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The Caregiver

Evanelys Darias

M3, FIU Herbert Wertheim College of Medicine.

It was a hectic Monday afternoon on the Mobile Health Clinic as I flipped through my white coat pocket notebook to familiarize myself with the next patient waiting to be seen. The encounter begins as soon as the patient walks up the steps of the camper bus and is invited into the very snug space. I could not help but notice that he appeared sweaty and restless. He was anxious. It had been three years since the last time he visited a doctor. The staff began taking his vitals and commented on his elevated blood pressure. He mentioned to them that he had walked to the appointment as he lives in the trailer park community where our clinic was stationed that day.

I took a few steps over to his chair and with a warm smile introduced myself as the medical student working with the team. He immediately looked at me and said, “Tu eres Cubana, no?” (“You’re Cuban, no?”). There I was living the dream. In my first clinical rotation as a medical student serving my community. A day I had dreamt about for as long as I could remember. In that moment he joined and celebrated that sense of pride with me. We spoke Spanglish the remainder of the visit.

It did not take long for him to begin sharing his story with me. He began by confessing that he was nervous about today’s appointment. He knew that as a diabetic with hypertension, he had been neglecting his health for far too long. This is because he had other priorities. For the last five years, he has been the sole caregiver to his 86-year-old mother who requires dialysis three times per week. Within the first five minutes of meeting me he shared intimate family dynamics. He had tears in his eyes admitting that he had not spoken to his brother in years because it hurt him to not have his support in the care of their mother. “That’s our mama. Its not right for him to walk away like that and expect me to take it all on. I have my own problems; I worry about my own health”.

I commended him for being the son that he was and acknowledged how difficult this situation must be for him. He did not hear this often enough. We agreed that he had to help himself to be able to help others, so we discussed at length his health goals. For the remainder of the visit, we focused on him and made his health our priority. We particularly focused on his medication regimen and mental health.

I took some time to share with him information on Diabetes and ways he could prevent further complications. Although Diabetes was such a significant part of his life and his family’s, he noted that doctors normally did not find the time to educate him on the topic. Being a medical student is not always a glamorous job but days like these remind me why I chose this career. I am here for him and all my patients. To empower them with the knowledge they need to become advocates for their own health.

We discussed with him plans to order lab work and schedule a follow up visit. I had the opportunity for further continuity of care by drawing his labs. He joked as I placed a band aid over the area that I was “todo una doctor” (“a whole doctor”). This patient encounter stuck out to me because I felt I was making a difference and flourishing into a culturally competent physician. From this encounter I will take with me the importance of simply listening to your patients because there are psychosocial factors affecting their health beyond what the eye meets.

About the artist: I am a proud Cuban-American, Florida Gator, and current M3 at the FIU Herbert Wertheim College of Medicine.

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