see if she could get charity care.
“I already tried that!” she snapped. “And it didn’t work!” She angrily held out her hands, in a gesture that seemed to offer up her problems for me to take on. The tone of voice clearly conveyed that this was someone else’s fault.
I pointed out that she had been suffering with this problem for years – she needed to take some responsibility for not having health insurance. She was very capable. If she had begun looking for a job with benefits a year ago, instead of staying at home, she would not be in this situation, and we could perform the surgery.
Whose Health Problem Is it?
I try to be as honest and open with patients as possible about how I can help them – and how I can’t. Sometimes maybe I am too honest, and I began thinking this was one of those times. I’d tried to communicate in a non-judgmental way, but I wondered as I went back to my waiting patients if I had not just been a big jerk.
About six months ago, a patient arrived at the office unannounced, with a plate full of home baked cookies. She asked if I remembered her. I didn’t. It was the same patient. She had come in to thank me. Three months after I had examined her, she had gotten health insurance, and one of my partners had performed her surgery. She felt better than she had in years. She just wanted me to know she had made changes. And she said thank you for my honest words.
“All these years I felt like my problems were somebody else’s fault,” she said. “I think you were the first person to tell me I had to help take care of myself.”
She said she felt feel better physically, but she was most surprised that she actually felt better spiritually and emotionally. “I feel like my life is finally on the right track.”
Health is not what someone does for you, and it’s not just about your body. It’s about your soul, and what you do for yourself. To be healthy and happy, you have to assume responsibility for your life. And as we come to the time of year for making new resolutions, it’s important to know –
God doesn’t smile on the Spiritual Couch Potato.
-Dr. Mike Litrel
