The cycle of poverty...

uneducated, poor, demanding, distrustful. I talk to a patient on the phone and she yells at me. I tell her if she doesn't stop yelling at me I will need to hang up the phone. She says, "I'm not yelling. Believe me, you'd know if I was yelling". I tell her I think she is yelling at me and she needs to stop. She calms down, and proceeds to tell me she will be at the clinic in a few minutes and has to be seen right away. I tell her there may be a 2 hour wait because she doesn't have an appointment. She hangs the phone up on me and comes to the clinic anyway. I bring her back to a clinic room and do my assessment. Her lip is swollen and she thinks she was bitten by a spider. She spent the last two nights in an abandoned van. She's African American. She has fake two inch purple fingernails. She tells me she must be out of the clinic in 20 minutes because she needs to pick up her 8 year old son who will be waiting for her outside the YMCA. I beg one of our doctors to see her ahead of other patients because her son will think he was abandoned. They are homeless. 

A Cambodian man comes to the clinic with his 14 year old son. They do not have an appointment as he rushed him there from school. He tells me his son was sent home from school because he's sick. I do my assessment. He has a slight fever of 99.5 degrees and a sore throat. I do a throat culture and it's negative for Strep. I tell them it's probably just a virus and he should feel better in a few days. The man, who was difficult to understand because his english is poor, acts as though his son is dying. He tells me he wants me to give him medicine so he can get better. He asks me how he got sick. He asks me if 110 degree fever is a lot. I fax in a prescription for some Tylenol and he feels like I'm helping his son. He has no understanding of illness.

I talk to a patient on the phone who needs more percocet because she's on a wait list to have her tooth pulled. She says when she went to the community health clinic dentist, he couldn't get her numb so she's on the wait list at the county hospital to have her tooth pulled with general anesthesia. She's been on the list for 3 months. I tell her I'll call the hospital and see how much longer they think she'll have to wait. Surely it couldn't be much longer. When I call the clinic in the hospital, I'm told she probably has another 9 months to wait.

I call a patient and ask if this is Charlene. She says, "Who's this?" This actually happens a lot. I wonder if they think I'm a bill collector. I asked someone one time why she asked me that question. She said, "I don't wanna talk to anyone I don't haveta."

I see an 8 year old boy for a well-child check. He comes in with his mother and older sister. They're all eating Big Macs and fries in the clinic room. The boy has fat cheeks and a fat body and weighs a whopping 110 pounds. The mother tells me she's a little concerned about his weight and wonders why he's so overweight. I look at the boy eating his french fries. I look at the mom with her long fake fingernails and wonder how she'll clean all the food out of them. I can't help it. I start laughing. After I compose myself, I start talking to her about nutrition. She doesn't know what a "protein" is. I give some examples and the 8 year old says, "You mean like Chicken Nuggets?" The mother tells me when she was growing up, her mother would give her fried sandwich meat and a soda for breakfast. I set them up to see our nutritionist.