Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Doctor accepting new patients
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

In social work, small actions make a big difference

Raymond Abbott
Conditions
July 31, 2020
Share
Tweet
Share

I first became acquainted with Michael after another case manager I work with, a woman, reported the proprietor of the group home (sort of a boarding house, really), Miss Samantha, as she was known, and whom I knew slightly, said she wanted Michael out because of his sometimes bizarre behaviors, often frightening to her neighbors.  Miss Samantha is a tall, white-haired woman of some dignity.  Sort of Southern in her bearing, and you might think she is well-to-do, but I know she is not.  She must be in her early seventies by now, and she has had her share of ailments.  Michael, she claimed, had a habit of startling people by popping unexpectedly out of the bushes and uttering incoherent speech. She also complained that he was smoking in the bathrooms and depositing the ashtray contents into the commode.

It all added up to our agency having to locate someplace else for Michael to live, no easy task He’d been with Miss Samantha for eleven years.  It was decided to try getting a male case manager to work with both Miss Samantha and Michael. That’s where I came in.

Michael is fifty-one years old, and is diagnosed as schizophrenic or schizoaffective   He is prematurely stooped over.   Also, he is very thin, and when I first met him, he had unusually long hair, like a hippie from the 1960s.  His hair is graying, and his teeth are in need of dental work.  Also, he has a wandering eye.  Lately, he has cut his hair short, or at least shorter than it was.

Samantha charges a hefty amount for room and board at her place, at least compared to the places I have put people in.  It is worth what she charges, though.  About twenty persons live at her home.  Most are mentally ill or mentally challenged.  Many, like Michael, stay for years. Michael’s father pays the additional costs.  I have yet to meet Michael’s dad, and may never meet him. He’s a bit of a recluse.  I know this much, however: Michael’s father has almost no contact with his son.  Maybe at Christmastime, there is a phone call.

The situation that was so upsetting to Miss Samantha came about, I soon discovered, because of the failure of a local pharmacy to deliver Michael’s medicines on time.  Often this pharmacy was two or three days late, and three days off of meds for Michael was not good at all.   I did what I could to correct that situation by protesting to the manager at the pharmacy.  He got my message loud and clear. The deliveries improved.

So it was in this atmosphere that Michael and I began to go out for coffee on Wednesday afternoons. That’s all we do, by the way.  Go out for coffee and talk some.  I try never to miss a Wednesday afternoon, because I realize how much he looks forward to this time together.  Usually, we go to Mark’s Feed Store nearby, but sometimes we frequent a place called Ditto’s.  We always pick establishments where unlimited refills of coffee are offered. The conversation is hardly sparkling.  Sometimes we exchange few words at all, and often the talk that does occur comes about only because of questions I ask him.  What about this?  What about that?  Did someone new move into the house?

Still, we talk, no matter how stilted or forced the conversation may be.  Most of the time, when he speaks, he makes sense, and if there is too long a silence (and I let that happen), he will come up with a question about my work.  He might say, “I guess you’re pretty busy these days?” And then, of course, I get to tell him just how busy, how overworked I am. I once asked Michael if he had lots of money, what kind of a car he would wish to own.” That’s easy,” he said. “A Corvette.” He then went on to describe where he would drive his Corvette, which would be on back roads where he was unlikely to damage it.

At our office, we have a kind of a slush fund, called a “wrap around” and I once requested and was granted an outlay of $200 to buy Michael some new clothing.  I could tell from the way he talked that he liked clothes, but what he owned was minimal.  So together, we went to Value City.

“Buy what you like, and if you see something you really want, but it costs more than you think you should pay, go ahead and get it anyway.” Of course, he understood beforehand that our limit was $200, not a great amount to begin with, but more than he was used to getting. He took me at my word and picked out a full-length leather coat for about $130. It was Christmastime when this happened, and I asked him. “What is your best Christmas memory?” He thought for a moment, and a big smile crossed his face.

“When I was about seven or eight, I wanted a small axe for woodcutting.”

“Did you get it?”

“Oh yes, and I went behind the house in the woods where we lived.  My mother was living then, and I chopped and chopped as long as I wanted.  I had a wonderful time.”

Last week, on Wednesday, when I came for Michael, Miss Samantha called me aside. I expected trouble.

“You know, Ray,” she began, “I see a change in Michael.  For one thing, he used to pick at his food (that was another of her complaints about him), but now in the morning, I notice he eats a big breakfast, bacon and eggs, and whatever else is offered.  He didn’t do that before.  Somehow he just seems, well, more content.”

ADVERTISEMENT

“All I do with him,” I explained, “is go out for coffee on Wednesday and talk a little.”

“Don’t minimize what you do,” she instructed me, “because it is a lot, more than you know.”

Raymond Abbott is a social worker and novelist.

Image credit: Shutterstock.com 

Prev

Something’s rotten in America’s health care

July 31, 2020 Kevin 8
…
Next

Automatic savings is one of the best decisions you can make

July 31, 2020 Kevin 0
…

Tagged as: Psychiatry

< Previous Post
Something’s rotten in America’s health care
Next Post >
Automatic savings is one of the best decisions you can make

ADVERTISEMENT

More by Raymond Abbott

  • How community and buses saved my retirement

    Raymond Abbott
  • From hospital bed to harsh truths: a writer’s unexpected journey

    Raymond Abbott
  • Proud dental school patient shows off a rare gold foil filling

    Raymond Abbott

Related Posts

  • Why social media may be causing real emotional harm

    Edwin Leap, MD
  • A physician’s addiction to social media

    Amanda Xi, MD
  • Are negative news cycles and social media injurious to our health?

    Rabia Jalal, MD
  • How I used social media to get promoted to professor

    David R. Stukus, MD
  • How social media leads to a loss of creativity

    Edwin Leap, MD
  • Are patients using social media to attack physicians?

    David R. Stukus, MD

More in Conditions

  • The “ethical canary”: How moral injury signals systemic failure

    Courtney Markham-Abedi, MD
  • Trauma reactivation: Why news headlines trigger past abuse

    Barbara Sparacino, MD
  • The healing power of physician presence in modern medicine

    Farid Sabet-Sharghi, MD
  • ATTR-CM screening: the missing link in heart failure diagnosis

    Radhesh K. Gupta
  • When the doctor becomes the patient: a breast cancer journey

    Amy E. Sanders, MD
  • Menstrual health in medicine: Addressing the gender gap in care

    Cynthia Kumaran
  • Most Popular

  • Past Week

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Sabbaticals provide a critical lifeline for sustainable medical careers [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Medicare must cover atrial fibrillation screening to prevent strokes

      Radhesh K. Gupta | Conditions
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • The “ethical canary”: How moral injury signals systemic failure

      Courtney Markham-Abedi, MD | Conditions
    • Medical bankruptcy: the hidden cost of U.S. health care

      Richard A. Lawhern, PhD | Conditions
  • Past 6 Months

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • AI-enabled clinical data abstraction: a nurse’s perspective

      Pamela Ashenfelter, RN | Tech
  • Recent Posts

    • The “ethical canary”: How moral injury signals systemic failure

      Courtney Markham-Abedi, MD | Conditions
    • Beyond Flexner: Why we must rethink medical training reform

      Ravi Agarwala, MD | Education
    • Rural emergency medicine in New Mexico: a physician’s firsthand account

      Sarah Bridge, MD | Physician
    • Trauma reactivation: Why news headlines trigger past abuse

      Barbara Sparacino, MD | Conditions
    • Ambiguous billing rules threaten every doctor in practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Deprescribing in health care: Why less medication can be more

      American Medical Association & John Whyte, MD, MPH | Meds

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Sabbaticals provide a critical lifeline for sustainable medical careers [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Medicare must cover atrial fibrillation screening to prevent strokes

      Radhesh K. Gupta | Conditions
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • The “ethical canary”: How moral injury signals systemic failure

      Courtney Markham-Abedi, MD | Conditions
    • Medical bankruptcy: the hidden cost of U.S. health care

      Richard A. Lawhern, PhD | Conditions
  • Past 6 Months

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • AI-enabled clinical data abstraction: a nurse’s perspective

      Pamela Ashenfelter, RN | Tech
  • Recent Posts

    • The “ethical canary”: How moral injury signals systemic failure

      Courtney Markham-Abedi, MD | Conditions
    • Beyond Flexner: Why we must rethink medical training reform

      Ravi Agarwala, MD | Education
    • Rural emergency medicine in New Mexico: a physician’s firsthand account

      Sarah Bridge, MD | Physician
    • Trauma reactivation: Why news headlines trigger past abuse

      Barbara Sparacino, MD | Conditions
    • Ambiguous billing rules threaten every doctor in practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Deprescribing in health care: Why less medication can be more

      American Medical Association & John Whyte, MD, MPH | Meds

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...