There's a post circulating of a letter written to a paper in Jackson, Mississippi from an ER doc in 2009. In it he details having to provide care for a woman who has a gold tooth, multiple, expensive looking tattoos, wears an expensive brand of tennis shoes and has an R&B ring tone on her cellphone. The patient received medicaid. His letter stated he didn't like that he was paying for this patient's health care when clearly the patient is choosing to spend her money on vices rather than getting herself health insurance and taking care of herself.
I find so many problems with implications made by the doctor in a letter like this, I'm almost not sure where to begin, but what I think it comes down to race and class.
The doctor doesn't name the patient's race, but gives enough cultural related hints, I think, for the reader to assume that she is black. This article from CNN.com discusses study findings of how doctors view and subsequently treat black and white patients differently. If this doctor were presented with another medicaid case of, let's say, a white woman who has a gold tooth and maybe some other non-typical items for a poor person, would he feel so resentful? For the record, my 93 year old grandmother is on medicaid, has a gold tooth and has many times needed care at the hospital that there is no way she could have afforded to pay for.
Does the doctor know where the patient's tattoos came from? Did the patient tell him she went to the city's best tattoo parlor? Or, did the patient do some jail time and get ink on the inside? There are so many ways they could have happened, that who knows and why try to imply something?
A quick look on the internet tells me that the current cost of milk per gallon is around $4.50. You can buy a 12 pack of Pepsi for $3.69 and a 12 pack of Natural Light Beer for $7.99 (this price was from a Mississippi liquor store). Does the extra $3.50 spent on beer rather than milk give the patient enough to pay for her own health insurance each month? Having provided my own healthcare in the past to the tune of nearly $500 a month, I'm guessing that answer is no.
And what about her food choices? There is a modified version of the letter circulating on Facebook that references the woman's eating fast food take out. While snopes.com puts that letter into the false category, someone thought it was worthwhile to ramp up the evils committed by this woman. Surely people know just how easily it is for the poor community to just walk down the street to Whole Foods and get high quality food at a low cost as well as finding nothing but fresh fruit and vegetables at their local convenience store. There is a reason why the poor are obese. Little Debbie swiss rolls cost $1.33 for 12 at Kmart.
Is she on medicaid because she isn't working and is just living off the system? There are an awful lot of people out of work in our country right now and that may be the case, but there are also a huge number of 'working poor' who can't afford healthcare even though they are employed. The doctor in his letter didn't seem to know how she ended up on medicaid, but again the implication is there.
First do no harm, doctor, which would imply to me you won't judge your patients, you will work to educate them and provide them with the care they need. Be aware of your own racial biases and perhaps inform yourself about what comes along with living in poverty before you pass judgment on another poor woman who comes into your ER.
Friday, September 17, 2010
Sunday, September 12, 2010
Mystery on Allen Street
A nice young family lives next door to us. They moved in a year after I did and last year, moved to the upstairs part of their house and rented out the first floor. When they moved in I would smile and say hi, but they really, really kept to themselves. Sometimes they'd nod, other times, no response at all. That isn't all together out of the ordinary in New England. We aren't exactly open and friendly folks all the time, so I didn't think much of it. But maybe I should have.
You see, when they moved in, they had two boys and now they only have one. I'm not kidding. The older boy is no longer there. The younger one is now about 2 and I see him get into the car to go to daycare with his mom in the mornings. The older one was maybe 4 or 5 when they moved in and he's gone. His bike used to lean against the side of the house, next to his dad's which was outfitted with a seat for the infant to ride in. Now, no little person bike, no running around in our driveway. Nothing. I'm not sure how long it has been since I last saw the older boy, but I hadn't really thought about it until this summer when E and I would be out and I'd see the mom out too, but she was always with just the younger boy.
Over the years we've become a bit more friendly and will say hello and chat briefly when we see each other outside. They had a yard sale earlier this summer and the mom came over to tell me the day before and said that she'd set aside some toys she thought would be good for Ella. I went over in the morning and got a bunch of great stuff. We were talking about kids, daycare etc. I commented that I couldn't imagine doing it with two. She just sort of looked at me blankly. I quickly moved on, but it made me realize there really isn't another kid living with them who would now be about 7 years old.
Um, where did the kid go? I can see two options. He was either a product of an earlier marriage and lives with the other parent (the husband has a foreign accent, so maybe the kid is on another continent?) or something awful happened and he died. I would think the neighborhood gossip would have gotten that one around, but who knows. Most of the talk around here centers on the geniuses who miss the one way sign at the end of our road and get yelled at by the old lady across the street who site out on her porch as they drive by (as though they can hear her inside their car).
There is no polite way to ask a question that would get the answer, so I quietly hypothesize and keep my eyes peeled for his bike to return. Now that I wrote this, I totally feel like Harriet the Spy. Or my mother, I'm not sure which.
You see, when they moved in, they had two boys and now they only have one. I'm not kidding. The older boy is no longer there. The younger one is now about 2 and I see him get into the car to go to daycare with his mom in the mornings. The older one was maybe 4 or 5 when they moved in and he's gone. His bike used to lean against the side of the house, next to his dad's which was outfitted with a seat for the infant to ride in. Now, no little person bike, no running around in our driveway. Nothing. I'm not sure how long it has been since I last saw the older boy, but I hadn't really thought about it until this summer when E and I would be out and I'd see the mom out too, but she was always with just the younger boy.
Over the years we've become a bit more friendly and will say hello and chat briefly when we see each other outside. They had a yard sale earlier this summer and the mom came over to tell me the day before and said that she'd set aside some toys she thought would be good for Ella. I went over in the morning and got a bunch of great stuff. We were talking about kids, daycare etc. I commented that I couldn't imagine doing it with two. She just sort of looked at me blankly. I quickly moved on, but it made me realize there really isn't another kid living with them who would now be about 7 years old.
Um, where did the kid go? I can see two options. He was either a product of an earlier marriage and lives with the other parent (the husband has a foreign accent, so maybe the kid is on another continent?) or something awful happened and he died. I would think the neighborhood gossip would have gotten that one around, but who knows. Most of the talk around here centers on the geniuses who miss the one way sign at the end of our road and get yelled at by the old lady across the street who site out on her porch as they drive by (as though they can hear her inside their car).
There is no polite way to ask a question that would get the answer, so I quietly hypothesize and keep my eyes peeled for his bike to return. Now that I wrote this, I totally feel like Harriet the Spy. Or my mother, I'm not sure which.
Thursday, September 2, 2010
Day Care, We Does It
It was a big old week here at the Wavis homestead. The Shorty packed up her lunchbox (along with 14 million other bags of diapers, clothing changes, sun hats, butt paste, bottles and formula) and trekked off to school. Well, daycare, but we call it school because she is learning stuff while in a place with 6 other little people all clambering for the same rattle.
We visited the day before she began and stayed for an hour. She was totally content and I felt good about the decision to send her there, regardless of how poor it is making us. Then, that night, it hit me. This whole being home and raising her is coming to an end. I was no longer going to be the sole caregiver for my little girl. When she has a boom, I won't be there to scoop her up and get her laughing again. I'll have to figure out how to get me ready and her ready and out the door with a nutritionally sound lunch that wasn't just rustled up from the fridge. It made me sad.
When the Hubs came home and announced that he was sad she was going to daycare. It made me mad. Who was he to feel that way? His life wasn't changing? He wasn't having to figure out anything new and refind his professional self in between diaper changes and nighttime wake ups.
Then I calmed down and realized he had a right to his feelings too and really, I was just needing to embrace this next change. I knew a part of me was yearning for it. It is HARD to be home all day, alone with a little one. Starting when we were would allow for some shorter days and a slow rolling start before I have to go in to school to teach was a good thing. Waiting two weeks was just delaying the inevitable and would add to the stress level in the long run.
The first day I stayed for half an hour until she seemed suitably distracted and I took off. When I picked her up that afternoon, she was on the floor, chattering away while playing with a book. She heard my voice and crawled at warp speed over to me. Yesterday, I just dropped her off and left and when I picked her up she crawled over to me but wasn't really anxious to leave. I stayed and chatted with her teachers until she sat next to me and threw her hands up in the air saying "all done" in sign and we left. Both days she did short naps but was totally over stimulated from the day and an exhausted mess by bedtime. Today, I could tell she was tired when she got up. When I dropped her off, she kind of gave me this 'there is no way you expect me to do this another day' kind of look and she burst into sobbing tears. I restrained my own tears and exited quickly, figuring they have a better shot of distracting her when I'm not around.
I've kept my cellphone close these 3 days waiting for the call to come get her because she can't stop crying, but it hasn't come. The kid is just ready for this (despite the fatigue, presumably she'll learn how to nap in a noisy environment soon). She loves being around people and has already buddied up with a little boy who is about at the same physical stage (despite being 2 months younger and about 5 pounds heavier) and the two of them crawl around together.
It is hard to believe we've made it here, but here we are. It is daycare for 3 days a week and mom and daughter days for 2. I'm hopeful that this is a good balance for everyone.
We visited the day before she began and stayed for an hour. She was totally content and I felt good about the decision to send her there, regardless of how poor it is making us. Then, that night, it hit me. This whole being home and raising her is coming to an end. I was no longer going to be the sole caregiver for my little girl. When she has a boom, I won't be there to scoop her up and get her laughing again. I'll have to figure out how to get me ready and her ready and out the door with a nutritionally sound lunch that wasn't just rustled up from the fridge. It made me sad.
When the Hubs came home and announced that he was sad she was going to daycare. It made me mad. Who was he to feel that way? His life wasn't changing? He wasn't having to figure out anything new and refind his professional self in between diaper changes and nighttime wake ups.
Then I calmed down and realized he had a right to his feelings too and really, I was just needing to embrace this next change. I knew a part of me was yearning for it. It is HARD to be home all day, alone with a little one. Starting when we were would allow for some shorter days and a slow rolling start before I have to go in to school to teach was a good thing. Waiting two weeks was just delaying the inevitable and would add to the stress level in the long run.
The first day I stayed for half an hour until she seemed suitably distracted and I took off. When I picked her up that afternoon, she was on the floor, chattering away while playing with a book. She heard my voice and crawled at warp speed over to me. Yesterday, I just dropped her off and left and when I picked her up she crawled over to me but wasn't really anxious to leave. I stayed and chatted with her teachers until she sat next to me and threw her hands up in the air saying "all done" in sign and we left. Both days she did short naps but was totally over stimulated from the day and an exhausted mess by bedtime. Today, I could tell she was tired when she got up. When I dropped her off, she kind of gave me this 'there is no way you expect me to do this another day' kind of look and she burst into sobbing tears. I restrained my own tears and exited quickly, figuring they have a better shot of distracting her when I'm not around.
I've kept my cellphone close these 3 days waiting for the call to come get her because she can't stop crying, but it hasn't come. The kid is just ready for this (despite the fatigue, presumably she'll learn how to nap in a noisy environment soon). She loves being around people and has already buddied up with a little boy who is about at the same physical stage (despite being 2 months younger and about 5 pounds heavier) and the two of them crawl around together.
It is hard to believe we've made it here, but here we are. It is daycare for 3 days a week and mom and daughter days for 2. I'm hopeful that this is a good balance for everyone.
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