Before Lunch

Long week of "chronic care" patients. Nothing exciting enough to jump up and down about. Nothing funny enough to laugh out loud about. Nothing depressing enough to vent about. Just a long week of HIV, Hep C, DM, HTN, chronic pain, and hypothyroidism. OK maybe a bit of subconscious venting there....

I went with the doctor to the special housing unit where patients are on lock down 22 hours a day, and can walk back and forth in a little kennel like structure for the other 2 hours. We practiced medicine in what seemed like a dusty closet. A musty concrete smell clouded the body odor. I could hear the showers down the hall from where I was seeing patients. The whole building echoed loudly with the sounds of guards and radios and showers. The orange of the inmates jumpsuit was a sharp contrast to the gray and white metal of the cells, the floors, and the handcuffs they wore throughout the exam.

Awareness of surroundings is critical in this environment. But this heightened attention creates a shifting of senses. The mindfulness leads to a sharpness. The background becomes just as important as what as in front of you. The ink scratch.. of the tattoo.. on the arm.. of the patient.. in the jumpsuit..on the table.. in the jail cell..with a window..to the outside..with it's blue sky....all individual pieces that make up the terrain that my senses navigate.

Then I went to lunch.