Dichotomy

Does anyone else share the dichotomy of feelings I have towards my patients and their families? On the one hand, I feel tremendous sympathy for them. Many of them are poor and uneducated, and frankly have not had many breaks in life. The stress of their everyday life is high, with concerns about money and transportation always near the surface. For those of us with our own cars, simply needing to take a bus to work or the hospital, as many of my patients' families do, would be a time consuming chore.

On the other hand, though, I feel tremendous frustration with some of them. It doesn't bother me if a teenager comes in with their first pregnancy. Accidents happen, anyone can make mistakes. But when a woman comes in with her fourth or fifth pregnancy at age 21 or 22, I want to say to them, what part don't you get? Don't you get that by having one baby as a teenager you greatly increase your chances of not finishing school, but that with two or more kids at an early age it's almost certain you won't get much of an education? Don't you get that you're condemning yourself to a lifetime of dependency and poverty? Don't you get that someday you'll want better for yourself and your kids, but you won't be able to do anything about it but buy lottery tickets?

I want to respect everyone, but some people sure make it hard.