30 July 2008

Optimism, Or Lack Thereof...

We've all had the experience...
You encounter the "gloomy gus" who wants to go into the details of his quadruple bypass and recovery therefrom. If you see him in the grocery before he sees you, you hightail it to the opposite end of the store to check the price of premium diced clams, hoping he's headed for the checkout line.

It pays to be positive.
Like flies to sugar-water, positive people attract others.

I'm mostly a "positive attitude" guy, but it's getting more and more difficult.
One of my last flights bummed me out.
"Your patient is at Rock City Memorial Hospital. She's a 58 year old female, renal failure and rule out sepsis. She weighs 320 pounds."

Ugh.
Ugh for several reasons...
It's hot. The Rock City helipad is adjacent to tall utility poles with wires, mandating a one-way in, one-way out approach/departure.
I check, and the wind is cooperating for an into-the-wind departure, thank God. But that can only happen after we have loaded her bulk into the helicopter. Hoisting that kind of weight through the clamshell doors will be a task that will require two people on the lifting end of the stretcher and another inside the helicopter holding the folds of fat away from the wall as the other two push and lock the stretcher in place.

Ugh.

I always stay close to my crew on these flights... these little hospitals don't have many hands to help lift these heavy patients, so I frequently need to don gloves to help transfer them from the hospital bed to our stretcher. This time is no different. She has about a foot of tissue overhanging each side of the hospital bed, so I'm interested to see how we'll elevate the siderails of our stretcher after we have loaded her there.
Six people around her, three on each side, we all grab handfuls of the bedding beneath her...
Steve counts "one, two, three", and we move her more easily than I thought possible until I do the math: 320 divided by 6= less than 60 pounds each. No big deal. Steve reaches from the opposite side of the stretcher and lifts the fatty tissue out of the path of the siderail as Jim raises it, then they do the opposite side. The siderails disappear. It's an amazing sight.

We load her, fly her, unload her, and get her to the ICU safely.
On the flight back to base I ask, "Was she insured?"
Laughter from the crew answers my question. "She was on Public Aid."
Your tax dollars paid for this "Uninsured" patient to fly by helicopter to get the health care she needs, folks. And tax dollars will pay for her hospital stay, because no federally funded hospital can turn her away, and all the Level One trauma hospitals in Bigtown are federally funded.

I'm conflicted here. How much of this is a lack of personal responsibility?
I realize she's probably mentally ill. I realize she needs a support network.
I realize for her, food is a drug. To her, it's a drug every bit as powerful as heroin.
But she is our slave, isn't she?
We have established a system where she has locked herself up.
On public aid, she has the funds to eat enough to make herself morbidly obese. (This case is worse than morbidly obese... what's the term for that?)
And the scary part? We deal with cases like this often enough that my question, "Was she insured?" elicited laughter.
I ask, "How does she get so fat on Public Aid?"

Jim responds... "Government cheese."

What is OUR responsibilty here in our nearly bankrupt health care system?
Isn't caring for a patient like this a form of codependency?
The system we've established is partially responsible for her condition!

And here is where it begins to be difficult for me to remain positive about the course we're taking...
Let's get back to personal responsibility. These days no one is responsible for the mistakes they make.
"I stole those shoes because he was rich and I was embarrassed with my footgear."
"I stole his BMW because he looked so smug sitting there and I can't afford one."
"I'm fat because I can't stop eating trans-fats at McDonalds."

And instead of realizing where our real problem lies and resolving it, (that would be HARD and would require facing personal responsibility), we're headed toward more Socialist attitudes... more codependency. "Hope and change" means more government programs and more tax dollars helping more of these folks get more access to "government cheese"... a vicious cycle.

I'm in a funk.
Help me to see how we get back on the right course.
Show me how to be optimistic about our future.

8 comments:

Rain said...

I just lost my mozilla thanks to upgrading it. I think it might be emblematic of the systems we have today. There are no easy answers to what you ask here.

My feeling is if we do go to health care for all adults (Obama is just suggesting all children for now), it will present some real dilemmas. Oregon had a health care plan which is not totally working perfectly either but they listed off the most likely things you can treat with a successful result and based on income, that's what they offered the lower economic rungs that would otherwise not be able to afford any care. That still didn't make everybody happy.

If we consider obesity a problem for care, what about alcoholism, abuse of prescription drugs, smoking, and so forth for all the things people do that are not good for them? If we don't do something like that, pretty soon nobody will be able to afford any care.

In the countries with the best results from health care programs for everybody, from what I have understood, it's to offer basic care; then you pay insurance for extra which is how medicare works. If anybody is not yet to 65, they may not know that medicare is not free for what most consider good care. You pay for additional insurance for prescription drugs or more options for care. If you don't pay for that (which for someone in a retirement corporate insurance program the cost ends up about the same), in states like Oregon, good luck getting a doctor.

I think making all of our congressmen accept the health care the rest of us get might be a good start.

cary said...

You need a pick-me-up?

Heh - at least YOU fit in the chopper, without help!

Oh, I get it - you want a brighter outlook for the country as a whole.

Hmmm... may not be able to help you there. I, too, advocate for personal responsibility and accountability for one's own actions. Your patient is the result of a victim mentality, and the willingness to rely on someone/thing else for your basic needs.

The country is heading for an epiphany, and the left doesn't like it.

Paul said...

When I need a pick me up I count my blessings. Sad to say a lot of Americans do whine.

Rodolfo said...

I don't know all the details of Hopey and Changeys plans but with respect to insurance he wants to lower insurance costs so the majority of the *uninsured* can afford and pay it. If the majority of the uninsured in our country opt for the lower premiums my understanding is that it will reduce government socialism.

Don't think that helped much but I do understand your concerns. I don't want people who aren't pulling their own weight getting stuff for free but I don't want to see them left on their own either. The outlook for these people are bleak. My view is that it starts at the top. We need people in leadership positions that embody personal responsibility and that will hopefully set the tone for the rest of the country. The leadership the past 20 years have been dreadful. We should also focus on prevention care as opposed to simply health care. The secret to great health is simple: Eat less and exercise more.

I guess I'm naive.

Greybeard said...

Rain wrote:
"If we consider obesity a problem for care, what about alcoholism, abuse of prescription drugs, smoking, and so forth for all the things people do that are not good for them? If we don't do something like that, pretty soon nobody will be able to afford any care."

Is that what you intended to write, Rain? If our present system is nearly bankrupt, where do we find the money to "do something" about people who are responsible for their own ills?

People come from all over the world for health care in the U.S..
We dropped this woman off at one of the "top 10 hospitals" in the country. By Federal law she'll get the same care there that any rich Canadian would get if they came here to have a cancerous brain tumor removed.
(That's a reference to a previous blog-post on the subject.)

And Rodolfo-
Why should I pay a dime for ANY health care, even at low premiums, when I know it will be provided free? Do you think BHO is gonna require us to buy a government subsidized health care policy? What does that do to my freedom of choice? Do we deny care to those refusing to buy the government health insurance? Do you see that happening in San Francisco?

Oh my.
Yes, I think that's a little naive, but admitting it is a healthy thing. Thanks for your comment.

Anonymous said...

It's a beautiful day and you get paid to do what you love - fly a helicopter. Something that I can only dream of at the moment.

Take joys in the flying

Rain said...

Obama has not advocated health care for everyone. Just covering all children. That is not what many on the left want but if we are going to have universal health care (and I wrote what I meant), we have to have some accountability for behavior but that edges toward dictatorships and where does someone draw the line? You ate a transfat and we know because we have a computer in your home to tell and now we won't help you. The problem is we are getting to be a bigger and bigger country with more and more needing help and less and less money to do it. It won't solve the problem but just consider what could be done with the money that disappeared in Iraq... billions... and nobody knows where. No needy poor person got it. Too often our country has helped out the richest without worrying about those advantages. Anybody who thinks there will be an easy answer to the health care problem, hasn't been paying attention-- unless they don't mind letting people die who had bad luck as well as those who were lazy or greedy.

Rodolfo said...

GB wrote: Why should I pay a dime for ANY health care, even at low premiums, when I know it will be provided free? Do you think BHO is gonna require us to buy a government subsidized health care policy? What does that do to my freedom of choice? Do we deny care to those refusing to buy the government health insurance? Do you see that happening in San Francisco?

My sense is that the majority of the 47 million that are uninsured in this country WILL buy insurance if it were affordable. He's said before that those who are satisfied with their coverage NOW won't have to do anything so I don't think your freedom of choice will be affected too much.

At any rate this will all blow over. Maybe not in your time but it will. This has all been fun and stimulating but just like anything else in life it'll come to an end soon. All I can do is follow the Golden Rule and wish for the best. The rest (god willing) will take care of itself.