I was in my 2nd year of residency, 3 years out from medical school and in my late 20's.
She was the same age. I'd been consulted because she couldn't afford her epilepsy medication and had a seizure. She was also pregnant with her 4th child. So she was in the OB ward of the county hospital.
I had a job, an apartment a few miles away, a 4-year-old car in the parking lot, and a girlfriend (now Mrs. Grumpy).
She was homeless. None of her kids had the same fathers. She bounced between different shelters and whichever guy would take her and her kids in for a few days.
I'd showered that morning. She and her kids smelled awful, and obviously hadn't bathed recently.
I was in a generic shirt, tie, and pants from Target, with the required white coat. She and her kids were in tattered clothes from a donation center.
As I talked to her, scribbling her history down on my note pad, I suddenly realized I knew her.
10 years earlier we'd been in the same year in high school. We took PE, economics, typing, social studies, and chemistry together. We weren't close friends, but knew each other and said "hi" in the halls and local stores when we crossed paths. I suddenly had a vivid memory of her running to third base when I hit a single in a softball game.
I didn't mention it, and if she recognized me she didn't say so. I don't think she did. Her chart was huge, and I was just another in an endless stream of residents she dealt with on her frequent admissions. I restarted her seizure med and folic acid and she was discharged later that day. I went to another rotation the next week and never saw her again.
To this day I think of her. We came from the same upper-middle class backgrounds. We went to high school in American suburbia. Her parents were as successful in their area as were mine. Not wealthy, but comfortable, with expectations for their kids of college and a job and self-sufficiency.
I wondered how she got there. In 10 years we'd landed in very different lives. Had she made bad choices? Drugs? Alcohol? Had she just encountered terrible shit luck that all of us dread happening to us? A marriage gone bad? Domestic violence? A financial catastrophe beyond her control? I remembered seeing her and her parents posing for a picture at graduation. Did they know where she'd landed?
Sometimes, while trying to sleep, I think of her sitting there. I wonder if she's still on the streets. If she got her shit together and was able to move out of poverty. If she's even still alive. I'll probably never know.
Maybe she did something stupid, the kind of thing where all of us living in comfort can say "that would never happen to me, I'd never do something like that." Or maybe the circumstances were entirely beyond her control, the kind of financial clusterfuck nightmare that all of us dread destroying everything we have and work for.
I'll never know the answer. But the encounter always reminds me how much of life can be terrifying random chance, no matter how much we'd like to believe otherwise.