I love volunteering at the free clinic, it is truly one of the brightest spots in my week. The people I meet there are so kind and grateful, it is humbling to have the opportunity to serve them. Each week I see some frequent flyers and some new faces. I develop a relationship with them, I know if they live in town or if they commute to come to the clinic. I know if they are living with their parents or kids. I remember what they came in for the week before and ask them how they are doing this week. I know them. They aren't patient #14 but instead Ms. Smith* who lives on the other end of town.
Each week, I also have the chance to see the trends of who is coming in. The sick obviously, but some are young people, younger than me, who don't have insurance. Some of them are elderly, with the same birth year as my Nana. Whenever I see someone who is close to the age my Nana would have been were she still with us, I can't help but picture her in their place. My Nana was very stoic and reserved and it actually brings tears to my eyes to think of the shame she would have felt for seeking out the services we offer and I have to wonder, do my elderly patients feel the same? But the truth is, if she didn't have a fiercely loyal family, full of children who would fight to the death to give her what she deserved/wanted/needed, she could have very easily wound up as one of my elderly patients. Isolated from much of society, with little or no income, and at the mercy of a broken system...Passing away in a state run institution rather than in the comfort and dignity of her home.
How is it we have come to this point? How have we built ourselves to be so big that those who paved the way for us are now lost in this massive system? And because we are so big the effect on our empathy/feeling of responsibility is much less, we do not have a personal connection with patient #4394856867259405-0067264, we don't even bother to look at their name anymore. Historically, in smaller societies such as hunter gatherer or early agricultural communities, we knew everyone. There was a social responsibility to serve the community for the betterment of everyone. And if you didn't, everyone knew it and you had to face the shame and possible exclusion. But now...now, there is no social pressure to give a damn. Instead we try to push people through the system as fast as possible, never really caring if they get lost in the frequent staff turnovers of social workers.
Each time I see a patient, I try to imagine a beloved family member in their place and how I would want them treated if they were at the clinic, and I treat them exactly that way. It seems that the down trodden are so often fodder for others, whether an eager-beaver premed who wants to read their chart for interesting cases, or a physician who mocks their lack of hygiene with the nurses in the hall. As if the guilt and shame they so often feel for seeking out these services aren't enough of an unnecessary weight on their shoulders, now they must also be seen as zoo animals open for observation by any and all. I can't imagine the president or Bill Gates standing for this type of treatment, or even your average Joe. What entitles them to more respect than these patients? Ink and paper? Because that is all money is when you get right down to it...
Now, I don't want to give you the wrong impression. Some of the physicians who donate their time are amazing. They are kind and compassionate beyond compare and I can only hope to one day be as dedicated as they are. But not all of them are like that...
Oddly enough, the free clinic is the only place a physician is allowed to be human. Here the patients must sign a liability waiver that basically states that except in cases of gross negligence, they waive any and all rights to sue for malpractice. Why can physicians only be human when the potential casualties are societies castaway's?
*All names have obviously been changed.
