Friday, May 13, 2005


triskaidekaphobia \tris-ky-dek-uh-FOH-bee-uh\, noun: A morbid fear of the number 13 or the date Friday the 13th. (

"Wow,"Mary says. "Glad I don't have that!"

I'll say.

Despite the underlying feeling that today was expected by many to be a cursed day, it wasn't too bad, or not relatively worse than any other day, that is.

The question on my mind today had to do with why I choose to do the work I do. Why do I want to work with the disenfranchised, the disempowered, the chronically ill, the poor? It is genuinely frustrating and frequently maddening work, and I often feel like I'm banging my head against a very uncomfortable wall. (Are there comfortable walls out there somewhere? Padded ones, perhaps?)

I have many patients who seem so disempowered, unwilling to make positive decisions for their health, unmotivated to change, unwilling to try something new. Today I visited my 69-year-old patient with AIDS, schizophrenia, asthma, and diabetes in the hospital---again. She just has to quit smoking. She complains of consistent shortness of breath and a dry cough; and she smokes more than a pack a day. Her AIDS is completely controlled. The smoking will kill her.

I also visited my 350+ pound patient with severe asthma and diabetes. She had a few weeks of rehab---exercising and such---and now she's back home, spending about 22 hours of each day in her bed. The smell of urine is sometimes overpowering. What can I do with her? We've had the same conversation for years.

Then there's my schizophrenic patient who feels fine despite wildly out of control diabetes. "I feel great," he said today. "I'm a health freak." That can be interpreted in many ways, I guess.

Granted, others are motivated, proactive, responsible and responsive. They make the days easier. And more rewarding, as well. What would I do without them?

In my rounds around the city, I drive past the homes of some of my patients who have died. I picture scenes, conversations, interactions, snapshots of days gone by. Many ghosts walk the streets, perhaps still uncertain exactly what caused their untimely demise.

Mary asked me why I don't just work in a nice little doctor's office or medical clinic here in Amherst. I responded that I might die of boredom---all those white people like me with sore throats and high cholesterol. Where's the challenge? Where would I speak Spanish? Mary's answer: "Wouldn't a little boredom be nice?" She added, "Struggling is relative. White people and other people of priviledge need compassion and care. They, too, could benefit from your kindness. Maybe that's the padded wall you need."

Triskaidekaphobia. I felt no fear today, but it sure was nice to leave that office---that city--behind for the weekend. Now for a pair of days focusing on myself, my home, my lovely partner, my needy and loving dogs. Then back to the fray, with all its frustrations and maddening moments.

Flick the switch. Turn out the lights. The day is laid to rest.
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