“I Have No Money”

Alternative title: Case of Middle Class Guilt

Coming from an upper-middle class family, I have never had to worry where my next meal was coming from, or if I could afford to see a doctor (although, ironically, I hate going to the doctors).

In my profession as a doctor, and especially working with a diverse population of patients, I see the full range of socioeconomic levels – from homeless to fully insured and everything in between. This always adds a level of complexity to how I manage their medical problems.

For some reason, the patient encounter I had today really affected me.

A patient, coming in for an acute visit, casually mentions that she doesn’t have any money – could not afford this visit copay and literally can only afford cereal for dinner (as her only meal of the day). The only decent meal is from a food voucher during her volunteering in the hospital once a week. She uses heating pads to keep warm (and drinks tea), otherwise she has no other reliable source of heat. I thought back to last week during the polar vortex. I thought I was cold, in my cozy, warm apartment. She is also such a sweet person. Not that this should matter, but you know it does.

I used to jokingly talk about “not having money” or “not being able to afford something”, but the truth is, there are many people for which this is actually true.

Even now, I never need to check my bank account before buying anything. I don’t worry about buying food or clothes. I come home to a home with central air and electricity and don’t have to worry about staying warm or cooling off. Basic things to which I never give a second thought.

After clinic today, I went to Target to pick up a few things. My mind was still stuck on this patient. I felt guilty picking up a carton of Lactaid milk. I felt guilty for even being in the store. It felt wrong. The lump in my throat remains, even hours later as I reflect.

I can’t change this reality (at least not overnight).

I will try not to take for granted the things that I have and the worries that I will never have to experience.