The other day I volunteered to do blood pressure workshops for some less fortunate people. All of the people who attended the workshop were either homeless or lived in low income housing.
These blood pressure workshops are run regularly and usually get a strong turnout. Unfortunately, this workshop was on the Saturday after Welfare Wednesday. In BC, people on welfare receive their cheques once a month. The government seems to think that giving people who are addicted to alcohol or hard drugs (certainly not true of all people on welfare, but often is for the people who attend these workshops) a fat cheque once a month is a brilliant way to help them out. Oddly enough, it turns out that most of these people take their cheques to the liquor store or the shady looking guy on the corner of the block and blow all of their cash on booze and drugs. They end up drunk or high through the rest of the week and end up missing my blood pressure workshops, which, let's be honest, would probably solve all of the problems in their lives. Anyhow, since I'm only a pretend doctor and not a pretend politician, I'll keep my opinions about how I think we should fix this problem to myself.
Other than the low turnout, the workshops went well. I was told that most people who attend our clinics out there tend to have high blood pressures; however, I didn't have a SINGLE patient with high blood pressure and neither did any of my colleagues. We assumed that most of the people who came out on the Saturday after Welfare Wednesday were the types of people who take pretty good care of themselves, so it made sense they had decent blood pressures. We also had a few people who were clearly high on heroine or some other downer. In their case it was obvious that the drugs were going to lower their blood pressure somewhat.
One intersting thing I realized was how our patients valued talking to us much more than they valued learning from us. I was teaching a patient about his blood pressure reading and he was clearly interested in what I had to say...but I started seeing that he just wanted to talk, he didn't really care about blood pressure. I feel stupid about not picking it up sooner...if I was wearing a shirt layered in 3 day old vomit stains, the last thing I'd want is for some pretend doctor to tell me about hypertension. From then on I decided to just chat with the patients about what was going on in their lives and hold off on the blood pressure talk until they brought it up.