“She’s a really nice lady, but she has somewhat of a complicated history — a female with multiple medical conditions and mental illnesses honorably discharged from the Army,” my attending stated before we headed into the room. I did not know what to expect from this visit, but I was determined to help my patient to the best of my abilities.
I introduced myself to her, and I will refer to her as Carol. Carol was a woman I found sitting comfortably on the examination table. Her warm smile disguised the fact that she had been through a lot in managing not only her health but her life in general. As we spoke, I learned more about this resilient woman.
She had a fairly good childhood with a loving and supportive family, but her father’s infidelity and alcoholism led to her parent’s divorce when she was a teenager. After the divorce, she lived with her mother. She eventually went on to enlist in the army.
She mentioned being married twice; her first marriage was dissolved when she found out her husband had a drug problem. She then married her second husband, and they ended the relationship due to his severe medical problems which required him to live in an Assisted Living Facility (ALF). It saddened me to learn that she divorced him so he could receive the proper social security benefits to live in the ALF.
During her second marriage, she lost her job and apartment and found herself seeking alternative living arrangements. She stayed at her brother’s old home and tried receiving assistance from a homeless center. Ultimately, she ended up living out of her car parked in a Walmart parking lot for one and a half months.
She eventually was able to move to a shelter for the last six months before her admission to a transitional housing program. At the time, she had no substantial income — she was on food stamps until she could begin her job as a security guard after she finished her licensing for the job. With these struggles as her priority, Carol did not have the time to focus on her mental and physical health. She fell into a state of depression. Her condition made her feel like running and screaming, causing her to sleep in more, lose her appetite and feel unmotivated. In addition to her depression, she seemed to suffer post-traumatic stress disorder from past experiences of sexual violence.
It was hard listening to her experiences and knowing not much could be done in her situation, as no one can change the past. This realization brought me frustration, but her smile and viewpoint of her experiences made me realize that we should not let the past define how we live our present and future.
Despite her hardships, Carol persisted in turning her life around and taking care of herself. Not too long ago, she was successfully discharged from the transitional “Clinical Housing” program. She was able to achieve permanent supportive housing with the help of the social workers. She continues mental health and medical care in the area. She was able to take care of her acne inversa and treat her depression and even get her smoking habits in control. Currently, she has a stable job and takes charge of her health and diabetes. Her endocrinologist, pharmacist and primary care physician have given her many recommendations and insights which she implements in her daily life. Her A1c was at a peak of 14.5 while homeless and is currently eight and a half on recent labs. She is compliant with all her medications and continues to make significant lifestyle and dietary modifications. She is currently trying to incorporate a plant-based diet.
In the final moments of our encounter, as she exited the interview room, we made eye contact and she said, “You will make a fine physician someday.” I hope to hold up to her expectations to become a physician who provides the highest quality of care to any patient who walks into my office, regardless of their previous experiences. It is always possible to view life and every situation positively as a lesson to be learned or an experience in our journey. I respect her level of resiliency and will continue to treat my patients considering all facets of their life. This experience has helped me develop my understanding and skills. I see every day as an opportunity to learn from our interactions with patients.