Monday, April 21, 2014

Dichotomy

I was sitting at a desk in the clinic, my mind on autopilot as I clicked through patient files on the computer. It was the kind of boring but necessary work that any well functioning medical practice is built on. This particular morning, I was updating primary care providers in a new patients' medical records.

I was so focused that when my fellow volunteer, Cameron, tapped me on the shoulder, I jumped about a foot in the air. "Someone is looking for you. There's a Spanish patient." Chagrinned about being interrupted and perplexed by the lack of detail (Who needed me? What was the nature of the visit? Was it a quick question or an entire visit?), I rose and followed him to the door of the small counseling office, which I had never entered.

The counselor introduced herself and quickly explained the situation as she turned the knob and ushered me in. Already in the room was a middle-aged, Hispanic woman who had an appointment with the counseling intern. I introduced myself as a student translator and began the awkward process of sorting out the session.

I worked out the details of the story: the woman was a patient of the clinic and had been referred by her primary care doctor. She filled in the rest of the story, which took 45 minutes to relay, between my mistranslations and her rapid cadence. Several months prior, she discovered her partner was abusing her granddaughter. She confronted him, at which point he threatened her with violence and fled the scene before he was apprehended, released, and finally skipped his arraignment. He is now at-large and authorities don't know if he has fled the country, a fact his family refuses to confirm or deny to our patient. She lives in constant fear he will return and guilt over what happened to her granddaughter. Additionally, her lack of closure over the whole situation leaves her wracked with confusion, self-blame, and depression.

As her words washed over me, I allowed myself a minute of reflection. How had I gotten here, walking the fine line facilitating a tearful discussion of very personal mental health issues, when minutes before I was just quietly completing my clerical tasks.

But this dichotomy is the essence of our program. It helps students understand both the practical and the human side of primary care in such a population. We're asked to contribute in the less glamorous but absolutely essential daily functions of the clinic but also given the privilege of working with patients and learning through our interactions with them. By learning through a variety of sustained experiences, the C-VIP program is preparing future physicians to be more informed, hard working, and compassionate professionals.

- Julia Tasset