Since I’m Not Getting a Damned Thing Done Anyway…

I live in a locality with unusually poor medical care. I cling to the “unusual” qualification, having lived in only two other places; Ft. Drum, N.Y., where the military provided what was equally bad healthcare (but it was the military, expectations were low to begin with), and a brief stint in suburban Chicago, where the healthcare was my first experience being treated like an actual human being in an emergency room. Since then, however, I’ve had enough horrifying experiences with medical care in my community to start a separate blog and post daily for at least two years, never repeating myself. I suspect that our community is not, actually, all that unique, which is pretty terrifying.

My mother became very ill the night before last with a high fever, extreme body aches, and weakness. She’s 62, swims three times a week and uses her Nordic Track everyday. She’s a partner in an accounting firm, takes no prescription medicine, and is a health nut. She couldn’t get out of bed, so my sister and I went to her house and called her doctor; he’s a skilled physician, but like most of the system, he’s a doc for profit. His office told us to take her to the ER. There, we had a really bad experience and they managed to nearly kill her, which I’ll share in a moment.

First, though, let me say that in spending the entire day in an ER, with momentary breaks to go get things from my mom’s house and take a kid from one caretaker to another, I noticed what I think is the absolute cornerstone of What’s Wrong With Healthcare In America. I’m sure you’re curious as to my discovery, so I’ll let you experience it as I did.

In the ER waiting room, my mother’s hands began to constrict and she couldn’t move them. She was barely coherent, and my sister and I had to repeatedly demand service from the admissions rep before, a full fifteen minutes after we arrived in the waiting room and after a supervisor had been called and we had started threatening to call 911 from the waiting room, a triage nurse deigned to stagger out and take my mom back. Once in there, she lectured me on the concept of hyperventilating (which caused the hand constriction) while not treating my mother. Then she made great show of announcing that the only other hospital in town had just closed its ER and was diverting everything to HER emergency room.

Once in a treatment room, my mother’s temperature was 103F, and she had chills and severe aches. We waited just under two hours to see the doctor, who was the only doctor on staff. He decided that she had the flu through this sophisticated technique:

Doctor: Have you had a flu shot, Ma’am?
Mother: No, I never get them.
Doctor: You have the flu.

He then prescribed antibiotics (nonsense in the case of a flu virus, but ERs are places where patients go trick or treating, and you can’t leave with an empty sack) and pain medication. They gave her Oxycodone. Now, I’ve never heard of treating fever related body aches with narcotics, but I’m not a doctor. The narcotic caused my mother to pass out when she got up to go to the bathroom, and her BP dropped to 80/30. This is bad. Two hours later, they sat her up, and her pressure dropped to 40/20, her respirations stopped and her heart rate plunged down to nothing. Kind of like, oh, being dead.

It was after 5:00 pm when her personal physician arrived at the ER and started ordering tests, you know, to DIAGNOSE her beyond the anecdotal flu. She was admitted and given a room around 9:00 pm, just under twelve hours after we entered the ER.

Every single person that we talked to about our frustrations; nurses, student nurses, friends and acquaintances, blamed all the failures of our system on one thing. Who or what is it, you ask, Grasshopper?

THE POOR PEOPLE AND THEIR MEDICAID.

Now, one of my core beliefs is that medical care cannot be effectively delivered using a for-profit model. It works well for doctors, who make salaries that place them in the top 2-5% earning brackets. No for-profit system works well when it has to give services away, hence the belief that the problem with health care is the damned, whiny, lazy-ass poor folks.

What it apparently is not the fault of, is:

--Physicians who continue to accept new patients until their practices are too crowded to deal with existing patients’ sudden illnesses.

--Physicians dumping patients on the ER for non-emergencies that they, themselves, don’t have time or inclination to treat.

--A for-profit model for healthcare that requires that drugs be handed out regardless of their necessity in order to support the great pharmaceutical machine.

--A for-profit model for healthcare. Did I mention that?

--A propensity on society’s part to believe that making less than $250,000-$300,000.00 a year is totally inadequate for a doctor. (I know the average is $150K, and I’m just not moved to tears by that, either).

--The status of physicians as demi-gods who are smarter than normal human beings, rather than specialized service providers like numerous others who are well educated in their area, but not dieties.

--Understaffed emergency rooms that operate on the philosophy that everyone wants narcotics and/or antibiotics and if you hand it out, they’ll shut up and go home.

--A complete failure on the part of the healthcare system to incorporate compassion and humanity into the larger model upon which it is based.

--Entrenched racism and class bias.


No, no, no, you might be saying, “It’s the poor people’s fault. The have the Medicaid, they want us to treat them, they’re dirty and smell bad, and, and, the whole family comes to the ER, they don’t have any decency, the poor people. They drink and smoke and fuck and what do they expect? It’s the poor people’s fault that those of us with money, with insurance, with education, get sub-standard care! They’re draining our resources!"

What’s so marvelous about this realization is that it means that the rest of us are completely off the hook. As long as we can blame the poor people, we don’t have to fix the system, or have difficult conversations about entitlement and medical business. It’s so, so, American of us to think that way. Makes me want to put on some Lee Greenwood and have another beer, while pretending that I’m economically safe because I deserve to be, and anyone who wants to work hard enough can have what I have. If they’d put those Medicaid cards down, hell, they’d be able to pull themselves up by their own bootstraps, the lazy bastards.