On Thursdays, the Daily Voice showcases selected Thursday Morning Memos, reflective essays about clinical experiences written by faculty, alumni, residents and students of the Department of Family Medicine & Community Health and, occasionally, contributors from other departments. Thursday Morning Memos is UMass Medical School’s homegrown version of narrative medicine, in which the authors process their experiences through writing. To learn more, visit: http://www.umassmed.edu/news/articles/2011/personal_stories.aspx.
In her second reflection, first-year resident Serena Hon, MD, from Hahnemann Family Health Center, starts with a discussion about homelessness but ends with questions about the role of the family medicine provider in the lives of our patients.—Hugh Silk, MD
Reflection on Community Health Month
Part of this month gave me a glimpse into how much need there is in the community—how much suffering homelessness can inflict on a young woman, man or family having difficulty finding solid ground, difficulty providing for themselves and those who depend on them, and difficulty finding those who believe in them enough to give them a chance. It made me stop and take careful notice of the people I pass on the corners of Route 9 and Main Street, Park Avenue and Salisbury Street, Route 70 and Concord Street, when I turn up the heat in my car and they hold their cardboard signs like a shield, scanning the traffic with glazed-over eyes and pink noses.
We had the opportunity to see how much good there is in the community—how many people are working at these jobs to help others, even when the work is difficult and beats you down a little bit every day. We sat at a table with a woman who, after telling us about the trouble she’s had with one occupant at her shelter or another, smiled brightly as she described the Mickey Mouse party they had the night before for all the January birthday kids, and the decked-out holiday party they had, complete with visiting Santa Claus, in December. We smiled with our eyes ducked as she described a day off from work where she went to Dave & Buster’s with her daughter because, “Sometimes you just need to get away from work, you know? It gets wearing sometimes.”
I began to realize how much there is to offer people, but that it is limited in scope and duration, and for people to truly thrive and benefit from these resources and become self-sustaining, they need to do a great deal of work on their own. While they are offered parenting classes and GED classes and career counseling, there’s no question that they have to do all these things—get their GED, find their job, and raise their kids—when all is said and done—on their own. Their problems are great and while their solutions are few, the point of these programs is not to fix these peoples’ lives, but to give them the tools to bear the heavy burden they already carry.
And so we play a role. With the people who have limited resources and need to scrounge to find ways to make it all come together, as health care providers we have but 15-to-30 minutes to scrutinize them, pick them apart, make sure we’re not missing big gaping holes, and give them as much as we think they need, within the boundaries we think they can handle. Often, with some of these patients, I hand them cards and information sheets and phone numbers without expecting anything from them, and wonder if all my work is for naught. At the same time, I think that people often come to us when they don’t have other places to turn. They ask us questions they think only we can answer, and they trust our word because eons of societal norm has encouraged them to. People who may come to us out of panic, out of fear, out of last resort-dom . . . isn’t this the closest thing to a life fix that we can come near when treating our patients?