It was the first day of my rural primary care health fair week, and my second patient of the day taught me a lesson that will continue to affect my practice of medicine for the duration of my career.
Within 1 minute of entering the patient room, by myself, I learned that my 48-year-old male patient was an ex-convict, released from prison about 8 months ago. This was not the first time he had been in prison… he has been in and out of jail and prison since the age of 15. Within these first few moments, I became fearful for my safety, and I desperately wanted to exit the room. Fortunately, I held myself in my chair and continued to listen to my patient, who has often been regarded as not worthy of respect by society and within the health care system.
He talked to me about his health concerns, countless suicide attempts, incarcerations, reasons for incarcerations, and his current living conditions. I was in awe of his willingness to so freely talk with me about such sensitive subjects, and I was devastated by much of the history he provided. I listened as he proudly told me about the tent he lives in behind Target and was humbled by his pride that his tent area is the cleanest in his tent community. I listened as my patient described various suicide attempts and was saddened by the story of his Coumadin overdose suicide attempt (with the hope that it would burst every blood vessel in his body and kill him). I was honored to be the provider whom he so proudly told the only illicit drug he sometimes uses is marijuana. He was proud to state that he quit abusing prescription pain medications, alcohol, and tobacco. I talked with my patient about impulse control, mental health resources, and employment opportunities. My patient presented for health clearance for his applications for employment.
However, my encounter with him enriched my education and provided me with the first opportunity to see the “human behind the bars.” My patient is a man struggling with severe mental health disease and nearly constant problems with the law. Despite this, he is a human, and I was honored to be the provider for whom he let this shine through. I learned early on that Wednesday morning the degree to which genuineness and respect can impact patient care, impact the patient on a very personal level, and can change the life of a (future) physician. I discovered in these moments my calling to family medicine, to provide holistic health care to my fellow humans.
Humanism is a large part of the art of family medicine, and patients are, first and foremost, human beings. May I always practice the words of Maimonides: “The physician should not treat the disease but the patient who is suffering from it.”Namasté.