The Doctor

(Community Matters)

I have a patient at the clinic, she’s a dancer. . . . Maybe we don’t want to heal her.  That’s all I can figure.  Maybe there’s a cost we don’t talk about – . . . . . . . . . . . . .. ……….Steven Tomlinson

He’s performing his 4 short pieces written for People’s Community Clinic again today

THE DOCTOR
© Steven Tomlinson 2011

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I have a patient at the clinic, she’s a dancer.

She invites me, so I go to see her dance.  What I see on stage is more than courageous, it is wholehearted.

I see what it looks like to be unafraid.

Every step is graceful, every gesture has purpose.  But beneath the choreography, you see something else.  Something more primal than an artist could imagine — a truth that is part of her body.

She has kidney stones.  On x-rays you see crystal spikes cutting into her flesh.  You see obstruction and inflammation.  You can see why she is in constant pain.

I give her ibuprofen.  We treat infection with antibiotics.  We manage.

I’ve noticed this urgent curiosity about pain.  We’re eager to learn how people live with what hurts.  We need to believe that if we cannot end suffering we can at least make meaning from it.

This is what I see when she dances. Pain, like an invisible partner, lifting and holding her as she points towards what we are seeking.

Here’s where it gets surreal:  We could end her pain today.  Extracorporeal shock-wave lithotripsy.  Sound can pulverize kidney stones and send them on their way.  It’s modern medicine at its most graceful.

But the machine’s at the hospital; and to get in, you need insurance; and she doesn’t have it.  Her restaurant jobs don’t offer any and she’s too old to be on her parents’ plan and private coverage was expensive, and now it’s too late.

Apart from the pain, her health is remarkable.  She has the vitality that comes from purpose, from doing what you were put on earth to do.  That’s what you see when she dances.

So many of the people I saw in managed care were slowly dying from their work.

Now, I’ve got some connections.  I know the system.  I’ll make calls on her behalf.  It’s irregular, but if you’d seen her dance, you’d risk it, even if you knew it wouldn’t help — that we’ll have to wait until it gets worse, until she has a crisis we can’t ignore.  She’ll come to the ER vomiting, high fever, barely conscious, and they’ll have to admit her, because that’s the law.

Of course, there’s another option — an option that most of my patients don’t have.  She could get a real job, you know, with benefits and coverage for pre-existing conditions.  It seems like a sensible thing to do, doesn’t it?  It shouldn’t matter that a real job might not leave time or energy for dancing.  She should do what the rest of us do.

But then what would that cost her?  What would that cost us?

It would really cost us nothing to heal her.  Underneath all the bills, and paperwork, it would cost society almost nothing.

So, maybe we don’t want to heal her.  That’s all I can figure.  Maybe there’s a cost we don’t talk about.

Maybe we know that our most important work is making meaning out of suffering.

Maybe we need proof that wholeheartedness is worth it.

Maybe we need her to show us what to do.

the other three pieces are: The Nurse, The Competition and The Patient