Monthly Archives: June 2012

Disconnected US health care

The Dressing Change

–Tara Frerks
I shook hands with Mr. Friedrikson and touched Mrs. Friedrikson on her thin shoulder to avoid the bulky dressing on her right hand.
“I need my dressing changed,” she said in a grandmotherly voice. She cradled her right hand in her lap and shielded it with her other hand and arm.
Mr. Friedrikson, a few strands of gray hair combed across his bald head, sat on the edge of his chair, tapping his left foot on the linoleum floor. “Do you know that you are the fifteenth contact we’ve made trying to find someone to help us?” He thrust a paper bag filled with dressing supplies into my hands.
I placed the bag on the counter and then settled onto a stool to listen. I enjoyed the independence and array of experiences I’d encountered in this small Minnesota community. I asked one open-ended question, “What can we do foryou?” and the Friedrikson’s story came pouring out.
A few months ago, they had retired to a house on one of the nearby lakes. They were new to this town and clinic. Helping her husband of forty plus years with a kitchen project, Mrs. Friedrikson had been trying to steady a two by four he was sawing. Her hand slipped and the blade of the circular saw sliced deep into the flesh and bones of her right hand. With blood soaking an old towel, they drove to the town’s emergency room. The ER physician deemed that the injury was too complex for the local surgeon to repair. An air-ambulance transported her to a trauma center for microsurgery. “We were discharged home last week, and they told us to get checked up here within the week,” Mr. Friedrikson said.
“We couldn’t find any clinic that would see us. Finally, we just went to the local emergency room this weekend. I have to tell you, the surgeon who changed the dressing was kind of nasty.”
“Now Herbert,” Mrs. Friedrikson said. “He was probably very busy.”
I controlled my smile, I’d worked with that surgeon.

(Excerpted and used with the permission of the author, published in The Country Doctor Revisited, KSU, 2010)

It doesn’t take much experience to see that our health care system is broken. Patients work hard to locate what they need and even with persistence, their needs often go unmet. This week we learn whether or not the Supreme Court declares the Affordable Care Act’s (ACA) mandate that patients purchase insurance unconstitutional. While the ACA has many problems, it was an attempt to address the fragmentation of the US health care system which spends exorbitant amounts of money and has little to show for the effort. Granted, many of the medical miracles achieved by technology are tremendous, but too many citizens don’t get the basic care they need.

Pay attention in your setting to what works and does not work about patients’ access health care. Whether or not the ACA’s mandate is declared unconstitutional or not, much needs fixing in the current US health care system.

A Psychiatrist Waits for His Ten O’clock Patient and Imagines He Is Han Shan

 

–Richard M. Berlin

Daughter gone,

hair gone, my father

dead for half my life.

Patients I saved from suicide

lived until old age,

died from cancer instead!

Twenty years of hospital work.

Twenty years pruning apple trees

on the west flank of Cold Mountain.

Once they were sticks.

Now the branches bow with ripe fruit.

A faint wind stirs them.

I’ll share a bushel with the crows,

another with the worms!

 

 (Excerpted and used with the permission of the author, published in The Country Doctor Revisited, KSU, 2010)

Dr. Berlin, a psychiatirst and poet whose poems we've shared in other blog entries, reflects on life's rhythms and transience mimicking the Chinese poet Han Shan. Han Shan referred to himself as Cold Mountain. Dr. Berlin lives on Cold Moutain. Han Shan was a cynic and a hermit who liked to poke fun at the self-importance of the other monks. Enjoy this brief reflection on all we try to do and hope to do as healers/physicians and what it all amounts too.