The Magic in Small Steps

I remember last March when I was trying to figure out what to do with my life after I graduate just scrolling through these blog posts on the National Health Corps website. I remember reading all these incredible stories of patient interactions and moving pieces of prominent social issues such as addiction and food insecurity. Yet, as I sit here now, clacking away at my own blog, I can't help but reflect on how incredibly strange but magical this service year is. I'm only about two and a half months into this journey, and I already feel like I'm a completely different person than I was last summer.

“Hi, this is Sakib from Pittsburgh Mercy Family Health Center. How can I help you?” The words come out so easily from my mouth nowadays that I almost forget how anxious I used to be to talk on the phone. As a Health Navigator, I’m usually on the phone with or without patients in the room, trying to schedule important specialty appointments, contact insurance companies, or outreach to people that my host site may not have seen in months or years. From waiting for people to call me back to the incredibly long times I’ve been put on hold, I think what these past few months have really taught me is the merits of patience and existing in the moment. I’ve always been a sort of go-getter, rushing to get things organized, perfected, and completed in order to do the maximum amount of aid that I can. But, change in healthcare doesn't move that fast. Everything doesn’t go right all the time. Sometimes, you get stuck listening to nerve-wracking music while on hold for an hour, or nobody picks up or calls back despite your best efforts. This is where I realized I’ve been approaching service and change in the wrong way because when I’m on hold on the phone, there’s still a patient in front of me. I’ve had some pretty interesting conversations so far while on hold, such as chatting about the Beatles, learning about how much Pittsburgh has changed over the years, or listening to incredible stories that people have decided to share with me. Maybe I couldn’t schedule a referral with the patient in the room, but I made the first move in getting the process started. I lent a listening ear, shared a laugh, and clarified what the next steps will be.

An interaction that has stuck with me for the past few weeks has to do with an older woman whom I sat down with after a provider had told me that she wasn’t here for an appointment, but needed about four referrals to be scheduled for her. It has only been a month since I started this position and I was immediately nervous about messing up, but I didn't let the nerves stop me. I entered the room and the woman handed me a manila folder that was stuffed with a messy stack of papers with confusing notes and scribbles dotted around. As I sorted through the papers and got to work, we began chatting. The whir of her oxygen tank filled the small room, but I listened to her talk about her kids, her chronic pain, and how confused she was about which appointments she had where. As we talked, I began calling offices and realized that some of her referrals had already been scheduled; it was just confusing to tell with all the papers she had in her folder. I printed out her referrals again and stapled them before writing out what, where, and when each of her appointments were, mentally thanking my mom for berating me as a child to polish my handwriting. For the fourth appointment to be scheduled, we were placed on a long hold before someone picked up. Together the patient and I walked through the process of scheduling a stress test for her, answering questions back and forth about her medical history, her insurance, and her diagnosis. Ultimately, the person on the other end of the phone coldly stated that the appointment couldn’t be scheduled at the time and that the patient would have to call back later before curtly ending the phone call. Perhaps I sounded a bit frustrated as I turned back to the older lady and apologized for how long I had taken to ultimately not have succeeded. I remember her incredulously looking back at me and shaking her head, holding four neatly stapled packets, and saying I had already done so much for her. It was work anybody could have done, but nobody else had had the time to sit down with her to puzzle over her stack of papers. I gave her my work phone number and the next day she called me to say that she was able to schedule her stress test appointment and wanted some clarifying answers about the locations of some of her appointments. I relayed the information and wished her a great day.

It’s easy to say that I’ve helped a lot of patients already in my short time here or that I’m filling a gap in service for my host site, but I don’t think those statements fully capture how much I’ve learned already because of this year. I’ve joked with patients as I help them fill out paperwork, and I’ve heard of incredibly sad news or obstacles from people too. I’m finally chasing my dreams of understanding and tackling health disparities by learning to ground myself in reality and actually figure out and implement what needs to get done on a day to day basis. Personally, it may not seem like much, but I’m learning to celebrate these small moments of victory when I finally get the appointment details of a colonoscopy that has taken days to schedule or a patient that the clinic hasn’t seen in a long while suddenly calls me back asking for a follow up appointment. A little tiny hop forward in helping someone to a better future.

Progress isn’t at all linear or fast. But if all you can do is move just a couple of small steps forward, well isn't there something absolutely incredible about that?