To be good is to be great

Wychus Creek - 4I feel like I have been sucker-punched. I am sitting in my patient’s living room on the morning of November 9, trying to listen to him describe his low back pain, but all I can think about are the results of yesterday’s election.

During my family medicine rotation at OHSU’s Rural Campus in Klamath Falls I had the opportunity to be involved with the I-CAN project. This project brings together students from across OHSU’s professional programs to provide inter-professional care coordination to the most vulnerable of patients. The patients who chose to participate all have complicated medical histories compounded with huge social problems. We helped them navigate the healthcare system, expanded their health literacy, and acted as their advocate with other healthcare professionals. Our main job, though, was to sit and listen to people who feel they have been systematically pushed aside.

The team I worked with was made up of two nursing students, a dental student, and me, a P.A. student. We had a small group of patients that we met with weekly for an extended time. We met them on their own terms, in their homes, and gained a greater sense of what their lives were like. We set attainable health goals with each patient, like getting one woman a badly needed new set of dentures. We helped one man complete his lengthy SSI paperwork and connected a recent widower with grief counseling. We worked with our patients to accomplish their goals and watched as they gained confidence and independence. This was a great experience, and I was sad to leave.

Today we are at the home of a man who has fought with chronic pain and PTSD for decades. One of his most consistent complaints is that no one listens to him, so while I am doing my best to hear what he has to say, I am struggling to corral my thoughts. This election has knocked over my sense of how things are. It’s like we’ve decided as a country that the way to win is to insult as many people as possible because no abuse goes too far. I know everyone can be mean and petty in private, but I thought we had collectively shelved the idea that it’s ok to be racist and misogynistic in public. (I also know that I am a sheltered white lady and that this knowledge isn’t new to a lot of people.)

Trying to understand what I perceive as our nationwide thumbs-up to hostility has temporarily short-circuited my brain and (unfortunately) my ability to control facial expressions. I’m pretty sure I looked wild-eyed and slack-jawed. Luckily I notice my patient giving me an odd look, forcing me back to the present. I spend the rest of our visit focusing on his concerns. His immediate need for care soothed my fear. Helping him helped me.

The more I think about that strangely emotional day after the election, the more I come back to my experience with this patient. Once I focused on the hurting person in front of me and gave all of my professional efforts to try and help him, the calmer I felt. The immediacy of my patient’s needs and my desire to demonstrate competence and compassion pushed aside the vague, seeping cruelty.

I will continue to be fearful that we are becoming a less decent country. And I can use this fear to spur me into being a better provider. My rebuke to open hostility will be showing kindness to all of my patients, including those who are going to be pushed even further out of the system during a time of ideological entrenchment. America is a great nation in part because we are good to each other. I am thankful for this reminder during my training as it will help me be a stronger P.A. in the future.