Tuesday, September 11, 2012

Our Stratified Society

I'm starting to suspect that there is a great divide in our country. It's not along the lines of race. Or income. Or even education.

Because we can always find common ground among those of different races, religions, income levels and educational attainment. I have no problems talking to my patients who were raised in other countries, who only have a 4th grade education and cleaned houses for a living. We can find plenty to discuss. Our children. Our families. Cooking. Places we've visited. Hobbies. We can laugh. We can talk of regrets. Share funny stories.

But there are people I meet that might as well come from another planet. Some of them are white. Some of them are educated. Some of them were raised in middle class Christian families, like mine.

Its hard to describe what they have in common... But they all seem to be rule-breakers. Not in a good way. They father children but don't support them. They scoff at medical advice. They blatantly ignore expert advice, like "Don't stand up on that leg. It's held together by pins. It won't heal if you stand on it now." They drink themselves into stupors and fall down stairs. They try to evade police on their motorcycle at 90 mph and get thrown a few hundred feet when they hit a car. They refuse to manage their diabetes and show up to the hospital mostly-blind, in need of bilateral foot amputations. They refuse to participate in physical therapy. The therapy that would allow them to walk again. They mock us for trying to help them. How dare I want to help them get out of their bed and living on their own again?!

I do not understand these people. They fill me with great sadness. Ignorance is one thing. But willful ignorance and overt resistance is another. Their rehab potential is limited. Only because they don't truly try. And I struggle to find compassion instead of taking offense. I'm willing to go to the mat for all of my patients. But if they won't go to the mat for themselves, what can I do?


  1. Ditto from my side of the therapy specialties. Ambition and pride are somehow under-related when pride blocks ambition and potential for improvement. 'Why doesn't Medicare Pay for someone to clean my house?' is what I hear from my patients. Are you too proud to accept my help but wouldl love someone to scrub your disgusting toilet? Does your ambition suffer so greatly from the prideful unwillingness to test failure, to step out, to get in the mud with the rest of us? No, I would rather, myself, pine over your every medical need; worry about your potential to return to prior levels instead of you appreciating my efforts. Your prideful inability to lift a finger in response is suffocating our nation and I am personally exhausted from keeping your health as my emotional, professional, and financial responsibility. Thanks to God that those of us who are therapists don't need external reinforcers. We are but the hands and feet and work through divine strength in caring for our patients. Bravo...

    1. Sigh. A patient of mine a few weeks back gleefully asked, "Hey, you think this will qualify me for permanent disability?" He was an alcoholic and drug addict before his small stroke. He was in his late 40's. I had a hard time not saying something nasty to him. I just can't understand why someone would be excited about going on disability. I just don't understand.