I think my heart is breaking, a little.

[Aristus]

It's so hard to stay objective in this line of work.

I have one patient, she's a prostitute and a heroin addict. And she has some serious issues with depression. She muscles her heroin, and she's in every couple of weeks to get an incision, drainage, and some antibiotics. She's always at least a little weepy and anxious, but yesterday really tore me up.

When I entered the exam room, she was distractedly putting on her makeup, and crying. I couldn't get her to give me a history of her current condition. Foundation, powder, lipstick, even mascara, even though it ran continuously, since she was crying the whole time. She finally took a minute to show me her new abscess; a little swelling and redness, but not ready for incision and drainage. Some antibiotics and a few days of warm wet compresses would take care of it. Then she went back to her frantic makeup application, still weeping. She even brushed some polish over the onychomycosis on her fingernails.

I got her taken care of. But when I finally had a chance to think about it, the makeup seemed to me to symbolize her human dignity, her sense of self worth. I can only imagine what a horrible train wreck of a life she must have. And I can't get rid of the image of her crying and compulsively applying her makeup, as if, fully made up, her life wouldn't be so awful.

Maybe that's some poor dime store analysis there, but that's my take on it.

I love what I do, but it can take a lot out of you...

Thank you for listening.

[CaliforniaPeggy]

1. I hear you, my dear Aristus...

My hospital nursing never brought me a patient like you had today...

It was a community hospital, and people like her just didn't go there.

Still, your writing is so damn vivid, I can see just what you're talking about, and it is heartbreaking.

Maybe she was using the makeup to cover up the pain she was feeling? That it could somehow change her life?

No idea...Hang in there, sweetie...

:hug:

[Kali]

2. that is heartbreaking

so much of it is ignored by so many, thank you for doing what you do for her and the others "we" don't want to think about

:hug:

[bluesbassman]

3. Sometimes the facade takes the place of who we really are.

God only knows the steps that have led this poor soul to her own version of hell. My heart aches for her.

You're a good man Aristus, my hat's off to you for what you do.

[Aristus]

20. Thank you, bluesbassman.

I can't bring myself to forgive Ronald Reagan for stating that homeless people were homeless "by choice"; but I will agree that a series of bad choices unrelated to homelessness can lead to homelessness. It's also not my place to judge the homeless for their state in life. To me, they're patients. And I will advocate for the rights of the homeless to my dying breath...

[tblue]

4. All the lonely people, where do they all come from?

Thank you for caring about her. The makeup must make her feel more presentable, like a mask to hide herself. The song Eleanor Rigby comes to mine: "the face that she keeps in a jar by the door...". Oh how sad. Poor thing.

[PassingFair]

5. But prostitution is so EMPOWERING! How dare you pity her!

:sarcasm:

Thank you for caring.

The fact that she can still cry
shows that she still cares, too.

:cry:

[seabeyond]

8. i was thinking the wrapping it up in a neat bow of pretty woman.

this is reality.

sigh...

a sad story

[La Lioness Priyanka]

13. starving to death to support her heroin habit is clearly better. nt

[Odin2005]

6. !!!!!!!!!!!!

:cry:

[TuxedoKat]

7. Is there something we could do to help her?

I feel so helpless. This is one of the saddest things I've read in a long time.

[Denninmi]

9. I blame a lot of this on the right.

Seriously. If we had a proper social safety net and sane laws on issues like drugs, we wouldn't have so many people that fall through the cracks. Of course there will always be some level of dysfunction, but I suspect it would be a lot less. Imagine a world where first of all, drugs aren't illegal, so those that do choose to involve themselves with them at least don't have to turn to crime to support their habit. Imagine a world where we have better drug treatment and prevention programs paid for by the taxes raised from the profits, which no doubt would still be substantial, made by agribus on legalized drugs, which after all are just more farm products when you boil it down. Imagine a world where the "lower classes" aren't treated like some kind of animals.

"Imagine all the people, living lives in peace"

Too bad we don't live in that world, but in this fundie hellhole.

[redwitch]

10. You are such a good man.

And that is a really sad story. You do what you can, sometimes it won't be enough to fix it. Heroin and depression together and still she wants to present her best face. Poor tragic lady. :cry:

[Bunny]

11. I'm wondering if it wasn't something different.

Maybe she had to put on the makeup and do her nails so she'd be appealing to her customers, and maybe the thought of having to suit up and do that again was just too much for her on that day. Either way, it's pretty sad.

[Aristus]

21. You know, Bunny, I hadn't thought of that simple and rather logical explanation.

I'm sure you're right about that. But the image in my mind of the incident seems fraught with so many unspoken meanings...

[applegrove]

12. You are a good egg. As long as she is still alive there is hope that she can turn it around.

[La Lioness Priyanka]

14. what does muscles her heroin mean? and what is onychomycosis?

:hi: :hug:

[Aristus]

15. She injects it into the large muscles of her body, butt, thighs, etc.

I tell all my IV drug-using patients: even if you don't re-use your needles, even if you exchange them for clean ones every time, even if you don't share needles, you can't control what goes into the junk, or black tar, or cheeva, or whatever. There could be anything in that crap. So, I see lots and lots of abscessed skin infections.

Onychomycosis is nail fungus; that yellowish-green stuff that distorts the nail surfaces.

Thanks for the hug, Lioness; I needed that... :hug:

[La Lioness Priyanka]

16. poor girl. what a terrible state to be in

[suninvited]

17. Maybe the makeup

is to cover the ugliness she feels inside.

Some of the most messed up women I know won't walk out of their doors without a face full of makeup.

[Flaxbee]

18. .

:hug:

So many people turn away, Aristus. You don't.

I've been pretty devastated before - not dealing with her lifestyle, but emotionally just ripped apart - and done the same damn useless thing. Kept putting on my mascara as tears messed it all up.

Something about preserving a bit of normalcy. Or routine. Or armor, even when everything inside you is cracked.

My heart goes out to this woman, and thank you for your kindness and compassion, Aristus. I hope you treat yourself gently after days like this.

[Aristus]

22. Thank you, Flaxbee.

On the first day of Physician Assisting school, we students were asked why we wanted to get in to Medicine. My response was rather paradoxical: I got in to Medicine because I can't stand to see people suffering. It would seem logical enough to avoid a profession that exposes one to so much suffering. But I'm glad I made the choice that I did.

:hug:

[grasswire]

19. you are a witness

and you are a natural writer. You could lend some meaning to these lives by journaling, and perhaps by writing something for publication. I can think of several magazines that would be eager for a first-person account like the short bit you wrote above.