Those left behind…still

Today was my house call day…or half day.  I wish it were a full day.  Or a whole day.  Or a few days of my week.  I love my home visits.  My patients are largely the forgotten ones.  The ones who spent hours under the sun as children, playing in cops and robbers in the dirt, their mommas calling when the lights came on, years raising kids (older, forgotten versions of themselves), and now they have shrunk down into brittle memories of their parents.  They can’t get to the office and most don’t have family to shuttle them into our office.  They have outlived their “people”.  So they have me.

The first house was to what could clearly be something right out of a Hollywood haunted house movie set.  Dilapidated two-story.  White paint worn off the wood decades earlier.  Second story windows boarded up.  Front porch screens torn.  Sometimes Cecil answers the door. Sometimes not.  I pick my way across the broken floorboards and stray-not-so-stray cats and carefully sit at his table so we can chat about what ails him.  He is forgetful and usually refers to me as “that nurse”.  I know he’s secretly happy to see me.  I’m pretty much all he has these days.

The next house is a brother/sister team who have more ailments than I have time to list.  And some of them painful.  Their house smells like something illegal.  I ignore it and take my migraine medication as soon as I get back in my car, leaving the window half-open so my other patients don’t finger me.  Narcotic medications are so tightly regulated, they can’t get them from their specialists.  This is what happens when too many prescriptions were written then narcotics were getting into the hands of the wrong people and then legislators had their usual knee-jerk reactions.  Patients who were good, honest people now suffer.  They can’t make it in to pick up a monthly prescription.  Nor can they drive every thirty days to their pharmacy.  Because they can’t drive anymore.  A neighbor checks on them once in a while and they get meals on wheels.  It would be an ethical violation for me to prescribe and pick up their narcotics.  Of course, not unless something happened.  But in this day and age, who wants to risk their whole life and license?  So as long as I don’t see it, I don’t say it.  No harm, no foul and they are not in writhing pain.

The third and fourth houses are much of the same.  These are the forgotten people.  The invisible ones.  The houses we all drive by, the ones which look almost vacant but not quite.  We wonder who lives there from time to time as we zoom by on our way to work, to run errands, to pick up our kids.  What I wonder is, what do those next door neighbors think?  What do they wonder?  Do they wonder enough to drop by?  To clip the bushes?  To cut the lawn on a regular basis?  Not ask, hoping for a polite turn down, but just get up on a Saturday and just do.  Who brings them food?  Who takes care of them when they outlive their family?  Close friends?

They don’t all go to nursing homes.  Or to live with families.  Or drop dead the moment they have ceased to be able to care for themselves.  No.  They are forgotten.  Forgotten too much, too often.