The Diagnosis I Wasn’t Trained to Treat

Walking out of the room, I wonder if I actually helped my patient.
I asked the relevant questions and attempted eye contact while my hands dashed across the keyboard to record their complaints.
But did I grasp the real reasons why they were in my clinic today?

Did I feel what was behind the calloused hands that I shook?
Did I recognize that their tattered clothes had first belonged to two others?
Did I see what their chapped skin, beaten from the wind, had experienced earlier today?
Did I hear the rumbling stomach of their daughter as I handed her a book?
Did I spot the glance between the couple as I stated the need for a specialist appointment located a few hours away?

I listened to their heart and lungs as the toddler next door shrieked.
With the press of a button, their prescriptions were sent off to the pharmacy.
But will my treatment plan truly help my patient?

How do I treat a diagnosis of “decades of hard times”?
How do I remedy a condition that began before my patient’s life?
How do I manage the fallout of “although punished, I did not do those crimes”?
How do I solve a system that limits medical care to just a visit or two?
How do I help when the roots of these inequities run nearly as deep as time?

At the end of the visit, I asked my patient to please return.
Although, I knew it may only be possible if they were in dire need.
When my patient’s goal is day-to-day survival, what will my interventions do?

I was taught to treat the conditions I had just seen: asthma exacerbation, diabetes mellitus, generalized anxiety disorder.
I was not taught to treat race-based discrimination, historical trauma, or social injustice.
One day these issues may not plague their home lives, but today their weight is crushing.
With all these problems I cannot undertake, I feel some defeat.
Yet, just as I hope to see the benefits of today’s preventive care in the years to come, I hope the seeds I plant each day will help overpower these inequities.

Walking to the next room, I say to myself, “Maybe I can help this one.”
I take a moment to pause, breathe in, breathe out, as I glance at the paper outside for my next patient’s name.
Three knocks on the door and I push it open with a smile, ready to try my best against the diagnosis I wasn’t trained to treat.