Blog | Tuesday, December 17, 2013

Why she had her stroke


The note said she was non-compliant with her medications and that’s why she ended up in the intensive care unit. But she came to her appointments with me every month, as regular as a sunny day in June (or, given her uncontrolled depression, as predictable as a rainy day in London). She couldn’t take her medications, no matter how convenient it would be to pin the non-compliant label on her.

Money was always tight. Her family stole from her time and again. She barely had enough for rent. As depressed as she was, she wasn’t sure sometimes that doctors or hospitals had anything to offer at all. Maybe they were experimenting on her. (After all, they have been experimenting on people for generations, sometimes people that look much like her.)

To call her non-compliant is a peculiarly cruel bit of note lingo. If anything, the system was non-compliant: not pliant at all, but brittle like a piece of untempered glass, and jagged, drawing blood.

Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews. He is also a poet, journalist and translator in Yiddish and English. This post originally appeared at his blog.