Reflection #2

Cassandra Rohm

SSO 430-22

Deborah Ciocco

11 July 2023
As I considered what to write about in my second reflection, I felt like it’s important to discuss a

couple of patient experiences that I have had over the years. Working in a primary care office has

given me the opportunity to interact with people from all different walks of life. I’ve cared for a

CEO in one room and someone who was recently homeless in the next. Different social classes,

different cultures, different views. Although the office is located in a small town in southwestern

Pennsylvania, nearly five years has given me a wide range of experiences.

The first encounter that I’m going to tell you about happened a few months ago. This

patient was originally from the area and then moved away to Arizona for several years before

coming back to help his elderly father. Admittedly, many of us roll our eyes when he comes into

the office. He can be a bit dramatic at times as well as demanding. I wish I could say that we are

never rude behind closed doors, but that would be a lie and it’s not something that I am proud of.

I work to be more mindful of that and to keep everything in perspective more. Anyway, this

patient is also a gay man with a significant mental health history as well as alcohol abuse.

Unfortunately, it is no secret that rural Pennsylvania is not the most accepting of places.

This patient recently underwent a spinal surgery which limited his mobility for a time

which led to his depression worsening. He came into the office seeking help. He felt like he had

nowhere to go and no support. My role in the office is to go into the room ahead of the provider

to start the note and get the visit going. As I was going over the patient’s chart and information,

he began to tell me his story. He told me about how he was bullied when he was younger and

that he found a home in Arizona. He talked about how he hated being home and that he doesn’t

feel like he has anyone to talk to. He had tried to attend local AA meetings but felt like he wasn’t

welcome as he listened to the other attendees use slurs and foul language. I listened to him talk
for about twenty minutes, much longer than I should have been there. I knew I should have

excused myself and allowed the provider to talk to him, but I couldn’t.

As I sat on my stool listening to him confide his fears and emotions in me, I felt

compelled to listen. He had chosen me to open up to and that was important. During the

conversation he admitted to having a passive death wish, information which I relayed to my

provider. Of course, he likely would have told the doctor about it, but what if he wouldn’t have?

Every time that patient has come into the office, I have been kind and compassionate, just as I

am with all of my patients. This behavior that I exhibit offers me the advantage of being able to

build rapport with the people I interact with. I feel that it is this skill that has brought me to the

field of behavioral health.

To tie up that patient’s story, I made a point to find local resources for the LGBTQ+

community that he could link up with and find support. He expressed gratitude and I felt like I

made a difference. I think that a lot of being able to work in behavioral health isn’t so much

learning various skills and the diagnoses in the DSM, but more of having the innate ability to

connect with people and listen to them and allow them to feel heard.

This next interaction was more with a patient’s mother than the patient himself. A couple

years ago we had recently begun to see an early-twenties male who had suffered a TBI several

months prior to coming to our office. The patient had been involved in a motorcycle accident and

was hospitalized for several months as a result of complications regarding a shunt that was

placed following the accident. As a result of the brain damage that he suffered he had had

significant behavior changes. His mother described him as short-tempered, irrational, and

impulsive.
 When we started seeing the patient he was living with his aunt and only occasionally

seeing his mother. One day he came in for an appointment and his mother had requested to talk

to the doctor before or after her son’s appointment to discuss concerns that she had. I offered to

go into the room to speak with her to see if it was something I could quickly relay to him so he

could address it with the patient. The conversation was not quick.

As I began to talk with the mother and I learned of her concerns she became more and

more distressed. She was scared. She was worried. She didn’t know where else to turn. As I

spoke with her, I offered words of acknowledgement and support. I often make a point to

remember to avoid saying “I understand” because in truth, I could never understand what other

people go through, not really. The patient’s mother expressed frustration about the lack of

options for TBI care. I could agree with her about that.

I was familiar with TBIs as a result of my time and training in the military and I knew it

was something that was just beginning to be addressed in the Army. I knew there weren’t many

options on the “civilian side” of things. After speaking with her, I again looked to the internet to

find local resources that might be of use to her. I was able to find a website and organization that

offered help to people suffering with TBIs and she was grateful that I took the time to find the

information for her.

Although I work in a medical office, I use the skills that I learned in the Army and from

the classes I have taken to better communicate with my patients every day. Each day that I go to

work I never know what I’m going to encounter or if I’m going to have to be the voice of reason

during someone’s tragedy. My ability to connect with people is something that I am incredibly

grateful for and I’m further thankful to be able to use that talent every day to help others.