"Did you bring your meds with you?"
"Ah, yes. Wait on a minute", his distinct accent did not do anything to hide his frustration. "Eh, ack, I know it's here somewhere". In a Mary-Poppins-esque fashion, he pulled out the contents of his knapsack looking for his meds. A plastic bag containing two pots, a brown paper bag with his glucometer testing supplies and a toothbrush, two sweatshirts...
"So, how is your living situation these days? Are you still living with your daughter?"
"Well, yes, I stay in the basement. But, doctor, it is getting cold". He paused. "But I have eight kids, you know. I just, I just move around. I don't want to be no trouble"
"Sure, sure"
"I like doing by own thing. Don't want to bother nobody"
"But you can't do it by yourself", I thought to myself. We had been battling his diabetes for weeks, but he was no match for a disease process that demands one be at the fullest of faculties to conquer it. One needs vision to pick up tiny pills from a bottle, literacy to understand the complex directions involved in checking blood sugars and adjusting insulin doses, dexterity to snap on disposable needle tips to syringes that contained aliquots of Insulin.
I counted the number of steps required for him to give himself Insulin. Starting with picking up the prescription I write for him, he would have to jump through nothing short of two dozen steps before the insulin trickles into his veins. Each step involves potential for error (point and case: the previous prescription got called into the wrong pharmacy, and because he uses public transportation, he couldn't physically reach the pharmacy to pickup his medication). Add this to the fact that I was becoming increasingly suspicious that he was essentially living out of this knapsack, and the truth was revealed to me: we didn't stand a chance.
