Tender Mercies, Inc.

Natalie Hood, Summer 2013

Over the course of this summer, Chris and I focused on addressing the most common health conditions of our residents: obesity, diabetes, and hypertension. We taught 2 educational and 2 exercise classes per week. Additionally, we hosted regular drop-in “clinic hours” in which we provided health screens and education with regards to basic health concerns.

Far and above, my most rewarding moment this summer was during a health screening. We had a resident stop by the drop-in to check his weight, blood pressure, and blood glucose. He had the trifecta- obesity, hypertension, and diabetes. All undiagnosed. We promptly got him connected with the McMicken Health Collaborative for the Homeless and took him to each appointment. Prior to our intervention, this resident was walking around like a ticking time bomb- just waiting for things to worsen enough to be noticed. Our screening caught him before that point. It's stories like his that made this summer feel so fulfilling.

This summer was eye-opening regarding the challenges that physicians face in motivating and engaging patients to take charge of their health. In every interaction, we stressed the importance of engaging in regular physical activity and proper nutrition. We taught the classes, gave tips, hosted workouts, and went on walks. But each week, residents ate poorly and continued their sedentary life styles. At times, I found it both exhausting and frustrating to advocate for people I'd come to genuinely care for, only to watch them apathetically disregard my efforts.

I think it has been very representative of the experiences many physicians have with patients struggling with weight-related health concerns. Every physician will come across patients that are making lifestyle choices against his/her own best interest. We're going to fight against the diseases, but at times it is going to feel like we're fighting against the patients. It's important to have the ability to delegate those situations with grace, composure, and understanding. It's not enough to try different teaching tactics; you have to step into their lives for a moment and see from that perspective. For example, so many of our nutritional advice had to be modified around the realities of their health barriers. Equipped with small mini-fridges and even smaller funds, our residents couldn't realistically take on much of the advice we had planned. We had to adjust. I'll have to keep adjusting for the rest of my career.

I realized that this summer was less about me impacting the residents; instead, it was more them molding me. I learned how to be more of what this particular patient population needed. Working with a formerly homeless population is an incredibly unique experience. Our residents' mental illnesses took a backseat to the damages homelessness had wrought on these individuals. Being homeless had changed the way these people interacted with food, authority, and especially with the medical community. I often sensed a general mistrust- sometimes even some hostility- from our residents. I saw how important it was for me to be consistent, compassionate, and honest. I couldn't undo any of the damages of being stereotyped and overlooked. However, I could begin to create a new dynamic. As a representative of the medical community to these people, I strove to be approachable and friendly. I tried to show our residents that no matter their problem or attitude, I would always be on their side and working in their best interest. Lastly, and of utmost importance, I treated them with respect.