Friday, July 10, 2015

The Fight

Fighting the Fight

I've been unwell lately, body, mind, and spirit. I suppose that's why i haven't written.  The body, nothing too serious: gained weight, allergies out of control for the umpteenth time, cheek/ear/head pain that wake me almost every night around 2 or 3, a messy/disorganized/ disconnected house and a messy disorganized disconnected mind. I started meditating 30 days agoto try to reconnect. I think it may be working. I went to see my first Florida allergist, although I've lived here for almost 9 years. I've left a trail of allergists behind me in Maryland and DC and hoped to have left the allergies with them. As allergic people do, true to form, I have now succeeded in developing allergies to all the flora and fauna here. I had the sinus CTscan, the one I've been avoiding since my second sinus surgery in '92, having promised myself not to go under the knife for this particular ailment again. Next week we'll piece all the testing together and come up with a plan that I hope will look like: allergy shots, check for improvement, experience improvement, have no need for anyone's surgical skills. Since January the depression has been bearing down on me and I have tried to hold it at bay, but only succeeded in becoming more detached than usual. Crying started up again, which is a good sign. It is the light at the end of the tunnel, the feeling of something, anything at all, means the possibility of feeling good in the near future.

Work has been boring beyond boring because I've learned all they really want me to know and seen the boundaries of what they don't want me to know.  As I work in an pediatric allergy department I am viewed by some parents and children as a CIA operative in charge of torture. Try as we may to get the word out to parents and pediatricians alike, the questions are: child development. Where is the child in the continuum? Based on that placement, will the child be able to tolerate allergy testing? For most 3-7 year old the answer is absolutely not. Is there a real likelihood based on medical history that this child's allergy could be life threatening? Will the result alter or guide our treatment recommendations? In spite of these logical questions most parents decide to proceed with the testing even if we recommend waiting until the child is a little bit older. Then begins what sounds to an outsider like a torture session, rather than a procedure that rarely even draw blood.  Lots of screaming children, glowering or simpering parents, burned out Medical Assistants and Nurses.

Most of my allergy shot patients, to the contrary, accept their plight without a fight. I enjoy getting to see them weekly, hear about what they are doing in school, their hobbies, families and dreams.

This week one of my teenage allergy shot patients came in after an 8 week hiatus. We made adjustments accordingly to his dose and schedule, so as not to induce anaphylaxis after such a long time between shots. I advised him that he would need to come every week for the next 4 weeks to get back on track and could then return to once a month. At the end of the visit, Dad came in, 6'5" full confrontation mode. He advised me that it was impossible that he could be overdue, he had scheduled all the appointments. We reviewed the electronic chart, at which point father saw that indeed the last visit was May 4th? He said on his way out: "You couldn't have called me!" At that moment, I congratulated myself for not answering him. It wouldn't have been productive. I reviewed the chart again and saw that 4 appointments had been cancelled by the family, by a parent. I thought, what am I doing here? This is meaningless work. I remembered, oh yes for the $, the health insurance, the great co-workers.

I understand, that like me and 50% of the people you meet in life, this father is fighting a terrible battle. I don't know what his battle is, but I know that without it he wouldn't have confronted me as the cause of the communication and follow through short comings within his own family. If he returns this week I am going to ask him to remember and know that although his battle is hard, so too are the battles of those he meets. Save a nurse, be kind. That's all.

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