If I took all the patients I have seen and put them along an elastic spectrum, I could not stretch it far enough to encompass the contrasts in characters that I have encountered. The contrasts within this multitude of humanity are as bright as the sunniest day and as dim as the prospects of one of them rising above the genetic lottery.
During any given week I may see and treat a Nigerian boy who has barely learned to speak a bit of English, an old Southern farmer with tiny islands of blue eyes in a sea of sun-damaged skin, a shoulder-stooped Cuban man formerly a prisoner under Castro, a homeless skinny black guy washing his feet in the exam room sink, a boy from Wauchula or Arcadia being dragged in by his sleepless mother because his skin has peeled off from eczema and he has missed most of the school year and scratched and hollered every evening, a Haitian woman who arrived on our shores by boat in the middle of a moonless night, and any number of those whose skin cancer or psoriasis or itching has gotten to be so out of control that they have grabbed onto my office exam table like a buoy in the Atlantic during a hurricane and will not leave until they finally gain relief.
I hear the accents that curve around words, the nasal New Yorkers, the machine gun fire voices of Puerto Ricans, the haunting tone of former Russians, the halting staccato of a Syrian woman with one eye glazed over and the other slanted toward Mecca. I see the plastic rings around the wrists of the teens and the peace signs on their ripped pants. The parchment of skin is filled with visual stories–the tattoos that stretch over the multicolored skins, from alabaster white to speckled salmon. The ones with gold teeth and little sparkly diamond earrings and shiny silver crosses over cleavage. The room is filled with smells—the scent of outdoor workers in their stained shirts, the perfume of an older woman, the stinky feet of a teenager. Some with parched earth dry skin and others that have sweaty palms that drain like tiny faucets. One island guy had a head so small it reminded me of a shrunken head dangling from a black thread, his head so impossibly tiny that you could not imagine it on his broad shoulders unless you actually saw it as I did.
I prefer the “give me your tired, your poor” immigrants on any day of the week, with their just getting along by the skin of their teeth jargon, over the erudite utterances of the well-bred and highly-schooled with fleeting problems the size of diatoms that have disrupted their ancient Greek self-concepts. I live to serve the truly indigent with major impediments to a healthy life, the ones that struggle every day and come to me after years of no insurance and less medical care and fill my ears with stories I want to capture and woes I want to heal.
As a measure of my days, I take down the stories and desires filling the exam rooms and extract each onto paper and into computers. I offer treatments and explanations for maladies, and give my best wishes for safe journeys and good health. Please join me on my journey.