“You can see her in this room, Dr. Johnson.” The caretaker of the women’s shelter was glad that I had come to examine some of her residents. She politely escorted Felicia and me away from the crowded gathering into a small side room. “You will be able to hear them from here, but they won’t be able to hear you talk with Felicia.” All the residents were anxious to see the doctor; there just was not enough time to interview and examine them all that day.
This is a halfway house for women as they transition from jail or prison. Some are escaping violence in their homes or avoiding life on the streets, where they are forced to sell their bodies for food and shelter. This place is safe. Here, they can find the consistent comfort of blankets, caring providers, and, for today, a doctor visit.
Once we were alone, Felicia stood before me, her arms shaking like the limbs of a tree caught in a violent wind. She paced in place like a sprinter getting ready for a race. Then she opened up: “All I want is to stop the voices. I have not had enough of my medicines since I was released from prison two weeks ago. They only gave me just enough medicine till I could see a doctor. I don’t have insurance, and I don’t know any doctor. I have been afraid of using all of my medicine because I did not want to run short. So I only use it when I hear the voices. They are beginning to whisper now.”
In order to keep the voices at bay, Felicia devised a plan to make her medications last a long time. She was desperate and knew a psychotic break would happen if she was not medicated soon. The scenarios for using prescription drugs are as varied and confusing as the stories of the almost two dozen women in the room we left behind.
I am no psychiatrist or psychologist, but I do know something about compliance when it comes to taking medicines. I never advise a diabetic to take medicine when nearing diabetic coma or a hypertensive patient to wait for onset of stroke to do likewise. I know that waiting to hear voices is not optimal therapy.
This type of care takes a team approach. I asked my wife, Kay, who is the clinic administrator, to pursue getting a release of medical records from Felicia’s most recent emergency room visit. I reviewed the records and discussed the medication regimen with Dr. Pitts, our clinic director and clinical pharmacologist. Together, we consulted his wife, Pat, who is a practicing psychiatric nurse. She helped us formulate a plan that will readily renew the prescriptions.
I have studied and managed illnesses and diseases for a long time. However, providing healthcare for prostitutes and drug addicts is new to me. Then, of course, there are the people who have been recently released from incarceration and cannot afford their medications. Medications which, if they could afford them, would slow their organ failure, prevent infections, clear skin rashes, elevate their mood, and, of course, stop the voices.
My duties as a physician at Miriam Medical Clinics have brought me face to face with this reality. It's a rather complicated community, but as we gather around the common cause of health, I am reminded that God doesn’t always call us to clean, safe ministries. As I ponder what patient God will have me consult with next, I can rest in the assurance that God has a plan for each one and offer praise that for Felicia, the voices have been stopped.
Maybe once the voices are gone completely, Felicia will get the chance to hear His call.
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