Informal-curriculum Lessons Medicine Nonfiction Reflection Seattle

Crossing Streets.

I didn’t mind that I had to wait to cross the street. The yellow-white light of the Spring sun shimmered in the infinite depths of the lapis lazuli sky. The afternoon breeze lifted the fragrance of sweet flowers over the concrete and fluttered the short sleeves of my summer blouse.

Then I heard a man. He seemed to aim his voice, full of gravel, towards me.

“WOOOO WHEEEE!” He chuckled. “Lawd have mercy!”

ignore him don’t turn your head ignore him don’t look ignore him stay still

My peripheral vision saw his tall figure approach me before I heard him: “Doctah!”

okay he is probably talking to you take a breath

I turned. Though his pants, tee shirt, and jacket were all too large for his frame, it was a stylish look on him. His baseball cap was on backwards and pinned his dreadlocks away from his face.

“How you doin’?” he greeted, his smile revealing several missing teeth. He extended his right fist, a wordless invitation to extend my fist for a bump.

“So what are you supposed to do when you see your patient out in public?” We all looked at the professor with great expectation.

“What do you think?” (Of course a professor of psychiatry would answer a question with a question.)

“Well, you want to respect the patient’s privacy, so you probably shouldn’t say anything.”

“But what if your patient sees you first? And says hi?”

“It seems rude if you don’t say hi back. But if your patient is with another person, that could get awkward fast. What if the other person says, ‘How do you two know each other?'”

“I’d probably go out of my way to avoid my patient. I’d cross the street or something.”

“But that’s weird, too. Your patient might wonder why you’re avoiding them.”

“Or my patient might appreciate that I am keeping the boundaries clear.”

“If my patient said hi to me first, then I would probably say hi back and then try to get away as soon as possible.”

“What do you think they do in smaller communities? Doctors and patient see each other all the time when they shop for groceries and stuff.”

“That might be embarrassing: I don’t want my patients seeing me in sweats when I’m shopping for food.”

“Why are we assuming that patients would want to talk with us in public, anyway?”

The group reached a consensus: If you see your patient, but your patient doesn’t acknowledge you, don’t acknowledge them. You have a duty to keep things confidential. If your patient says hello to you first, be a person and say hello back, but keep it superficial and brief. And the next time you see each other, ask the patient how s/he would like to proceed in the future if you two run into each other again.

“I hope I never run into my patients,” someone mumbled.

The most memorable patient run-in I’ve had in a public setting occurred on a bus.

I was sitting in the back half of a double-length bus. Most of the seats were occupied and a few people were standing in the aisle. The grassy trashy odor of marijuana wafted from the rear of the bus. A young woman, who was under my care several times at a crisis center, and a young man boarded the bus. She saw me first.

“Hey! Doctor! How you doing?” she shouted at me. I nodded back at her. The older woman sitting next to me shot a glance at me, then sighed.

The young woman grabbed the young man’s hand and pulled him down the aisle. The two or three people ahead of them had no place to sit, so they halted and turned around. The young woman was thus about six feet away from me; she couldn’t get any closer.

As the bus lurched into motion, she leaned around the two or three people and raised her voice over the rumble of the engine: “Hey, Doc! I’m doing better these days! I haven’t been to the crisis center in like a month!”

“That’s good,” I replied. Maybe this will be the end of the conversation.

“I still take the Seroquel and Depakote now,” she continued. “Those meds really help. I take them every day.”

There was no street for me to cross. Okay, I guess this is really happening.

“But the meds are expensive! I want to keep taking them, but they cost a lot. Do you know where I can get meds for cheap?” Her eyes were eager.

The older woman sitting next to me heaved another sigh and closed her eyes.

Okay, if we’re going to do this, let’s really do this, then. I took a deep breath.

“Target has a four dollar list and those medications might be on that list. So, best case scenario, each medication will only cost $4 a month. Costco also has medications for cheap, sometimes medications that aren’t on the Target list. You don’t need a membership to use the pharmacy there.”

“For real? I can get medications at Costco without being a member?”

“Yeah. It’s a good deal.” Maybe someone else on the bus can use this information, too.

“Okay, cool. Target and Costco. Thanks, Doc!” She turned to the young man and began planning where they would get food for dinner.

As I stepped off the bus a few stops later, she called, “Bye, Doc! Thanks again!” I smiled and waved.

“Hi!” I said to the man with the gravel in his voice. you look familiar but how do I know you jail yes you were my patient in jail and what is your name what is your name wow you look so different but of course you do because you’re wearing regular clothes and you’re smiling and you’re outside on this beautiful day

I extended my right hand. We bumped fists.

“I’m doin’ real good, Doc. I take my meds every day and I live here.” He pointed to the handsome brick building down the street. “I ain’t picked up in a while and I’m takin’ care of myself. Things are good, Doc.”

“I’m glad to hear that.” I smiled.

“How you doin’?” he asked again, the gravel rattling in this throat.

“I’m well, thank you.”

“Well, you have a blessed day and you take care of yo’self!” He laughed and pointed at me while he walked away.

The white walking man appeared on the traffic light. I crossed the street. I was still smiling.