Crazy is how you feel when working within a system you feel you cannot change


You know that one patient? The one who calls the nurses every five minutes and keeps hoarding the jello cups down the hall? She has a thousand problems but doesn’t bother to take care of herself. She keeps coming back complaining about her issues and wasting our time by asking the same question again and again without listening to what we say. And don’t get me started on how awful her feet smell. The stench can seriously kill someone. She’s just crazy.

Dude, I totally know what you mean, our whole service is crazy. I have this one alcoholic patient with no teeth who drinks a liter of vodka a day and then wants us to clean up the mess. He’s 35 years old with ESLD and wasting his life away. Why should I care when he clearly doesn’t?

Seriously, I don’t understand how there are so many of these crazies. My lady won’t stop shooting heroin long enough to be out of the hospital for a week. This place is like a hotel for her, and we are her servants. I’m tired of having to babysit a druggy.

She’s just crazy. They are all crazy.

Yes, it is crazy. It’s crazy that about a third of the U.S. population is living in poverty. That about 10 percent of the American population is still without health insurance. And even crazier that when impoverished and uninsured patients seek refuge within our hospitals, the challenges they face, such as homelessness, substance use, and addiction are seen as a personality trait rather than a means to cope with trauma.

No, crazy is the fallibility you feel when working within a system you feel you cannot change. You are crazy for caring so deeply that you feel responsible for the harm people bring upon themselves. Is it then crazier to put in the effort to try to change a futile cause or to distance yourself from the discomfort?

It is best to distance oneself, of course. After all, there is only so much lack of control we can feel until we reach burnout, and they are the crazy ones, not us. We are different, better, stronger. We choose wiser; we’re smarter, worked harder.

I am one of you. But as the colleague sitting next to you who has faced homelessness, substance use, and addiction, would you call me crazy too if you knew?

Nina Mirabadi is a medical student.

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