A Day in the Life of Siloam: Provider's Perspective

A Day in the Life of Siloam: a Provider’s Perspective

Originally published in the Winter 2002 edition of Healing Waters
By Morgan Wills, MD

Reflections from the Exam Room

Morgan Wills, MD

If you’ve read any of our “Day in the Life” stories, you might think that our job is always exciting and exotic! After all, it’s hard to pass up a chance to share about the many humorous and touching anecdotes that God sprinkles into our days at this little clinic in Edgehill. Where else do you have the opportunity to care for an immigrant who has removed a bullet by himself from his abdominal gunshot wound (because he was afraid to go to the E.R.)? Or to “defend” the restroom from a neighbor who routinely walks in to steal the toilet paper and diapers? Or to often be humbled by your inability to distinguish common cold viruses from malaria?

These and many other examples certainly do serve to keep us on our toes. But our most substantive work—just like yours—still takes place in thousands of routine, humdrum activities and encounters that occur.

For providers like myself, the “daily grind” often involves a stack of patient charts which has been left on my desk each day, progress notes to finish, lab results to check, referral letters to write, and “problem cases” to consult on. I want to share with you the surprise blessings I experienced in the seemingly mundane management of one such “problem case.”

Mr. Nguyen (we’ll call him) is an elderly but vigorous Vietnamese man who has been in and out of clinics around town for years for diabetes and hypertension. When I first read his Siloam chart, I noted that he tended not to show up for scheduled appointments and he appeared to be a “noncompliant” patient.

As you can imagine, I didn’t look forward to seeing Mr. Nguyen -- my first encounter confirmed my fears. He spoke poor English, but rarely came when a Vietnamese interpreter was available. He did not take his medicines as prescribed. He did not check his own blood sugar, and he resisted my attempts to have him back for frequent follow-up visits. Though he was jovial and talkative, I was often stern-faced and frustrated at his inability to appreciate the severity of his problems.

When Mr. Nguyen did come in, we spent a lot of time together – too much time , I thought to myself initially. In order to streamline these laborious encounters, I began to “pick my battles”. More importantly, I began to pray for God to soften my hard heart and give me a genuine desire to care for this man. On a practical level, we agreed to him coming less frequently than desired and we always called to remind him. Slowly, by God’s grace, we made some progress. He didn’t come close to meeting any of the national guidelines for control of either of his diseases, but at least he started keeping his appointments!

Just as slowly, my heart began to crack and soften towards Mr. Nguyen. I began to question him about how his life experiences and culture shaped his understanding of health, but my awkward attempts seemed to go nowhere. I prayed again. I sensed no dramatic directives from on high—just a sense that we ought to stay the gradual, plodding course. And over the months, Mr. Nguyen did seem to start grasping the concepts of chronic disease management. He even began to take some pride in showing me his lower blood pressure and glucose readings!

At one of these follow-up visits, I learned that Mr. Nguyen had good reason for not taking his medicines. He told me with tears in his eyes how he had previously received frequent prescriptions for medicines without any explanation of what they were for. Pressed for time and reluctant to wade through linguistic barriers, other clinics had hurried to get him in and out of the office. Consequently, Mr. Nguyen had no clue about his disease. He was also caught off guard by unexpected medication side effects, one of which was so severe that he was temporarily admitted to a psychiatric hospital.

Although his body kept telling him to seek medical help, he had zero trust in what the physicians had to offer him. But through a series of routine office visits and slow but methodical care at Siloam, his trust was restored. Nothing fancy; just basic, day-in, day-out health maintenance. Today, Mr. Nguyen is usually the one asking the questions of us. He tells us that he sees something here that is “good” and he wants more of it. He comes from a nominally Buddhist background and has harbored some hard feelings towards Christians. But just as God has mercifully burst many of my preconceptions about this Vietnamese patient, Mr. Nguyen has begun to reassess some of his own prejudgments about Christianity.

This summer, God used another of his routine appointments to shatter my preconceptions. During this visit, I mentioned that several staff members and I were about to go to Peru . Before I even had time to explain that we were actually going to do medical missions, Mr. Nguyen opened his wallet and handed me all of the cash inside it as a personal gift! He was grinning from ear to ear—just as proud of his gift for my “vacation” as he was of his low blood pressure numbers.

I was stunned.

It’s one thing to serve “those in need”—and receive the expected gratification of helping someone else towards a healthier life. But it’s a totally different and humbling thing to be the recipient of what seemed like a lavish, undeserved gift from an unlikely source! Although I don’t know exactly where this man stands in his relationship with God, I do know this: God used Mr. Nguyen to show me something about Himself.

As the gospel reveals, God, too, is a lavish giver who chose to bless needy sinners like us in a most unlikely way—through the birth, life, innocent death, and resurrection of a common Galilean man named Jesus. The offer of exchanging His life for ours is so unnerving—because we are so undeserving!

This Christmas season we want to pause and thank all of you whose generosity makes it possible for Siloam to care for patients like Mr. Nguyen—in mundane yet eternal ways. We are equally thankful for the opportunity it affords us to experience Christ more deeply ourselves by meeting Him in His work of caring for the poor. As our mission statement reminds us, may all our ministry partners share the love of Christ through the work He is doing at Siloam. After all, the patients may not be the only ones “in need.”