What I love about my practice - The Art of Medicine

Journal of Family Practice, April, 2002 by Cynthia Carmichael

Driving to work ... I love the juxtaposition between the industrial area, the oil refineries, the criss--cross of railroad tracks ... and then suddenly the newly constructed single-family homes, little and not-so-little boxes on the hillside ... and then turning the corner, seeing a rooster scurry across the street. And my patient, Mr H, walking in the middle of the street in his blue jumpsuit, wearing the latex gloves I gave him from the clinic straining against his overloaded shopping cart full of recycling.

I love the groups of men standing on the corner ... the churches, empty in the morning, sometimes full in the afternoon, when well-dressed people mourn their losses and the hearse awaits.

Being at work ... I love arriving early and opening the window shades and looking out and letting the sun in. A few minutes of solace before the storm. I love closing the door behind me and being alone with my patient, leaving my world behind, and entering, contemplating, observing, considering, respecting, puzzling over, touching, another person, another life.

I can ask after the children, inquire about the swollen knee, the painful ear, the murdered niece, the many murdered nephews, the headache, the heartache.

I get to laugh and try, sometimes in close approximation to each other. I get to feel the firm gravid belly, and the chubby toddler thighs, and the lump that shouldn't be here or there. I get to lance the abscess and ignore the familiar stench.

I have to deliver the bad news about the HIV test, or the lump that shouldn't be here or there. I have to ,say no to refilling the narcotic prescription that somehow got lost, or stolen, or eaten by the dog, or fell in the toilet, or in a puddle, or blown away, or left on the bus, or all the above.

I have to bear witness to the ravages of heroin, crack, alcohol, of guns, of homelessness, of hopelessness, of futurelessness, of self-worthlessness ... every single day.

Leaving work ... I love knowing the clinic was built on the former site of a popular blues club. A patient once remarked that it seemed appropriate that we should be here, trying to save lives, on the same ground where blood was often spilled during fights at Minnie Lou's. A rough neighborhood....

I love closing the window shades ... and humming a few bars of the blues ... and knowing I'll be back tomorrow.

All correspondence should be addressed to Cynthia Carmichael, MD, Contra Cost Country Health Services, North Richmond Center for Health, 1501 Third St., Richmond, CA 94801. E-mail: ccarmichael@pol.net.