the long ride home

i love coming home to this.  this face.  the humor of a 4 years old.  it makes me laugh even after 10 hours of driving, and patients, and poverty, and awareness of my wealth, and injustice, and even more driving.   

today was good- but i think i need to sit with it.  tomorrow i'll be back to see more and hear more.  i will continue to pause and reflect.  right now i'm just tired and trying to process the differences.  i'm amazed that people whose newborn babies are having seizures, are unable to have them worked up because of a lack of money.  people who have unexplained weight lost of 15# in 2 months, people who's upper arm diameter can fit in the circle between my thumb and first finger, people who are unable to get up and would be admitted in a heartbeat in the US, go home with a proton pump inhibitor.  

i'm trying to wrap my heart around where i end and begin in all of it.  i can do somethings- i can give to some- but i can't do it all.  how do i make these choices? 

i remember during my residency training in san francisco i was taking care of a homeless man with HIV and some bad infection requiring IV antibiotics.  he had no home, no job, no family, and no insurance, but being in the US, in a public hospital he would be treated fully, and it would be free.  he would be fed, medicined, given a bed and generally provided for. but.  the TV didn't work in his room.  i was paged multiple times in the middle of the night by the nurses saying that he was threatening to leave AMA (against medical advice) unless he was switched to another room or his TV was fixed.  i went the speak with him, try to reason with him- but i was pretty mad.  i had other sick people i needed to see, other patients that needed to get admitted, and those who were not stable, and i was hoping to get a few minutes of sleep.  instead i was running back and forth to 5C to deal with some spoiled man who was trying to 'punish me' by not staying in the hospital to get better because of a television when normally he doesn't even have a bed?? what??  the hospital was full- there were no spare rooms- i think i managed to get him to stay the night and sleep with the hope that in the morning i could find a portable TV and wheel it in to him.  i remember thinking to myself that i needed to let it go- that i'd done my best but if he'd left it was his choice.  i thought about intense parenting and boundary setting with my child- but that at 40 something in the middle of the night when i was exhausted- teaching him better boundaries wasn't worth it.  

but really...

what is wrong with this world?  people dying because they don't have access and people walking away from good access because of inconvenience?  i know that it's complicated- i do.  i know that we are all complicated and choice itself is complex, as is illness.  

but these are the things i think about.

before i moved i was lucky enough to be a part of an amazing group of women who love to do what they can to make the world better.  we got together once a month for a 'giving circle'.  someone hosted, people brought food, and someone presented an organization or a non-profit that is working to make the world more fair, to right the wrong, to bring justice and peace in places where it's not- and we all gave some money to the cause.  it was a time of fun and good food and community and priority alignment.  a few months before i left i was able to set up a fund for people in uganda who have medical need and can't afford treatment.  these friends, these women have given to this fund and these women will continue to make a difference in the lives of many. 

so on the way home from work today i stopped at the bank to take out money, so that it can begin.  tomorrow i will be able to send that baby to get his seizures worked up and treated.  tomorrow we'll be able to give that mother peace of mind- because at last she'll know what's wrong- and that she's done all she can for him.   

tomorrow there will another person with another need.  there will be several.  and i will do the best i can for them, and i will pray for wisdom. and i will be so thankful for the generosity of others who have sacrificed for me to be here, and to provide care for people across the world that they have never met, but with whom they share the moon.  

and the world spins madly on.