As the week comes to a close, today's theme emerged as one of thirst, both literal and figurative. My mouth seemed unable to reach a state of equanimity and fluid balance today, remaining just slightly dry and uncomfortable throughout the day. Multiple bottles of spring water, a few cups of decaf coffee (admittedly a diuretic), and a few sessions of toothbrushing later, and the thirst just barely abated by the end of my long workday which was sandwiched between two different per diem gigs of short duration (two home visits as a visiting nurse before 9:00 this morning, and three hours as a clinic nurse this evening after 5).
Speaking of thirst, my experience of patients today also revealed an unrequited longing. For what, you may ask? A longing for self-empowerment among my patients, for the taking of personal responsibility, and for patients to fully appreciate the quality of care which we provide. There exists for most of us an unquenchable thirst for patients to seize their own care by the horns, take charge of their lives, and rise above the feelings of disenfranchisement and disempowerment which relegate many of them to the ranks of the Walking Wounded.
We sometimes long for more patients who will honor their commitments to appointments, show up for surgery, and come in for bloodwork in a timely manner. We wish that a larger number of our patients could arrange their own transportation and advocate for themselves in the face of a bureaucratic system which seems to promise their disempowerment.
Of course, any of us could at any time choose to work in a suburban clinic, serving white middle-class baby-boomers in need of throat cultures, prostate exams and Prozac. Instead, we choose to slog away here in the inner city, fighting the good fight, improving the healthcare of "vulnerable populations", giving of ourselves and hoping to prevent negative outcomes for patients with multiple co-morbidities and the added insult of poverty.
Communities of color suffer disproportionately from a multitude of diseases when compared to their white counterparts. They also are documented as being more likely to receive substandard medical care, less aggressive treatment of chronic and acute disease, substandard pain management, and are underrepresented in clinical studies and pharmaceutical trials. A burden unknown by mainstream American citizens? You bet.
In the end, what do we really thirst for? We thirst for justice, for parity, for equanimity, for equalized distribution of resources and healthcare dollars, and the recognition that our thirst may very well be the fuel for future change and revolution.