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April, 2017

Healthcare - Can't Live With It; Can't Live Without It

by Larry

I came across an interesting statistic in researching this little essay: without exception, every patient served by the U.S. healthcare system has died. It is good to know we have a perfect record in something.

On the other hand, just about everyone has experienced, or at least knows someone who has, terrific examples of great improvements, and in many cases lifesaving instances, of how healthcare has come through with flying colors. Yes, it costs way too much. Yes, it can be extremely frustrating, even totally absurd. Yes, any particular one of us could likely make it a lot better if only we might be listened to by decision makers and they would come together in constructive, statesmanlike, cooperative ways. Yet, on balance, it is better than if we did not have one.

Nonetheless, the exasperation level is so high...wish I could get every lawmaker in a room by him- or herself, point a gun, and say with absolute truth and conviction, your life depends on this (as, by the way, actually do the lives of many of their constituents): come up with a workable healthcare system for our country, one at least tolerable for 90% of us, one that is more convenient and patient-oriented, costs less than what we have now, provides better care, and results in ours being right at the top of the heap in terms of medical outcomes and life expectancy. You have one month, or you'll be dead. We all know, however, that is not going to happen. If it did, we might lose a large number of Congressmen and Senators. We are for the foreseeable future, and though it is tweaked around the edges, either stuck more or less with what we have or in for an even worse arrangement at some point down the road.

Accepting this then as best I can, I would like to pay tribute to a few glass is half-empty and glass is half-full aspects of healthcare as I and others I have understood it and benefitted or suffered from it. A little girl who would have been my aunt Wilma died of congestive heart failure at age 5. Her doctors could not save her. My dad was so badly treated after a motorcycle accident that he vowed, and largely stuck with this pledge to himself, for the rest of his life never to see a physician or go into a hospital again. My mother survived a rattlesnake bite, but was nearly killed in the hospital by the care received there for it. I had congestive heart failure as an infant and toddler and suffered symptoms similar to my young aunt's. As it happened, by then x-rays were in their pioneer days of use, so the doctors decided to cure me by giving repeated, massive doses of them in my neck and upper chest. I survived despite their care, and later was told that the treatment would make me more susceptible to cancer in the affected areas. Happily, that has not happened. I do have significant thyroid (neck gland) dysfunction for which medications are required. Dentists have left the left side of my mouth in worse shape, so I need to chew anything hard only on the right. Doctors fixed a birth deformity, a partial club-foot difficulty (the soles of my feet turned inward instead of down to the floor or ground), but in doing so left my spine in an odd configuration and my natural stance set with shoes turned outward instead of straight ahead.

A brother of mine had an apparently severe concussion, with confused thinking and passing out, yet was left largely without supervision once at the hospital.

During numerous instances from my times as an orderly at Austin State Hospital (in TX) and Herrick Memorial Hospital (in Berkeley, CA) I noticed that patients were badly treated, were neglected for many hours at a time by medical staff, or were allowed to be abused or injured by staff or other patients. Heart patients were sometimes left in the care of people who did not have basic CPR training. Unresponsive schizophrenic patients were left with little or no stimulation for long periods. In one case, an apparently unnecessary lobotomy was performed. In another, a patient was violently hit by another with a broom handle, hard enough to knock the victim down and leave a big knot on his head. His assailant was unrestrained and had been committed there as criminally insane. In yet another, a man just being admitted had an apparent heart attack, was not seen by medical personnel for over half an hour despite emergency calls, and died. Another man had multiple cancerous lesions so large they extended from outside to inside his abdomen. He leaked blood and fecal material more or less perpetually onto his bedding. A woman had a cancerous breast that had not been treated for at least many months, years more likely. A young man in his twenties somehow managed periodically to get hold of and swallow "sharps," needles and razor blades, necessitating new surgery each time to remove the extra hardware.

My mother has been deemed too physically unstable from a recent fall to be on her own in her apartment and so is being charged hundreds of dollars a day for "rehab" care, yet after nearly a week has yet to be seen by a doctor, has had minimal therapy, and is not being treated for her complaint, pain of the right ankle and foot. She has on her own regained most all of function from prior to admittance to the unit and wants very much to return to her own apartment, but is not being allowed to leave, the staff saying, without conferring with her doctor, she should be there for at least several more weeks.

Yet, balancing these harsh circumstances are many positive instances of great benefits from medical care. For instance, another brother as a small child swallowed poisonous chemicals he had discovered under a sink before anyone realized he had the mobility or inquisitiveness for danger from that hazard. When found, he appeared near death, yet a rush to the hospital resulted in his life being saved. When another of my brothers was not yet born our mother fell all the way down a flight of stairs hitting the concrete basement below. A rush to the hospital allowed her to be OK and that brother to be born healthy. A brother accidentally slashed his thumb almost all the way through with a machete used for cutting small limbs and brush as fodder for our goats herd. Swift medical attention led to the thumb being saved and now functioning normally. A nephew fell and injured his back badly. It healed incorrectly, leaving him in great pain and unable to do feats that were easy before, yet a surgery corrected the damage and restored him to normal functioning. I have seen severely depressed patients respond so well to treatment they can give up both therapy and medication. Almost miraculous surgery has removed a growth on a niece's pituitary gland. Replacement of my then 92 year old mother's knee occurred and was so beneficial that she was essentially pain free and walking better than in years only weeks later. Procedures for her cardiac fibrillation condition have returned her to good health and energy. I have witnessed folks who were almost immobile become strong and able to walk again through medical assistance. I have seen folks with the among the worst kinds of mental diagnosis restored to gainful employment and normal activities of daily living. What is more, I have seen how American physicians have risked their lives and gone into war zones where they have helped hundreds or thousands of injured or otherwise dying patients, who had been hurt in the regional conflicts, get new leases on life.

There is much left at this point to be desired in our healthcare system, yet, for all the division and dysfunction in Washington, there is yet a great deal of cause for hope. We are not starting from scratch, and medical service provision is, I am convinced, getting better all the time. It is to be sure a mixed bag, and there is much to which we can point with disfavor. However, for all its faults, it permits our average length of years in this world to creep more or less steadily upward, mostly also with good quality of life.

We may wish for much to be improved, and I certainly am one of those who do, but still there are many boons in today's medicine available to us, and maybe we can learn and build on what still ails our system, till it too is clearly on the mend.

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