Journal Entries Week 6/30 – 7/5

Journal Entries Week 6/30 – 7/5

Monday:          At the beginning of the week, I put a few more hours at the Denver Rescue Mission Lawrence Street Shelter. I served food to hundreds of people suffering from homelessness and spent more time in the contact office, where beds were reserved and resources were given out. A friend came with me, and presented the opportunity to learn more about the state of homelessness in Denver, as staff at the shelter explained the issues at hand to my friend. Homelessness is not any easy fix, of course, but is not even easy to treat. Only so many can be housed each night, and many more do not wish to be, the director of the contact office stated. All of this, I knew, but the instruction served to remind me of how complex the issue truly is. I wondered why it was that many resisted help out of homelessness, even in the form of shelters. Those on the streets are, much of the time, there by their own will. It occurred to me that there was at least a possibility that those who reject the resources available may have problems with conformity. This leads many to plain delinquency, but may drive others to simply reject traditional opportunities for help. Finding a way to encourage these people to pursue prospects for a better present or future is of the utmost importance. I left the facility, knowing I might not be back for some time, as my clinical shadowing opportunities became greater.

                   

Wednesday:    Wednesday began my short, periodic times in the Academy Park Pediatric Clinic. The facility specializes in primary care and happened to be the headquarters of my primary care physician throughout childhood, Dr. Afrsten. The day was not an incredibly eventful one, but a worthwhile one, nonetheless. I was introduced to a staff of nurses and the second doctor who was there for the day, Dr. Goldberg. As patients came in, the nurses prepared them for the doctor and took care of any vital signs and preliminary questions which needed to be asked. Then, the doctor spent a small amount of time with the patient and administered whatever sort of diagnosis that was called for. Each patient was in and out quickly, and the doctors only spend around 10 minutes with the patient each time they were in the room. There were simply too many patients to see to allow for more. And, on top of that, the needed paperwork and documentation, which was predominantly typed into computer systems, needed to be completed between each patient and the next. Though the doctors went about their duties calmly, there was a presiding feeling that there was no time to waste. Certainly, I would expect nothing less from a physician.

Babies were examined and immunized, children’s growth was assessed, and small infections and sprained joints were treated. Yet the most important lessons of the day were not of medical origin, but rather focused on the way that doctors interact with patients. The physicians of Academy Park were rushed, but never conveyed it to the patients, or even very much to the nurses. Their composure presented a confidence and trustworthiness which calmed those around them. Then, when a complicated situation came up, all involved were ready to face it logically and swiftly. I hoped one day to be able to present such character in my own practice. If I am able to rise to nearly the standard that the doctors who I was able to spend time with did, I would consider myself a very successful man indeed. I realized that this sort of life was, in one way, something that I sought in order to attain self-actualization. The doctors I experienced each had found something which fulfilled them. Perhaps it says something about me that this is the sort of thing I aspired to, reflecting something of my own superego. What I find to be moral and right drives me, but also defines me. Freud himself would likely have a great deal to say about the matter, I am sure.

Saturday:         On Saturday, I returned to Academy Park Pediatrics for a second half day. This time I was to shadow both Dr. Arfsten and Dr. Nicholson, with a familiar batch of nurses helping out. The morning began with a steady torrent of babies with caring mothers and fathers. Some were in for a quick check or an immunization; others were experiencing minor or concerning problems and needed treatment. Yet all seemed to be in stark contrast to the men and women I had been working with in previous weeks at shelters and food banks. Many on the streets had grown up on the streets or had never experienced the loving personalities which the parents who came into the office with their children displayed. Many of the homeless at the shelter had children and would likely never be able to care for them in the way that those at Academy Parks could. The children who were seen here could expect warm clothes, meals, houses. The children on the street or even in indigent neighborhoods would likely never experience these things. Thus poverty would perpetuate poverty, as it always does. This sort of socio-economic trend raised its own psychological questions, but after my time at the Denver Rescue Mission, it seemed as if the differences which separated the fortunate from the unfortunate were determined, by genetics or by environment. No baby chooses to be born onto the streets. Similarly, no child chooses to be born into affluence. But where someone is born is irremovable from their future, perhaps even existing as the most powerful influence into who a person becomes.

Later in the morning, my mind was torn from socio-economic principles and returned to medicine. A boy came in with a severely reddened and swollen tongue, typical of a condition called Glossitis. The boy was in immense pain, but there was little to do, other than monitor diet for something which could be causing a reaction and ensure that infections didn’t take place. Recommendations of ibuprofen were made and the child was sent on his way. Next came too potential ear infections: one that existed and one that did not. Of course, many mothers and fathers who came in with children were just being overly-cautious about something non-threatening. Such was the case with a boy who was in slight pain, but had no typical presentations of an ear infection. He was sent on his way, with instructions to come back if it worsened. The next eardrum I looked at, however, was incredibly red and slightly swollen. This child’s pain was, no doubt, caused by an infection. Antibiotics were prescribed and similar instructions given as to the last person, albeit with a bit more concern. As the day came to a close, I wondered if a homeless man, woman, or family would likely even seek care for these conditions. And if they did, would they be able to find the quality that exists in the insurance-dominant practices of the suburbs?