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Tag: social determinants of health

Seeing the Light

Sarah Houssayni August 30, 2014 5 Comments


Sarah Houssayni

Many healers, teachers and parents have them.  

At one point, I did, too. I had delusions. I thought I was a hero, a rescuer clad in a shiny white coat and wielding the sword of clinical wisdom. 

 

I look back on those days with nostalgia and regret. I wish they’d lasted a little longer–my belief in my own medical grandeur and invincibility. 

 

My most memorable patient changed that for me.

I remember how her mother, Gigi, first brought Serenity to see me when she was a newborn. Gigi was fifteen; I was

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No Place Like Home(less)

Josephine Ensign May 30, 2014 21 Comments

Josephine Ensign

Recently I had dinner with a friend of mine who, decades ago, had sat on my doctoral dissertation committee. At one point we touched on my dissertation, which covered the health issues of Baltimore’s homeless teens.

“You always had an uncanny connection with homeless kids,” my friend said. “You really understood them.”

I gazed out the window, seeing the homeless people with their shopping carts in the park across the street.

Then I said, “That’s probably because I was homeless myself.”

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Joe the Handyman

Angela Yang June 28, 2013 No Comments

Angela Yang

“Forty-two-year old male, chronic pain syndrome,” the chart reads. 

I’m a third-year medical student doing an elective at a physical medicine and rehabilitation clinic, and this is my first time seeing Joe. 

Sitting expectantly in the exam-room chair, he’s a gaunt man with a long face and dark tattoos down his arms. Wire-rimmed glasses, stringy ponytail, faded jeans and leather jacket complete the look. 

“Nice to meet you,” I say. “I’m Angela, a medical student. I’m doing a couple of weeks here with Dr. Ross, the chief physician.”

“Thank you, doc. I’m Joe.” He smiles, dark eyes twinkling, and I glimpse yellow-stained teeth. 

Probably from smoking, I think. 

Joe starts talking, jiggling his leg nervously.

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An Orphan’s Tale

Peter Ferrarone July 27, 2012 No Comments

Peter Ferrarone

At the outset, I confess that I have no experience in the medical field. I’m not a doctor or a nurse; I’m a recent college graduate, a writer and someone who’s interested in the world. And, all last summer, I was a volunteer in Uganda. 

I’d met a Ugandan priest who was visiting the States on a lecture tour. He described his work overseeing an orphanage located in Western Uganda, a day’s bus ride from Rwanda and Kenya. When he invited me to go and help out there, I accepted.

Upon arriving, I discovered that the orphanage was a small, broken-down concrete house perched on a hill

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Kennet Square Clinic

Jessica Bloom-Foster July 20, 2012 No Comments

Jessica Bloom

The young woman’s daughter
is shy and beautiful.

Her mother comes to the clinic 
with vague complaints:
headache, stomach pain,
fatigue, weakness.
A small, sturdy woman
with an anxious face,
her square jaw is just a bit
bigger on the left. I picture 
the long-healed fracture
in her jutting mandible,
sealed beneath unbroken skin
the color of wheat fields.

Her story is slow to come out.
Many of the patients here
migrate from Mexico each year
to work on the mushroom farms.
I imagine the smell of wet dirt,
the cool, shadowy barns
with stacked rows of wooden pallets,
soft, white globes emerging
out of black soil.

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A Greater Truth

Nancy Elder May 25, 2012 No Comments

Nancy Elder

Should someone have to lie to get care? For millions of uninsured Americans, finding a way to receive health care is a challenge. In my practice, I’ve been seeing more and more of the following:

“Where have you been living lately?” I ask my third patient of the morning, a heavy-set, forty-nine-year-old man with dark, weathered skin and rough hands.

“I’ve been staying with my friend,” comes the casual reply

“How long have you been staying there?” I continue.

“You know, for a while.” His tone is a bit guarded.

“How long is ‘a while’?” I am wary now.

“You know, a bit of time.” I can

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Finding a Way Home

Erin Imler October 28, 2011 No Comments

Erin Imler

Preparing to assemble my new bed, I open the wordless instruction manual. The first page shows a picture of a single stick-figure standing there, hands on hips, and sadly regarding a bungled, not-put-together bed; the next image is two happy-looking stick-figures standing with their arms around each others’ shoulders, looking at a successfully constructed bed.
Despite the warning, I’m determined to do this by myself. For almost four years, I’ve slept on my couch, preferring it to my twenty-year-old mattress. Now that I’m starting a new job in a new city, it’s finally time for a new bed.

Just This Once

Majid Khan May 20, 2011 No Comments

Majid Khan

It’s a rainy Thursday evening in our small inner-city practice. Today is the receptionist’s birthday, and I’ve been cordially invited to attend a small party prepared by her coworkers.

As I descend the green carpeted steps to the lounge, my aching muscles remind me about the torture session (otherwise known as “boxercise”) that I attended last night in my ongoing effort to get fit and control my weight. I still feel slightly resentful of Robert, the trainer; when he caught me slacking off during sit-ups, he embarrassed me in front of the class by making me repeat them.

Good job I didn’t tell him about those two

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Girl Talk

Warren Holleman November 12, 2010 No Comments

Warren Holleman

“I got pregnant. Quit sports, quit school. Quit all my dreams.”

Brenda looks fit and handsome, despite the scar running down the middle of her face. At six feet tall, she commands respect, even though her sweet, high-pitched voice belies her imposing physique.

We are sitting in a circle: Brenda, six other women and me. Most are in their thirties and forties, and in their fourth or fifth month of sobriety. They look professional in the suits they’ve assembled from the donations closet of our inner-city recovery center.

No one is surprised when Brenda says that, twenty years ago, she trained for the U.S. Olympic volleyball team.

“Did you ever compete again?” someone asks.

“Nope.”

“Why not?”

Brenda shakes her head. The group

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Angels and Phantoms

Joanna Dognin August 13, 2010 No Comments

Joanna Dognin

“Mama,” a little voice pipes from the back seat. “Why is that boy in a chair?”

The sun is beaming into the car as we sit at a stoplight, waiting to exit a store parking lot. My two-year-old daughter has spotted a young man, barely twenty, who smiles weakly as he rolls by in an electric wheelchair, collecting money for muscular dystrophy.

“He’s in a chair because he needs help moving around,” I say.

“Why?”

“Because his legs need help.”

“Why? Because they don’t work?”

“Well…”

“Why are they broken?” she asks. “Is he broken? Why is he here? Where is his mama? Mama, where is the boy’s mama?”

* * * * *

“Dr. Lobozzo, you got any

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James and Bob

Paul Rousseau July 30, 2010 No Comments

Paul Rousseau

I think his name was James, but I can’t remember for sure. What I do remember is the day’s heat, the metal cart and a rust-colored dog. 

Like many homeless people, James carried his belongings in a grocery cart–a sort of mobile home for the homeless, but without the protection of a roof, the support of four walls or the security of a front door.

I’d just walked out of the local Safeway store into its parking lot. He ambled over from a park across the street. His eyes were narrow, his face tanned and his clothes dirty brown from weeks of sleeping in the streets.

Being a dog lover, I found my eyes drawn to the dog–a mixed breed with matted hair,

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Help Me

Jennifer Reckrey November 13, 2009 No Comments

Jennifer Reckrey

Editor’s Note: Jennifer Reckrey kept a weekly journal of her experiences during her intern year.


Week 13

I had a few free minutes at the end of my clinic session this past Thursday morning, so I took over a walk-in patient from an overbooked colleague.

The patient was a large, muscular Salvadoran man in his early forties who had long-standing hypertension. He said that for the past three months, he’d been feeling tired and didn’t have the energy to take his daily medications. Just a few months back, he’d finished a five-year prison sentence for armed robbery. Now he was living temporarily with his twenty-year-old daughter and her boyfriend, but he told me that he couldn’t

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