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The Differential

Water All Around, And Not a Drop to Drink

Rick Pescatore, DO, Emergency Medicine, 08:11PM Sep 15, 2013

The air is turning colder in my small section of the world. Dry brown leaves fall silently from trees that have seen more winters than most, and it seems that all too quickly we've traded the air conditioning for the fireplace. I use the coming cold as an excuse to relax in front of the flames.

The latest rotation switch, moving from a sleepy rural clinic to a bustling emergency department in the Philadelphia inner city, has been as abrupt a change as the weather. Where much of my time in the western valley town was spent chatting with hospital staff while waiting for occasional patients, my shifts back in Philly are defined by constant patient turnover, overflowing waiting rooms, and only the rare opportunity to meet my newest team. When my school assigned me to the far-off rural rotation, it was meant to be an exploration of medicine delivered to those with little access to healthcare. It took coming back to this city Emergency Department to see the true consequences of the same.

Hardly a day passes where the patients I see aren't victims of their own circumstances. Late-stage diagnoses that offer the grimmest of prognoses. Resuscitation beds filled not by the acutely ill, but by individuals forced to use the curtained rooms as an unfortunate surrogate for a primary care physician. Nearly all of them cling to a government-subsidised insurance card, underlining the oft-forgotten point that access to healthcare insurance rarely translates to access to healthcare.

I'm thrilled to be back in a setting where I feel just a little more at home. As much as I enjoyed my sojourn in the tiny mountain clinic, it's the flourescent lights, ever-chirping monitors, and constant pace that I crave. With two more weeks left in the emergency department, and just a few more days left of summer, I hope I can make some small difference among those with such little access to care.

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    Philadelphia College of Osteopathic Medicine

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