July 13, 2016

People : Gifts

I know several people who work at Kaiser and occasionally their patients will bring them gifts, like a bottle of wine, a gourmet snack basket, or tickets to a baseball game.

Working at an FQHC (federally qualified health center) where most patients are publicly insured through Medi-Cal (California's version of Medicaid, or insurance for low income patients) and Medicare, I get gifts too--of a somewhat different sort.  

For example: a bright pink selfie stick, a personalized astrological map, an origami swan, a handmade print, and a message that is pretty much one of the best gifts I've ever gotten.

Selfie stick: The patient who gave this to me is terrified of taking medications. She worries about having a possible life-threatening reaction to starting any new medication.  After several failed attempts at having her start a new medicine to lower her very high blood sugar, I had an idea. I suggested that she come into the clinic with the medicine, take it while she was there, and she could stay as long as she needed until she felt sure that nothing emergent was going to happen. Knowing that we would be there if something did happen, she felt comfortable trying the medicine.  At our next visit, she brought me this very nondescript selfie stick as a thank you:

Astrological map: Over the course of several appointments and phone conversations, this patient acquired my full birthday down to the time of day.  At first, she simply asked for my sign.  Then she asked for my birth month and day, and I withheld the year.  When she finally explicitly asked for the year, I had accepted that it likely didn't matter much and provided her with the year.  When a long phone conversation with her was serendipitously interrupted by another phone call, she frantically asked for the hour of my birth as I was trying to get off the phone.  For some reason I thought this was more personal than providing my birth year and tried to dodge the question by saying I didn't know the exact hour. She replied, "Oh, at least at a general time of day?"  I said quickly: "The afternoon."  The next time I saw her, she gave me this--a cosmic map of my soul based on when I was born.

Can anyone decipher its message?

Handmade Card: This was given to me by an elderly man who came to our Advance Directive workshop. He's a spunky, bright man, witty even with routine questions; he plays bocce ball with a regular group of friends. When he told us that he wouldn't want any type of healthcare intervention, even if he was sick from something treatable and reversible, he got into a heated argument with his close friend.  His friend didn't understand why he would give up so easily, especially since he's such a vibrant person.  "Don't you feel like you have a purpose? You're so active for your age."

He explained to me that no one could imagine the kind of active, vibrant life he used to live--he was a journalist, traveled all over the world, danced salsa into the night with strangers.  Then he suffered a brain injury, and though medical intervention saved his life, it left him without the ability to read or write and he now needs a cane to balance his walk. He tells me earnestly and with full conviction how his life has lost all dimension for him. He's able to draw, and he drew this card.  It amazes me how much color and shape comes from a man who sees his world as so lackluster.

Origami swan: This was given to me by a man who looks different each time I see him.  He'll dye or perm his hair, put on a wig, switch between a black beret and a hat knit from green and yellow yarn. He has a psychotic disorder and subsequent anxiety, and has been on all sorts of strong medications. He's more recently developed symptoms of dementia and some sort of unclear neurodegenerative disease. His neurologist administered neuropsychological tests.  When the patient heard about his results, he then interpreted them to me as this: "When one part of the brain doesn't work as well, our mind moves and uses another part.  In my case, so many parts have been damaged that there's no space to move."

He gave me this swan, and I told him that there are a lot of spaces whose bounds are so vast we can't see them with our narrow tests.

The best gift: One morning, I saw a post-it on my computer with a message from the patient from this post, the schizophrenic patient who takes a very long time to respond to questions and prefers to ask me random questions. In that post, I wrote about how he asked me if I had any pets and I told him about how I really loved my brother's cat and wanted to keep him as a pet but couldn't due to our landlord's no-pet policy.  This was several months ago, and since then, we've had a couple visits during which he has come up with new questions ("what time period would you want to get stuck in?").

Here's the message I got from him:

And that is why gifts of a different sort are the best sort.


  1. "I told him that there are a lot of spaces whose bounds are so vast we can't see them with our narrow tests."


  2. This whole post - YES.

    Kim you inspire such beautiful gifts from people. And see so much as gifts.

  3. Tanvi & Jackie--so grateful to have such YES friends!


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