The refugee health care is always the most challenging and rewarding part of my weeks. The horrors and trials and tribulations faced by the patients here are unimaginable in every sense of the word. How do I imagine being born into a country in violent conflict, escaping but leaving my whole family behind, spending 10+ years in an unfamiliar country without a home, a family or even an idea of a future, only to end up finally in a safe country, away from refugee camps, but all alone and unable to understand the language or the frankly alarming weather? (As I write it's single digits outside. It's July. C'mon, NL).
I say that to preface the situation. But the frustration was real today and it took effort to keep in mind the challenges that many of these newcomers are facing. It absolutely sucked to call someone 6+ times throughout the day, dialing their entire family before reaching them, relying on an interpretation line each time. But they have a new baby and have no one else home to help them. They just couldn't come to the phone, and they were scared by the private number that all our cell phones are now blocked off as.
It sucked to not be able to communicate with a patient because they're illiterate in their own language to begin with, and I don't have their language available as a translation services because it's spoken by so few people. When I asked if their family could help, I was told matter of fact-ly that all their family was still in refugee camps or had died there/in the conflict. "Oh. Okay." I couldn't find another reply in that moment, and the patient did not want or need my automated "Oh I'm sorry to hear that" spiel. Their concern was the medication they ran out of. My concern turned out to be their medication is for HIV which I did not know about, and for which they have been out of pills for, oh, a month. Great. They didn't know my priorities and I didn't know theirs. Fortunately we came to a rapid agreement and a decision to book an advanced interpreter for this language.
It sucks to spend an extra 1.5hrs writing notes to the dentist, to the pharmacist, to anyone who will listen and might help to please, help this young person find floss and explain what it is. Please explain what the creams are help them find the cheapest one because not one is covered by the health plan. And please please be patient. They don't have a regularly translator available. They're just doing their best. And please excuse the fifth fax I've sent asking you to help someone with things probably above and beyond your scope of practice, but that's just what I'm trying to do, too. I can tell their patients to call their worker and find creams, or I can research the cream, fax the pharmacy, and make a plea for a cheaper available option.
But it really sucks to have someone not respect all that and hang up on you 3 times because they don't like the answer you're giving them, or you took too long answering while looking up their chart and pleaded for their patience (mine was certainly running out). I hope that it was misunderstanding, that they don't know that not all doctors work in hospitals, but after the 3rd hang up I had to just order the investigations and prescribe what needed to be done, and hope for the best for harm reduction purposes. Paternalistic? Definitely a touch. Necessary? Unfortunately so.
But I bought some bubble bath products and sat in the bath for 3hrs and read Harry Potter again, so that's always comforting. Now where's my wine?
*Originally written in July and forgot to publish it
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