Please, Help Yourself

"The people who need the most help are usually the hardest people to help." It didn't make complete sense when he first said it, but after a week working in the OU Family Medicine clinic in north Tulsa for a week, it became crystal clear. What my new doctor/teacher was trying to tell me was that the people in the worst situations almost always are those who are the least willing to help themselves.

For example, a lady comes in with chest pain, lightheadedness, and flushing; all signs of heart attack (which of course she's had before) and asks the doctor "what's wrong?" The obvious answer was another heart attack, but we ran the full gambit of tests anyway. Sure enough, she had suffered a heart attack and the doctor returned to tell her that she needs to get "worked up" at the hospital. She replied, "I ain't going to no hospital, it's boring in there. I'm going to work!" The doctor stressed the life or death magnitude of her situation and she didn't care. She signed an AMA form, grabbed the "last ditch effort meds" prescriptions and headed to work, knowing full well that she faced a good chance of dying at work that day.

Another lady came in for an OB follow up visit. She was 19 with 2 kids already. She was frustrated, depressed, and fighting her new best friend: morning sickness. The entire patient interview was miserable as I watched a girl who hated her latest "mistake" that grew inside her. Afterwards, the doctor told me about how he had counciled her in the past, with her other two children, to start using birth control and exercising better judgement. It just keeps happening.

Another lady came in with vaginal discharge and bleeding. She said she had sex 3 nights ago and that they weren't using any kind of protection. The doctor asked her if she wanted any birth control but she adamantly refused it for some reason. She explained, "I ain't never using no birth control! Ain't nobody gonna make me get fatta! Them things make me sick anyways!" The doctor told her, "if you don't use birth control, you're going to get pregnant or contract a disease," and she totally sluffed it off. Amazingly, the next moment, she was getting checked for all kinds of STDs because of her unexplainable bleeding and pain. Hmmm.

I can't even begin to tell about how many people came in dragging oxygen tanks for their advanced COPD and yet were still smoking! What's even more difficult to understand is that they would often times be accompanied by one of their children (seeing how they aren't very mobile anymore) who also smokes! They sit there watching their parent dying from the effects of smoking while they cruise down the same highway. The doctors always point out this sad irony and every single time it's met with complete ambivalence.

Why do these people even come to the doctor? Because we pay them to. Our taxes fund their ridiculous attempts to get cured in the doctor's office, no questions asked. They unashamedly destroy their bodies with wild living and poor decisions and turn to Uncle Sam for some help. Ole' Sam smiles and hands them our money (and plenty of it) in the form of medicaid and absurd disability settlements so they can keep spending $300/month on cigarettes and still get their oxygen tanks, hypertension meds, and heart caths. Why not go to the doctor? Thanks Uncle Sam!!