Model stories written by young professionals/students.
Our backgrounds and upbringings, for good or for bad, are things that we did not choose and cannot change. So much about our lives is simply out of our control. Sure there are things that we can do to better ourselves and we can take steps to improve our circumstances in life, but it still remains a fact that we are never fully in control. If we were fully in control of our lives I’m sure that no one would choose to be poor, disadvantaged, or ill-treated. Life just sort of happens, and sometimes when life happens we find ourselves struggling to survive in impossible conditions.
I spent some time this week shadowing in a clinic. I was observing a program designed to guide pregnant women with substance abuse addictions through their pregnancy by providing them with anti-addiction drug prescriptions, prenatal care, and therapy sessions. These are women who, for whatever reason, have made some obvious poor decisions and now find themselves facing dismal prospects. They have chosen to participate in this program on their own; there are no court-mandated participants. However self-destructive their behavior may be, it cannot be said that they do not wish for a better life. These women are battling their addictions and attempting to better themselves.
I was able to observe the clinic functioning and attempt to take it all in. It quickly became apparent that some of the biggest issues threatening to impede the success of the clinic, and the success of the patients themselves, were outside factors. Social determinants of health come into play here. Many of these women live in poor, drug riddled, neighborhoods; some are even homeless. Living in these poor conditions, where temptation is literally at the door certainly does not make the quitting process any easier. The social workers present discussed some different avenues they might investigate with the patients. They mentioned helping patients seek placements in group homes and shelters and seek out government assistance.
I sat in and listened as the doctors and social workers on staff discussed the caseload for the next day. They discussed their knowledge of the existence of these issues and told me that these factors are among their largest concerns. If the patient falls prey to temptation their health and the health of their unborn baby could be in jeopardy. If they are abusing drugs while taking the prescribed narcotic the results could prove fatal. The clinic takes precautionary steps by conducting urine analysis and lowering prescribed doses if the patient presents signs that they are not taking the prescribed dosage; this helps deter prescription abuse.
However, there is also the issue of transportation. There are several meeting requirements that have to be met in order to remain in the program. If the patient is without transportation, relying on public transportation, or homeless, they will probably have some issues with attendance. These social determinants of health impact their access to proper medical care and may in the end result in their premature termination from the program.
It saddens me to think that here are these women, who have led incredibly hard lives, and they are taking steps to try and better themselves, to end the vicious cycle, but once again things out of their control come into play and spite them. Life just happened. It was an eye-opening experience to say the least. I hope to one day be a family medicine physician so I realize that substance abuse cases will be prevalent in that field, especially in a rural medicine setting. As is the case with most aspects of medicine these cases will have to be handled sensitively. I am glad that I have had this opportunity to see how other medical professionals are handling these sensitive issues and treatments.