Yesterday, a chronic low back pain patient sits across from me. "My back has been killing me for the last few days, since I ran out of my meds."
He is one of the few who has the privilege of having a primary doctor, this area of IHS being severely understaffed. "When is your next appointment with your regular doctor?" I ask.
"Oh, I missed my last appointment, and they were going to set another one up for me, and I haven't heard back from them. That was in September." September? That's almost two months ago.
I pause for a moment and try to sort out the right thing to say. I've heard lines like this so many times in the past month. There's a bunch of thoughts and emotions spinning around in my head, and I'm not sure which direction to go.
"Look, I know the system can be difficult, and I know sometimes you might have limited communication resources, but this is your health and therefore your responsibility. If you don't hear back from them, call them. And then call them again. You've had two months. I know it would be nice if everything would be done for you, but it is and will always ultimately be your responsibility."
He nods graciously and doesn't seem overly put off by my miniature rant. I pray for the ability to be merciful as I walk out the door to work on his paperwork.
There's another chart waiting for me at my desk area. "Dr. McLaughlin, this is a patient you had instructed to follow-up today, and he didn't show." He is a new diagnosis of diabetes, and terribly symptomatic from it. There's a form for me to fill out, as to whether I called him or sent him a letter, and what follow up he needs. What does he need? He needs to show up for his appointment! If he doesn't care enough about his own health, why should I? The words of Cain spring to my mind, "Am I my brother's keeper?"
Important aside: Domestically and abroad, the question of how aid work can stifle initiative and responsibility is an important one. I haven't decided whether my actions or my words were inappropriate, in and of themselves. But that's not the point at present. The point is this:
I tell this to Rachel over a dinner of a precious jar of curry we imported from Phoenix, wanting her to agree that I'm in the right. "Hmm, that doesn't sound very compassionate," she says softly. She also reminds me that this is likely to be all the more potent in Africa, where we have been told (i.e. warned) that losing your temper or speaking in anger is the greatest of cultural sins, and is the quickest way to sever ties with Africans.
Paul says "speak the truth in love." I'd like to think that being right is enough, but it's not.
Bob Lynn is fond of pointing out that the Good Samaritan parable was in response to the question "Who is my neighbor?", and Jesus gives the answer that we are to extended neighborliness wherever it is needed. Am I my brother's keeper? Maybe not by any natural right, but as a Christian, I make others my neighbors, and accept the responsibility that comes with that.
I am grateful that I have a month more to work on this, prior to heading to Kenya. Could this be the reason why God brought us here? I won't presume to say, but we're here, and "as long as it is called Today, let none of you be hardened by the deceitfulness of sin."
I found this the other day:
“Oh God of Abraham, please give us humble hearts. Oh God of Isaac, please give us thankful hearts. Oh God of Jacob, please give us faith. Let us see Jesus.”