I had a patient once.  Her name was Alice (not her real name).  Alice was in her mid-thirties, diabetic, had chronic pain, high blood pressure and was an alcoholic.  She lived on Kuper Island which was just a short ferry ride from the small pharmacy I managed in Chemainus, British Columbia.  Alice would come in every month or so to see me for her medication, go over her blood sugar results, take her blood pressure.  Most times Alice was sober and sometimes she wasn’t.   When she was sober I would encourage her and she seemed hopeful.  But eventually, the wagon would tip and she would be drinking again.

One such time Alice came in to see me after a night of drinking.  I came out from behind the dispensary counter and sat next to her in the waiting room chairs.  I put my hand on hers, looked into her face and asked her why.   Why did she go back to drinking?  She knew it could someday kill her.  We had discussed often the risks involved in drinking with her medication.

She looked at me and said, “Carlene … too much pain.  So much pain … it’s too much.”

Alice was a survivor of the Kuper Island Residential School.  And while I had studied about residential schools in University and knew that most of the Aboriginal population around Chemainus had been affected by this tragedy, it was a different thing entirely to sit with a woman who had survived such pain in her life.  The alcohol helped her forget.  The community she lived in was rife with it.  No amount of convincing, referral or compasion from me could change that.

Alice was unable to overcome her addiction and shortly after that conversation died of a stomach bleed.  A consequence of the alcohol and her pain medication.

It was one of the first losses I experienced in my early years of practice on Vancouver Island, but there would soon be many more.  At times I would be overcome with frustration when I felt unable to reach people steeped in pain.  But other times I was personally challenged as a young health professional to overcome my own preconceived ideas and personal judgements.

Those years taught me the value of stepping out from behind the counter; that sometimes I need to let down my own guard and be open to being challenged in order to reach people where they are at.  Some days I am better at it than others, but patients like Alice have been and continue to be my greatest teachers.

Carlene Oleksyn is a pharmacist in Canada who blogs at An Examined Life. She can also be reached on Twitter @colekpharm.

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