I realize that a big part of the reason I’m often unhappy with what I do is that, in many ways, my job is incredibly negative. Unfortunately, our project is at a stage where we’re (and by we, I mostly mean I, as I’m the only one working on health projects full-time) struggling to keep our (my) heads above water. We do what we can for the people we’ve already “taken” as patients, try to treat the most urgent needs of those we haven’t “taken”, and pretty much turn away the rest. So it’s become that at least half of my interactions with people in the centre and in the street are them asking me for things that I just don’t think I can do (or don’t want to deal with, or there’s not even a difference, I don’t know).
And there are basically two ways to look at that: either me turning them away isn’t really going to affect there health much, as they’ll just go pay for it themselves somewhere; or me turning them away is pretty much the end of the line, and they go back home and wait out (or don’t) whatever their malady is. Neither of those is particularly palatable, from my point of view. If the former is true, then my job isn’t really necessary, and I’m risking imperialism/perpetuating the current oppressive societal structures for no good reason. If it’s the latter, I’m no longer acting as an agent of change and have turned into just another health access point that is blocked. In which case, my job isn’t really necessary and I’m risking imperialism/perpetuating the current oppressive societal structures for no good reason.
It’s not like both of those are true all the time, and I’m sure often enough it’s not even that me turning them away is really going to negatively affect their health in any major way (it’s not like we normally give out basic pain medication or decongestants anyways). But I can’t always help the sneaking suspicion that every time I tell someone I’m too busy, or I don’t go up to their home because they missed a BSL, or I wait until they come to me for meds when I know they need a refill, I’m not quite doing the very thing that I explicitly came to do.
And fine. My excuses are in general legitimate. I’m stretched beyond thin, doing the majority of the health stuff on my own. I can’t just indiscriminately take everyone that comes in off the street, take them at their word for where they live, what their need is, how much of our time they need. If I did that, AIC would be broke and I would be crazy. But there’s the nagging thought that I could do more, I could rest less, I don’t need a day off every week. Still...
Still, where does the line come where I’m just another barrier to healthcare? I mean, fine, there’s a fair amount of “maybe if I’m super inefficient then you’ll just give up and go away” in the bureaucracy in pretty much every institution we’ve dealt with here, but in general, I think people are doing the best work they can under the circumstances.
It comes down to the fact that in a lot of ways I identify a lot more closely with people working at the hospitals that with the people I take to the hospital.