Photo credit: David Mason, Flickr
From the doorway, my patient looked pregnant — but his protuberant belly was actually a sign of serious liver disease that had quickly worsened. Given the fluid pressing on his abdomen, he was no doubt in pain. Yet his spirits were high, and raucous laughter often accompanied his nearly toothless smile.
After our team drained the fluid, he was ready to leave the hospital. We added a new medication to his already long list of medicines, sending his prescriptions to the hospital pharmacy as usual.
When I nonchalantly told him that he could pick up his medications on his way out, he suddenly seemed nervous. I thought perhaps he was unsure about how to take the new drug and asked him if he had any questions. His smile dimmed and his voice dropped to a whisper.
“I know how to take the pills, but I can’t buy them,” he said, his eyes refusing to meet mine as he stared at a spot on the hospital’s beige floor.
I ended up paying for that patient’s medicine out of my own pocket. But I thought about him again after reading a recent report in The American Journal of Medicine that found that one-third of Americans suffering from a chronic illness such as diabetes or high blood pressure said they had trouble affording medications, food or both.
Looking back, I wonder whether my patient’s poverty was the real reason he had landed in the hospital. Maybe he wasn’t taking any of the medicines we had prescribed for him, but was too embarrassed to volunteer that information without prodding.
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