MEDICAL CONSULTATION IN THE INDIAN COUNTRY
I am proud to be a Physician to some Native American Indian
tribes. On this day, this 54 year old
Indian came to see me regarding his uncontrolled Diabetes.
To get to the Clinic, he has to walk to the collection point
for free transport offered by the hospital and Clinic. It is offered twice
daily. The town he lives in is 35 miles north of the Clinic. The winters can be
brutal in this part of the world, but he very seldom misses an appointment.
He was born in the Indian village where the clinic is located.
He attended an Indian boarding school and then joined his mother who had moved
to the town where he still lives. That was in 1975.
He had last worked in 1993, 22 years ago. Alcohol abuse had
been a part of his life. He was sentenced to 5 years in prison for domestic violence
(he was drunk). He sobered up, like they say, on 13 April 2003 (nearly 12 years
ago)
His current “income” is $194 per month in food subsidies
provided by the US Government. When he can get a ride, he would shop at Wal-Mart.
Otherwise he is forced to buy food at the neighbourhood petrol station (junk
Food at higher prices). He lives in a duplex in a poor section of the town,
rented by his sister, owned by a Mexican Immigrant. His sister, unemployed,
suffers from the complications of Diabetes , with one below Knee Amputation and
she is on Dialysis, three times a week. Her boyfriend, also unemployed, takes
care of her, helping her reach the Dialysis centre three times a week, using
public transport. A nephew who is disabled with a hip injury is also
unemployed, 42 years old also lives at
the house. Two nieces also call this small apartment home, one of them is
currently incarcerated, the other, also unemployed, leads an itinerant life
style, alcohol features predominantly in her life.
No one owns a car. The nearby Church provides clothing
donated by charities. He wears XXL shirts and 38 waist pants.
This patient uses his 194 dollars food allowance to buy the
following: Eggs, White bread, Cottage Cheese, potted meat, Diet pop, Crystal
light powder to make sugary drinks.
Do you eat at Fast Food Restaurants, like McDonalds?
No Way, he laughs, I cant afford it, since I have no money.
I know I should eat better, but I have only 194 dollars in
Food allowance to last me one month.
Pleasant gentleman, no resentment towards any one, no
gripes, honest, not jealous towards those who has more than him, goes to extra
trouble to come to the clinic, with both of us knowing that it is the
availability of human warmth that he seeks here, that brings him here. We
reciprocate what he gives us and do whatever we can do for him. The least we
can do for him, is to make sure that he has enough medications, make sure that
his feet are without any dangerous signals of impending ulcers, that his eyes
are checked and also to make sure that he gets home safe on the hospital transport.
Why doesn’t his Diabetes come under control? The society has
cornered him, he has no access to food, only chemically laden processed food.
Medications can combat the effects of Food on his Diabetes but cannot deal with
the chemical’s effects on his Diabetes.
He reaches out to us, the nurse educator and the doctor at
the Diabetes Clinic, the Family Physician who cares for him in the hospital
clinic, he gets to visit some people he
may know at the clinic/hospital, and a day is pleasantly spent, before going
back to his lodging, in a city where he garners no value or respect, an alien
city with an alien culture.
As he was preparing to leave, something compelled me to take
out my wallet, empty it and give the money to him. Believe it or not, he was
reluctant to accept but I could see he was happy to have some cash, not food
stamps issued by the US Government. He smiled broadly and hurried to catch the
hospital transport home.
I thought of 3 women in my life, all three sisters in one
way or another who have influenced me and also watch over me.
The Diabetes Educator Nurse puts the welfare of the people
like this patient and many many others like him in this isolated, poor country.
To me, she personifies what I would call ‘christian” values of the western
civilization, non judgmental, all done in the sense of service, with thoughts
of relief from pain and suffering in these marginalized original inhabitants of
this land.
My Indian sister, an extremely efficient administrator, many
years ago , by her actions taught me what it means to be a relative, to the people
you work with, the people you come across in your every day life in this poor
community of Indians. She also believes that we must have a head to toe
approach to our patients, that we must provide the best quality care we are
able to provide to each and every Indian who comes to the clinic.
I have to reiterate that these unfortunate souls may be poor
in material things but they are not poor in spirits and generosity of
themselves.
My British-Jamaican sister has a big heart and as I write
this, aboard a flight to Miami, it is she that I am going to see. I am certain
she would have prepared some dishes that I like. She knows that I had been in a
food desert for the past one week. (PS . I enjoyed the Curried Goat she had
prepared, with rice, she has already prepared the breakfast for tomorrow of Jamaican
fish fritters and avocado, and always good strong British Brooks Bond Tea)
This past week, Consultation of this sort took place, over
and over again. Patients had travelled from far and mostly from the village,
most of them wanted to talk, some had problems (not medical but social) which
took hours to negotiate with the authorities. As my Indian sister would say:
Let us take care of them, head to toe.
The role of Medicine/Medical Care Provider is not limited to
diagnosis and treatment but also alleviation of their suffering, not just
physical but social, cultural and spiritual.
I am proud to be a Physician to the Indian, the native
people of America.
As I pulled into the drive through window of the small bank,
the only one in a thirty mile radius, I realized it had closed for the day. So
here I was, metaphorically without any money in my person, beginning a pleasant
journey to my Miami and Cuban homes and hearts.
May my Mezhinga be blessed with the good spirits of these
ancient people.
