Monday, February 18, 2008


One of the issues I worked on while I was in south Florida was the relationship between primary care services and mental health services. I have always had a problem getting good health care as soon as the provider asked what medications I was presently taking. It seems like the list of psych meds I take deafens the medical doctors’ ears. Studies support that we die at an earlier age than folks without a mental illness and I don’t think all of it can be contributed to our bad habits which they tell me research shows we have at a higher rate than chronically normal people do. The truth is we get poorer health care than the average person in this country.
In today’s New York Times in a piece by Kevin Sack we learn about another study. “A nationwide study has found that the uninsured and those covered by Medicaid are more likely than those with private insurance to receive a diagnosis of cancer in late stages, often diminishing their chances of survival.”
When I moved here to Morganton, NC I picked a local physician who was just starting her practice. Soon after seeing her a piece appeared in the paper that she had just successfully completed the Certification Examination of The American Board of Family Medicine. I was surprised to find out that the ABFM is one of 24 member boards of the American Board of Medical Specialties and is the second largest. However, my biggest surprise was what the exam covered. It covers (but not limited to) the disciplines of the specialties of adult medicine, care of newborns, infants, children, adolescents, maternity and gynecological care, community medicine, care of the older patient, human behavior, care of the surgical patient and mental health.
When I went to see her the first time I had to take the list of the meds I was on just like all the other times I had seen a new doctor. I have kidney and heart problems. I had had surgery to repair an abdominal aortic aneurysm in March 2007 which involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft), which is sewn into place. This procedure requires open-abdominal surgery involving a large incision and a lengthy recover time. An aortic aneurysm is a weakened and bulging area in the aorta, the major blood vessel that feeds blood to the body. The aorta, about the thickness of a garden hose, runs through the center of your body. Because the aorta is the body's predominant supplier of blood, a ruptured aortic aneurysm can cause life-threatening bleeding. I was lucky (or God was not done with me) that while doing an ultrasound of my liver the tech saw the aneurysm. My point is I am not the easiest case she ever had walk through her door either medically or personality wise, but because of her training and because of the person she is she has done an excellent job with a difficult patient. I don’t make a good patient.
What I am using all these words to say is that if I can be provided good medical care then any of us can. Just before this past Christmas I was awaken from a deep sleep with severe chest pains. I sat in my office almost hoping it was my time to go because I have been suicidal since I was sexually abused at four years old and it did not stop then. My bipolar illness has not done wonders for the suicidal thoughts either. Finally, I woke Patty and off to the hospital I went by ambulance with them popping nitro pills in my mouth. I was in the emergency room until about noon waiting on a bed. Through a mix up the cardiologist never got called, but even though my doctor does not see patients in the hospital (they have hospital doctors) she came by. She did not stand by the bed. She sat in a chair like she was visiting me. They wanted me to have a heart catheterization, but when things got so confusing I told Patty to either take me home (it was almost midnight) or I was just going to the street. I have not had the catheterization yet, but my physician is still working with me. I may be the most distrusting patient on earth, but she has not thrown me away.
I tell you this story because I want you to dream of the day when all my fellow sojourners will be treated by a physician with the same respect I am by her. She sees me as a person. The key to all of this folks is when the day comes we see ourselves as a person. When the world sees us as fully human too and not just as a diagnosis, we will have really won.
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