Syracuse, NY 13210
Volume 7, 2007
It's five o'clock on Wednesday night. It's shut down time.
Dinner? Check. Changed? Check. ID? Check. Bug spray? Check. Keys? Check. Drugs?
Great—load the car without acquiring anymore bruises on your legs or sweat down your back, you just changed your shirt so try to keep it dry before you get to clinic. But it's ninety plus degrees and humid—
Just be thankful you weren't out hunched over in the scorching hot fields all day picking strawberries and blueberries just so all of suburbia can have their decadent summer fruit.
So suck it up, load the car with the three thirty-pound boxes of cure, and get to Jefferson.
It's six o'clock on Wednesday night. Who's here and who's still coming?
The coordinators here? All five? Yes. Check. All MSII's here? Check. Translators?
Check. Residents? Check. Faculty? Check.
Pick a car and let's roll. It's so hot and humid and my stupid car has no A/C and I only think I know where I’m going with a car full of people I know from school or clinic or whatever—
Just be thankful they all speak your language and you can have conversations without confusion and communicate exactly what you mean to say and that you are at least traveling in your own country even if you don't know where you are going you at least know where you are which eliminates any apprehension you might have about the situation and if you did have questions about anything you wouldn't be afraid to ask for directions because this is home and not some big foreign country that might not want you here.
It's 6:40 on Wednesday night. It's setup time.
Tents? Check. Lights? Check. Tables? Check. Supplies? Check. Files? Check. Drugs? Check. Water? MINE, I mean, Check.
Is everyone here? Yes—well don't just stand there, get moving and pitch a tent or something…hurry up, group meeting in five and then we start—MOVE.
Just be thankful you're the one setting up and not the one waiting to be seen because you think you have that thing you know that scary virus uh HIV is it? Because you have this rash on your arm and you don't know what it is or where it came from but your friends tell you it's probably HIV and that you should get it checked and you know you've been having unprotected sex but is that really what it is it's just a small rash it's not like that other guy with the spots all over him maybe he has HIV too if anyone had it, it would be him because look at him he looks worse than you.
It's seven o'clock on Wednesday night. It's show time.
In-take ready? Check. Care teams ready? Check. Pharmacy ready? Check. Out-take ready? Check.
Let 'em in, folks. Ahhh, finally a reprieve for me. My pharmacy is set to go, but it will be awhile before I receive my first prescription to fill, which means I can hang out, dry some sweat, and drink some water during my calm before the pharmaceutical storm.
Just be thankful this little time-out is to wait for scrips from patients and not to wait to be seen by the care teams because you think you might have HIV because of this rash thing and while you wait it's with some white stranger walking you through all those white forms and then asking you a bunch of questions you don't always understand and hope you that you give the right answers while they squeeze your arm and pinch your wrist to get some numbers that they tell you are bien and you just smile because they seem really nice even though you don't know what the numbers mean and then you wait to go into a tent.
The eye of my hurricane continues as my eyes capture every moment around me. I feel like I am in my own calm with everyone hurriedly scurrying around, trafficking patients, filling out paperwork, making supply runs, take vitals, and simply sweating. Everyone is quitting their nightlife to continue their day job in the name of humanity. I savor this moment of calming chaos because I know the selflessness of medicine will not always be as evident, if present at all, in the hospital on rotations or during residency . . . .(Pharmacy, you have a call in Tent Five, please. Pharmacy, call in Tent Five. Thank you.). . .
It's 8:15 on Wednesday night. It's fix-lick-and-stick time.
Boxes open? Check. Pill counter? Check. Vials? Check. Labels? Check.
Ok, where's the scrip? Wait, there's no quantity, how many do you want? I know we have it here somewhere, I'm trying to find it.
You want ninety tabs? (Good thing I count fast). No, I don't need help (I've been busier). No, I really don't need help (I work retail, this doesn't even compare). Ok, fine I'll take help (because then people will leave and everyone is happy). I know, I told them I didn't need help. Yes, we have Bactrim DS. No, we don't have Flagyl, but we can get it (great, I hope he can live without cerveza for a week). Yes, I can give it to David like last time. No, I don't have condoms, I gave our stash to the nurses at out-take. If we fill it at the hospital, I need the scrip on an official blank. We don't have enough ibuprofen 800 mg, 600 mg ok? No, condoms are at out-take. Interpreter please! NO, I DON'T HAVE THE CONDOMS (what kind of farm is this?). Thursday at 2:30 is fine. (I hope I'm not the last one out again). You hope you're not the last one out again?
Just be thankful you get to leave at all you could be one of the patients and have to live here and work here and you're worried about being the last one out? Maybe you should worry more about what you're doing like dispensing medications to people who need them people who can't sleep at night because their back pain is killing them from being hunched over all summer or their indigestion is keeping them up or the thought of having HIV is worrying them and they can't sleep maybe you have these nasty bumps covering your entire body and you don’t know what they are and the medicine you need they don't have and who knows when you'll get it and you would have liked to have seen someone sooner but you didn't want to be sent back to Mexico because you need this job to send money home to your hijos and if that happens you may never be able to come back here to work. . . .
It's ten o'clock on Wednesday night. It's closing time.
Everyone have their scrips? Check. Everyone been counseled? Check. Everyone sign? Check.
This is the last scrip, I just need to finish the label and have him sign for it. No, don't take the tent down yet, I'm almost done. Ok, I guess you can take the tent down (it was keeping the bugs out, but if you must). No, the boxes can't go yet, I still need to put stuff in them. Ok, where did he go, he needs to sign. Firma aqui, por favor. Gracias. Yes, that can go. I think that's it, my car is loaded thanks to my helpful colleagues and all of my passengers are gathered and ready to go. Let's roll, but let's pick the right on-ramp this time—690 SOUTH. On the road again—
Just be thankful it's the road to home and not the next farm and that it's the road south to Syracuse and not the road to the South for the next round of growing season although as long as you keep migrating around the farms in Los Estados Unidos at least you know you're making money to send home and then it's not so bad as long as you don't get deported even though you do miss home and wish that you could be there with your family.