Patients 10, "I Can't Work"

     "I can't work," said Jimmy.
     "How old are you?"
     "Twenty-six."
     "Why can't a twenty-six year old like you go to work?" I asked.
     "I'm under too much stress."
     "What are you planning to do?"
     "I want you to write in my chart that I'm disabled."
     "You mean--you're applying for disability?"
     "Yeah.  I know people better-off than me who have disability."
     "I can't be of assistance to you in your disability application," I told him.
     "Why not?"
     "First of all, you aren't disabled."
     "I'm telling you, I'm stressed.  I got a lot of things on my mind."
     "Didn't you tell me you're about to get married?" I asked.
     "Yeah, that's another thing," he said, shaking his head.  "One more stress."
     "And don't you have a child with your fiance?"  I reminded him.
     "Yeah, she's five.  That's another reason I need help."
     "And aren't you two planning to have another baby?"
     "Yeah, Mara's pregnant right now."
     "Then...why don't you look for work?"
     "Cuz...I'm in school.  I can't work and go to school."
     "Yes, you can," I said.  "And isn't the government paying for you to go to school?"
     "Sort of," he answered.
     "You have a Pell Grant, and childcare assistance, and a monthly welfare check, and Medicaid, and food stamps," I reminded him.  "That's a lot."
     "It would be easier if I got a disability check," he insisted.  "I'm disabled."
     "Jimmy," I said, as if he were my own, recalcitrant son.  "The government just paid $50,000 for you to have heart surgery that saved your life.  One of your coronary vessels was twisted around your pulmonary artery, and you could have died at any moment.  But it's fixed.  Now, you're fine.  We found the problem, you got sent to Shands, and now...you're perfectly normal."
     "I know," Jimmy said, "but sometimes I still have pain in my chest--right here."  He pointed to the sternal scar where an incision had been made for the open-heart surgery."
     "That's normal," I said.  "It's from the surgery, and it will get better.  The stress test, EKG, and echo all show that your heart is working fine."
     "Right," he admitted.
     "Now...you need to quit asking for more.  You're strong, healthy, and smart.  You've got to pay the government back for everything it's done for you!"
     "What do you mean?"
     "Get a job, finish your education, take care of your family, and pay some taxes," I said.  "You owe it to this country.  You owe it to yourself.  And that's what will make you happy."
     "Well, probably the disability would just be temporary," he ventured.
     "I doubt it," I shook my head.  "If you ever got disability you'd stay on it forever.  People have a hard time giving up free money."
     "You don't know me.  I want to work.  I just can't," he said.
     "If you want to work, hit the pavement.  Look for a job.  Put in five or six applications a day.  You'll get one, sooner or later.  And when you do, don't tell everyone all your troubles.  Just show up every day on time, be polite, and do your best.  You're a lucky man, Jimmy.  If you lived in Thailand, or Mexico, or Bangladesh, you wouldn't have gotten that heart surgery.  You might be dead."
     "Hmmm," he said.
     "I don't want to hear any more about disability from you.  It's your right to apply for it--but if you get disability, I'll be very disappointed in you, Jimmy.  That's not what I have in mind for you."
     "What do you have in mind?" he asked.
     "I think you'd make a heck of a good auto mechanic.  Didn't you say you like working on cars?"
     "Yeah, in my spare time."
     "Well, turn it into a living.  Take some business courses.  Maybe one day, after working for a garage, you'll even open your own business.  I need a mechanic right now.  If you were in business for yourself, maybe I'd bring my car to you.
     He looked at me as though I had just said something in a foreign language.
     Then he got off the exam table.  First, he stared at the floor, then his gaze rested, piece by piece, on the four corners of the ceiling.  He was acting as though he had never really seen the place before.
     We stood together in silence.  Then, I patted him on the back.  "Go on.  Make a life.  You can do it," I said, opening the door for him.  "I know you can."
     "Okay," he answered.