Tuesday, September 2, 2014

An all-too-common tale

"Let your heart feel for the afflictions and distress of everyone."
-George Washington

Beware, however, of the paralysis that may follow.

Last week, I found out that one of the patients I had cared for while she was admitted to the hospital died within a couple of weeks of going home.

I suppose, depending on the expectations and theories one associates with being hospitalized, this could come as an expected eventual outcome. While I'm not feeling particularly profound or philosophical, I suppose it's worth conceding that the eventual outcome is always death. Except this sweet, unfortunate, confused lady was not here for any acute health issues, but rather, a worsening of many chronic ones. And her true cause of admission? A complex constellation of social symptoms. Her "eventual" death came too soon.

Her true illness was joblessness, near homelessness. No health insurance. No resources. Limited supports. A language barrier. A profound degree of not just health illiteracy, but illiteracy, period. The overwhelming combination eventually brought her path to intersect mine for a brief interlude. In theory, I cared for her and made her feel better. But I had no remedies, none at all, for the true causes of her multiple diseases. My prescription pad was useless in more ways than one -- not only could I not write her for a home, or a paycheck, or a family, but the few medications I could write her for, she would be unable to take due to lack of comprehension.

We try, with incredible efforts from our social workers and case managers, to set up safe discharge plans for our patients, but in so many ways, our hands are tied. She left our hospital bed and returned to her familiar ground. Within a few short weeks, she died -- ostensibly of medical causes, but actually of so many social ones. And since then, I've wondered what more I could have done to prevent this, and what more I can do for the next incarnation of her confluence of social issues who crosses my path. I've yet to come up with any answers, and am left feeling miserably inadequate.

This is not meant as a social commentary, though the situation deserves one. I have no groundbreaking insight or ideas on how to remedy this story and the multitudes like it, at least not just yet.

This is an outpouring of grief and regret. Of failure.
I'm sorry.