Sometimes life imitates art.
The final story in my collection, A History of the Present Illness, called “A Medical Story”, opens with a doctor making a home visit to a public housing building. While I changed details to protect the patient and create a meaningful story, this opening scene is true to my experience.
Just how true it is became apparent over the last few months as the San Francisco Housing Authority, the organization that oversees our 6500 units of low income housing, kept making the news for all the wrong reasons.
If you don’t live in San Francisco (and maybe if you do) you might be asking yourself why you should care.
The first answer is that the well-being of the most vulnerable among us should matter to all of us. While we’ve had a particularly bad run recently in SF, in speaking to housecalls colleagues in other cities across the U.S., there are many ways in which we are not alone.
The second answer is that this instance of life imitating art offers me an opportunity to show how fiction writing can be just as truthful as non-fiction, even if it relies less strictly on actual events.
So today’s post has two parts: FICTION - the opening paragraph of “A Medical Story” and NON-FICTION - an unpublished letter I wrote to the San Francisco Chronicle about the recent Housing Authority events. I spent time writing both, and conformed to industry standards for both.
–>Which one do you enjoy reading more? Which taught you more? Which will you remember next week?
From “A Medical Story”:
So much of medicine is stories. Or potential stories. For example: the year before I began doing palliative care, I visited an elderly couple in an apartment complex named for Martin Luther King. Rogelio said that was the only good thing about the place. Beer bottles and cigarette butts ornamented the sidewalk; urine and streaks of barely clotted blood garnished the walls. A woman reeking of dust and sweat reached for my jacket and stumbled, smearing saliva on my sleeve. The guard checked me over then buzzed me in, showed me where to sign, told me to take the elevator, not the stairs. The elevator wobbled and creaked. On its walls were faded admonitions about garbage disposal and use of fire escapes printed in English, Spanish, Chinese, Russian, and Tagalog. Rogelio and Carina lived on the fifth floor, in the last apartment along a narrow, windowless corridor. Someone had obliterated the hallway lights. I turned on my otoscope and held it in front of me to light my way. It helped just enough.
My Letter to the Editor:
As a physician in a practice that makes housecalls to frail older adults in public housing properties across San Francisco, I am not surprised that the San Francisco Housing Authority earned just 54 out of 100 points on their recent audit (“Housing agency’s troubles mount”).
I can attest to broad variability in living conditions at different sites and appalling unresponsiveness on the part of the SFHA. My patients, their families and I have all written letters to SFHA about health concerns such as a frail elder in a frigid apartment with a broken heater, or an older adult rendered homebound not by illness but by being housed in a complex without an elevator despite her advanced age and documented disability. All but one of these letters have gone without reply.
Other realities in SFHA buildings include burned out hall lights and crumbling stairs that increase the risk of falls, semi-permanent encampments of threatening non-residents, and malfunctioning, unreachable and relentlessly beeping smoke alarms. Such substandard conditions endanger, entrap, and threaten the health of SFHA’s already disadvantaged and disabled residents.
I hope the recent attention will inspire the SFHA to better serve its most vulnerable.