Home visitin’

What an amazing experience it is traveling through the Navajo country with the visiting community health reps . . . I met some wonderful people, helped some, learned a ton about Navajo culture.

The first woman I met was a really lonely 87yo whose husband had died and all she had was her sheep and her prayer meetings to keep her company in her 10’X15′ shack about 10 miles from the 89 highway with probably double that distance between her and the next human being. She was all packed up and ready to move from this, her winter camp to her summer camp down the road. She mixed all her meds up (red, orange, white, yellow, square, round, diamond shaped) all into an old green family-sized motrin bottle because as she said “it was easier to take that way”. The medical student side of me wanted to lecture her about being more “compliant” with her meds, using a pillbox or something more “rational” to take her meds. But another voice told me to listen and try to understand her point of view and most of all not to do harm by confusing her further and ultimately getting nowhere by imposing my view of the world and the human body on hers. As I left her house, I swung by her sheep pen to visit with her family. It was a surreal moment to have about 3 dozen sheep stop what they were doing as I walked up and stare at me. It felt like stumbling into a party where no one knows who you are or what in the heck you’re doing there.

The second person I met was a 78yo guy whose only family for miles around were his six dogs. I’ll never forget pulling up to his one room hogan where he was sitting on his porch chillin while his dogs were curled up in the shade next to him. This elder was also fiercely independent. Despite having a hot frying pan burn a 3X4 patch of skin off his right leg, he was intent on NOT going to the hospital because “they won’t do anything for me”. In addition despite his diabetes and a blood sugar of 226 (nl is around 100), he was dead set on only taking his medications every other day because it made him “feel funny”. Nonetheless, it felt really good making my first medical decison BY MYSELF taking into consideration his vital signs, his wound, his diabetes, his upcoming health maintenance check and deciding not to take him to the hospital and instead putting a dressing on for comfort and instructing the patient to take his medications every day.

The last patient I saw today was a cute lil ole lady who lived with her son who complained that she kept getting gas in her belly after using a nebulizer for residual wheezing from a pneumonia she had a month ago. Although I did not do much more than read the instructions from her prescription label to take the albuterol ONLY AS NEEDED instead of every 4 hours as she was doing, it felt really good explaining the physiology of swallowing vs breathing and reassuring a patient who was motivated to be healthy but just didn’t have access to the right information.

I guess what this day made me realize is that one CAN make a difference one patient at a time and that it DOES feel good to help those who cannot help themselves. All it really takes is listening, staying open minded and caring. I recall Dan telling me one time that he would never practice medicine in this country. Maybe he’d change his mind if he met these three wonderful patients.