Friday, February 7, 2014

An Ah-Ha Moment



     Yesterday at work was crazy to say the least.  Things had been busy, but I was keeping up until a new patient, who we’ll call John, showed up.  You see, this patient had just been diagnosed with a giant blood clot in his leg.  Blood clots in the leg are bad, because if they get loose they’ll travel to the lungs and cause something called a pulmonary embolism which can be deadly.  Usually, a patient with this kind of blood clot would be sent right away to the hospital.  However, John refused to go and so he was sent to me to try and keep alive in the outpatient setting.
     Unfortunately, besides the ginormous blood clot in his leg; John had many things going against him.  He was poor and uninsured so medication cost was an issue.  He didn’t own a phone so I would need to take care of everything with him in the appointment because there would be no way to call and follow-up with him later.  And, he understood things on a 5th or 6th grade level so I needed to keep his treatment regimen as simple as possible.  Yeah, the 15 minute appoint John had scheduled with me wasn’t going to be nearly enough time to get things sorted out.
     I knew that we needed to start a medicine called Coumadin (a blood thinner) for John, but here’s the catch--- while it’s dirt cheap, it takes FIVE whole days to start to work and when you’ve got a giant clot in your leg, you need something to work right away.  So I was also going to need to start something that would work immediately to cover for the Coumadin while it started to work.  That something else is an injectable medication called Lovenox, and besides the pain of it being an injection it’s also SUPER expensive; and I knew there was no way my poor patient could afford it.  So, I went to work looking for ways to find the Lovenox for John.  I checked the clinic and found we only had two doses of the right strength of Lovenox (which meant I would be leaving this guy 6 doses short for the weekend).  I began picking the brains of physicians asking their opinion of what I should do and I called in a social worker to help too.  All the while, I was popping in to John’s exam room from time to time checking in on him, asking more questions, and educating him about his current medical condition.
     Eventually, I was able to find a pharmacy that had a different injectable medication, Arixtra, which would also do the trick and although it was also super expensive, the pharmacy was willing to donate the medication to John!  The only catch was they didn’t have the right strength available and John would have to give himself two different injections of two different strengths to get the right dose of the medication.  So, I traveled to the pharmacy, picked up the medication and then went to work putting together daily packages containing only the medications John would need for each day; so he wouldn’t get confused and underdose or overdose himself.  I then finished by writing out step-by-step instructions for each day such as, “Thursday morning: Give yourself a blue injection.  Then give yourself a pink injection.  Then take 2 of the green pills.”   To go with each individual package.  Finally, after two-and-a-half hours I had found medication to keep John alive and out of the hospital for the weekend and had packaged it in a way he could understand.  Despite being exhausted and dreading the rest of the day as I was now 2 hours behind schedule and my appointments were starting to stack up, I was thrilled to have this happy outcome.
     As I went back to the exam room with a smile on my face and the medications in hand, I was greeted by a very angry John.  As I entered the room, he began screaming at me asking me if I realized that I had wasted two-and-a-half hours of his day.  Didn’t I realize that this was his day off and he wanted to go grocery shopping?  How dare I waste his time?
     I had to fight back tears as I tried to explain to him why things had taken so long and how many people I had talked to and how many hoops I had jumped through to grant his wish of keeping him safe and out of the hospital.  But, he wouldn’t listen to what I was trying to say and after grabbing the bag of medications, stormed out of the office angry with me.
     Now that I’ve had some time to calm down from the frustration, I’ve reflected on my experience with John and I’ve had a remarkable epiphany.  How often do I go through life like John?   How often do I get so focused on how I think things should work out, that I don’t acknowledge all that  behind-the-scenes work Heavenly Father is doing for my own good?  How often do I miss the blessings in my life because they don’t come in the ways I expect?  I think it’s safe to say in the eternal scheme of things, I’m just girl with a 5th or 6th grade comprehension level, who owes her Heavenly Father an apology, because WAY too often I get caught up in my own expectations of how things should go and miss all of the ways He's working to bless my life.