Medical Care

Learning the Art of Patience

njene / Shutterstock
njene / Shutterstock

IN THE MIDDLE OF THE NIGHT on July 23, 2012, I slipped and fell in the bathroom of our hotel room in downtown Indianapolis during a family vacation. My head slammed onto the sink and then the floor.

The noise from my fall awakened my spouse, but when she asked me what happened as I lay on the floor, all I said was, “I’m okay.” Seeing no visible sign of injury, she returned to bed. A stomach bug was making the rounds, so she figured that it must have nabbed me. My vomiting every hour or so the remainder of the night only seemed to confirm this assumption.

At dawn, however, the first words out of my mouth were: “I think I cracked my skull. You’d better take me to the emergency room.” My wife knew something must be wrong, because I never suggest going to the hospital right away. The physician on duty thought I probably had a mild concussion and that I would be able to go home that day, but a CT scan was needed to make sure.

Afterward, he told me that his earlier hoped-for diagnosis was wrong. Instead, I had fractured my skull, with a subarachnoid hemorrhage and a small epidural hematoma under my left frontal region. In other words, I had a traumatic brain injury, and my life was at risk. In fact, I immediately was loaded into an ambulance and taken to a hospital nearby where neurosurgeons would be better able to treat me.

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Short Takes: Nia Zalamea

Nia Zalamea
Nia Zalamea

Nia Zalamea is a board-certified general surgeon. After five years in a traditional medical practice in rural Virginia, she joined the Church Health Center, an organization in Memphis, Tenn., that seeks to reclaim the biblical commitment to care for our bodies, minds, and spirit. She is one of two general surgeons in the U.S. who does full-time charitable work.

1. Why did you leave traditional medical practice? I went into medicine to serve; it was the one craft and skillset I could offer to an individual in front of me. But after five years, I found out that I wasn’t actually living my mission; I had put five people into bankruptcy. What I saw in rural America was that even one operation could completely derail not just one generation but multiple generations. Not just in terms of economics, but in terms of social capital, education, and everything we know that affects health and medical care.

2. What exactly does the Church Health Center do? The Church Health Center is a medical wellness home for the underserved, the uninsured, and the underinsured of Memphis. We provide surgery on a sliding scale; if someone can’t afford the surgery, it gets written off. The hospital supports the surgery in not charging the hospital fee, which is a huge chunk of the cost. So it’s not free, but the out-of-pocket cost for the patient is extremely low. We just make it affordable.

3. What are some of the barriers that prevent your patients from having access to health care? We have ongoing workshops during open enrollment to get people on to Affordable Care Act plans, but what is deemed “affordable” is not always affordable; the majority of my patients are 150 to 200 percent below the poverty line. Another barrier is access: Just because you have an insurance card doesn’t mean the doctor will see you. And this is where a lot of the injustice lies; many doctors’ offices and businesses have closed their doors to new Medicaid patients. Finally, the Affordable Care Act doesn’t cover everyone; my patients include undocumented immigrants, refugees, and patients from other countries whose children are being treated nearby at St. Jude Children’s Research Hospital.

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Syria: Medical Supplies Critically Low

From The Los Angeles Times:

Escalating violence in Syria has shut down pharmaceutical plants, piling another worry onto the woes facing the Syrian people: Severe shortages of medicine.

The World Health Organization warned Tuesday that growing clashes between forces loyal to President Bashar Assad and opposition fighters around the cities of Damascus, the capital, and Aleppo have damaged and closed many of the local plants that make the vast majority of medicines. The country produces most of its own pharmaceuticals.

Drugs to treat tuberculosis, hepatitis, diabetes and other maladies are urgently needed, along with chemical reagents to screen blood before it can be used for infusions for trauma and surgery patients, according to reports received by the United Nations agency.

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It's Time For Us to Grow Up and Sacrifice

The other day the mail brought an advertisement for something I desperately need (or so the ad suggested). If I ordered it right now, the ad said, I would save a hefty percentage off the usual price. In vain I searched the flyer for the price. None was listed -- not the total, not my monthly payment. I was apparently supposed to place my faith in the kindly marketers and order it anyway.

I guess I should be used to this sort of marketing. After all, that's how our federal government does business. Shall we a. fight a war in Iraq? b. add a war in Afghanistan? c. subsidize medical care for seniors and the poor? d. rescue failed financial institutions? e. subsidize growers of corn and soybeans? or f. fund interstate highways?

Wanted: 1,000 Pastors For the Poor

We are looking for 1,000 pastors to debunk a myth based on the political assertion that government doesn't have any responsibility to poor people. The myth is that churches and charities alone could take care of the problems of poverty -- especially if we slashed people's taxes. Both this assertion and myth contradict the biblical imperative to hold societies and rulers responsible for how they treat the poor, and ignore the Christian tradition of holding governments accountable to those in need. Faith-based organizations and government have had effective and healthy partnerships, and ultimately, the assertion and myth have more to do with libertarian political ideology, than good theology.

Sky High and Rising

Five years ago, in my mid-30s, I was diagnosed with what turned out to be chemotherapy-resistant lymphoma. I was lucky: My job offered decent insurance, my doctor-father helped me understand what to ask for, and I lived reasonably close to Johns Hopkins' top-ranked medical facilities. By the grace of God, the prayers of friends and co-workers, and weeks of high-tech inpatient care, I am alive and well.

Back at work, I started reading about how the U.S., compared to other wealthy, industrialized nations, pays a wildly disproportionate (and growing) amount for health care -- in 2009, 17.6 percent of the entire national economy, basically half again the amount paid by France. The other countries of Western Europe, Japan, Korea, and Australia pay even less, often with percentages in the single digits, even though a much bigger chunk of those countries' populations is elderly. All these countries have higher life expectancies than the U.S; in general, their residents are more likely to get a same-day visit with their doctors when they get sick, to stay in the hospital longer after a heart attack, and to suffer from fewer medical errors.

So I have two questions: What can the U.S. do so that its health-care system would provide better results, at a less extreme cost? And, under such a system, would I be alive today?

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The Art of Dying

Death is a human reality that eventually catches up with all of us. Scripture and Christian tradition remind us that we are living with death from the moment we are born. Through the Christian tradition of ars moriendi, or the art of dying, we are taught to die well by trusting in God, repenting for our failings, forgiving others, and having compassion for those whose needs exceed our own.

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Sojourners Magazine June 2010
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