"I have been favored by God, and by those who have a say in what happens to me."

As I am winding down in the last rotation of the first quarter of intern year, I find myself looking forward to my first weekend off since starting. This process has been amazing, hard, exhausting, educational, and life defining. In other words, it's been crazy!

This rotation was a general inpatient month for patients with Kaiser insurance. I went into the rotation not really knowing what to expect. Honestly, I was nervous about the variety of patients I would see. I think I was expecting nothing but privileged individuals that could afford health care and would have the elements of disease seen later in life with well-treated chronic disease previously that reached a point where all the treatments we had would fail. Instead I saw a spectrum of patients ranging from a young woman with severe alcoholic disease to a patient with terribly controlled diabetes who had her life completely changed by a SCRATCH she suffered on her leg that will likely take her life in the next year, and all the way to an old man in his 90's with pneumonia who would transition to hospice (I am beginning to learn why they call it "old man's best friend"). This rotation was actually a really good one for me (even if I am so tired) and I really did see a wide variety of patients and illnesses.

My expectations of those favored enough to have a decent health insurance went out the window almost immediately.  Illness is a horrendously great equalizer.  The uninsured patients get the same diseases that the insured patients get.  I saw beautiful relationships carrying people through their times of illness on all ends of the socioeconomic spectrum.  I saw individuals nearing the end of life alone (and really what does it matter at that point if they had Kaiser insurance or Medicaid).  On a large scale I know how detrimental to a patient it can be to go through a disease process without insurance, but really when it comes down to the day to day, as a physician, I don't want to have to care how they will pay for their treatment. I want to be a hand to hold when they are scared, I want to be a teacher about an illness or treatment, I want to be a bright spot in an otherwise dark time.

Thanks for reading!
~vaya con dios