May 7, 2009
So, today I was taking a leisurely stroll from my ethics conference back into the big hospital. I saw a patient that I know all too well. She was leaving the hospital against medical advice. I knew this because she has a sitter watching her to avoid her leaving. She found a way to escape! The only problem with this is her severe mental illness, her chronic medical condition and her need for thrice weekly medical interventions that keep her alive. The other problem is that she had an IV in her that could kill her for a number of reasons and a violent boyfriend we had been keeping away from her in the hospital. She is young, about my age. She grew up near here and I knew her family when I worked in CPS. Her foster care file was too big to carry. Her childhood, and adulthood for that matter, read like a horror story. So, it’s no wonder she has some mental issues now. It’s no wonder she has a fatal sexually transmitted disease and it’s no wonder she has an addiction she uses to suppress the horrors she’s endured. This is a young woman whose only difference from me is a safe, stable home environment and a family that loved me, fed me, cared for me. Life is so unfair.
So I walked with this gal, trying to convince her back to the hospital. I tried to distract her with offers of clothes or some money for the snack machine. I would deter her for a minute but she kept walking. Knowing her history of erratic mental outbursts, I stayed a few steps behind. But also knowing that if she left the hospital she would die on the side of the street, I kept walking. I will say that there were many breakdowns in this hospital system that allowed this lady to walk out of the hospital. I will say too that I kept waiting for security that I dispatched who never arrived. I pursued her until she had enough. At a corner in downtown , she let me know in no uncertain terms that I should back off. I did.
A few seconds later, I realized that instead of dispatching SECURITY, an employee instead sent two nurses out to look for the patient- as if those two nurses and a spunky social worker could wrangle her down and pull her back to the hospital against her will. Yeah. Good thinking. Against our better judgment, we walked. I had an idea that she might be at a place she could get her check. We walked the 10 blocks and didn’t find her there. After giving up, we took a shorter way back to the hospital and saw her in front of our faces sitting on the porch of a church, smoking a cigarette. I realized that if she saw us, she would run and I wanted her to stay put. We called the police and will find out soon whether or not they were able to bring her back in. Legally, they may not be able to do this. I’m hoping they will care more for her well-being than legalities but time will tell.
A part of me laughs, that this is another day as an inner-city social worker. A part of me grieves for this girl who, given what I had as a child, would have a very different life. I pray she ends up back in this ER tonight, because if she doesn’t, I fully expect her in the ICU or worse within days. After all the hell that has been her life, I do not want her to die that death.
I write this so that I remember these stories, the ones that marked my early days as a social worker in the nitty gritty of humanity. And I write so that anytime I find myself praying for the poor, I have a face to imagine, a story to honor.