Another good thing about the outpatient service: for the first time since this whole thing started, I had the whole weekend off. Yesterday, I slept 14 hours. Today, I slept only 11. Not for lack of trying to sleep more.
This may sound stupid, but I'm surprised that the patients who don't speak English really don't speak any English at all. Like, they don't even seem to know the word English, or what I'm talking about when I ask them if they speak English. At least we do have the translator phone-- but for most of the things these people have to do, how does someone get around without speaking a single word of the language of the country they're living in? It makes me worried that if we end up giving them a prescription, at worst they're going to have trouble getting it filled and at best they're at risk of misunderstanding the directions on the bottle.
The patients we deal with at the clinic often don't have permanent addresses, or any way for us to contact them. I told a patient to call a particular specialist for a follow-up appointment but found out afterward that in fact the doctor has to call and get the patient the appointment. So I called and got the patient a slot, but I have no way of reaching the patient to tell her when this appointment is. I have to hope she'll call the office and they'll realize there's an appointment on the books and they'll tell her about it. There's nothing else I can do.
There's another patient who we had sent from the clinic to the hospital-- he was having chest pains and we suspected a heart attack. A couple of hours later we got a call that unfortunately the patient died. We had a phone number on file, we called the phone number-- but we didn't get an answer, and there was no machine. The hospital hopefully has procedures to make every attempt to locate and notify next of kin-- but it's hard to know what can be done.
The problem is that a lot of these patients are invisible-- they're here illegally, they don't have insurance, they don't have social security numbers, they're not in any system. We have the information they give us, but it's not like they're in the phone book, it's not like we can find them through government records, and they're (probably) not on Facebook. Maybe some of them are on Facebook, who knows.
No, honestly, it's very sad. It's sad that they have to live their lives in the shadows, and it's sad that even when we're trying to help, and trying to provide care, there's a limit to what we can do.
I will get less sleep tonight than the past two nights, but hopefully I have enough stored up to last me through the week....