Monday, September 25, 2006


I am sitting here forcing my son to do homework. Is it pleasant? It is not. The sun is slanting in in a hide and seek kind of way, the street lights will be on soon. And WE have not been able to go out and play. Yes, we. I want to go out. I want to pick flowers out of the garden and kill crabgrass. ( I took the lawn out years ago- there are still places where the crabgrass comes up. ) I want to talk to another adult who- unlike my patients or my coworkers- doe not want me to do something for them right now. I want my kid to develope the work ethic that has served me so well over the years- do the worst first, and then knock out the rest, then do whatever the hell you want.

Following my own ethic, the first patient I saw today 1) spkoe another language, 2)had a major medical issue that I was supposed to teach her how to manage, and 3) had a psychiatric illness. The MDs keep refering her to be taught, because she clearly does not know how to manage her illness. Problem is, she has been taught by every member of our department, and she can't learn. She lives with her little tiny old mom, she of the poor vision, the poor hearing, and the poor motor skills. Mom is supposed to make this lady straighten up and fly right, except mom- get this- is still working. I have no idea why, but I imagine that it is to make money to pay bills, as the daughter has no income. That's the only reason I would be working at age seventy. So, she is not home at lunch to give medicine, the patient can't take medicine, and the MD's refuse to put her on what they term a "less elegant regime". Well, hell yeah. What's less elegant than being disabled, non English speaking, and sick? What's less elegant than being so psychatrically disabled that you can't get it together enough to get on SSI? What is less elegant than having been saved in the ICU and being released into the world certain to end up in the ICU again? THere is no real inpatient psych anymore. We just dump them on their relatives or the street.

My son has still not done his math. What on earth am I going to do with him. Hopefully, one day if he's hopelessly mentally ill and homeless, I won't look back and realize that it was becuase I couldn't make him do arithmatic.

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