As a student devoting his life to rectifying pertinent global health issues and well on his way to graduate school for global health, I have witnessed and will continue to witness grave injustices and inequities in health. This past weekend, I had an experience which was, for lack of proper phrasing, humbling.
An emergency situation arose this past weekend in which someone I care deeply about developed a severe case of sinusitis, resulting in unbearable headaches, extreme fatigue and cycling fevers. Mixed with lack of sleep, dehydration and a tremendously stressful week organizing a conference on campus, we decided she needed to see a health professional immediately. It was well past Health and Wellness hours, but a cab was surprisingly easy to find on the corner of Snelling and Grand on a Saturday night.
We first went to a local clinic where the problem began. After answering a mélange of questions which were not even remotely relevant to her symptoms, the nurse performed an impressive amount of tests and decided, after waiting for the doctor to see us, we should go to the ER for further care. No, we did not see the doctor once.
Ever since I moved to the United States, I am unashamed to admit I have been blessed with almost perfect health, never needing to see an Emergency Department unless I interned in one. Thus, ‘waiting times,’ ‘denial claims,’ and ‘staff shortages’ were all concepts which carried meaningless weight, having never experienced them from the perspective of a patient. From what I understand (and hopefully never change), hospitals operate to serve the patient. Yet, from the moment we arrived, we felt invisible. We had no idea how long everyone had been waiting already, but as we took a seat under the TV, the movie blaring only to mask the uncomfortable silence, we felt as if we joined the longest queue in the world.
The air felt thick and heavy like a hot summer’s day, burdened by the unbearable weight of suffering. With each old man’s cough full of phlegm and pain followed a groan which one only hears when words are not enough. In the span of three hours until we were called into our initial triage visit for vitals, we witnessed the denial of two patients for the lack of medical insurance and financial capability. One, an elderly white male and the second a Somali woman, hunched obviously in pain. It’s hard to describe the feeling of watching a woman being denied care and asked to leave the room into the cold, without a jacket, at 11 p.m. in Minnesota.
After about four hours, sitting in the ER room, the outrageous circus began. A total of five health care professionals saw us, one technician, two nurses, the head supervising doctor and a woman who we are still unsure if she really worked there. All of them, and I wish I was exaggerating, asked almost the same scripted questions: “What are your symptoms?” “Are they localized here?” “Do you have a thermometer?” “Let’s check your breathing and heart rate/blood pressure.” Each took notes as we answered them, but we are still unsure what the notes were for if the knowledge is not passed along to the next nurse, doctor, technician or mysterious woman.
But, the struggle was not close to being over. Each correctly diagnosed that what we were dealing with was a case of sever sinusitis, dehydration and fatigue. Rest and antibiotics would solve the infection within a week. Each, save for one medical resident in her early 20’s who seemed to truly care for the health of the patient, asked if we would like a saline IV treatment for several hours with a regimen of Tylenol. They also attempted to persuade us that a CT scan and an X-Ray may be appropriate. The mysterious woman even suggested that a urine and blood test was needed, providing us with a container in case a restroom visit was in order.
Thankfully, my experience within the health care setting provided me with knowledge of what each test consisted of and the relative cost of each. ER visit: $100. Saline IV: ~$75 One Tylenol pill: ~$2. CT Scan: ~$370. X-Ray: ~$200. As college students with only a fraction of what the total cost would have been in our bank accounts, we denied the need for any of the tests. We are intelligent, aware students who knew better than to agree to tests which were obviously superfluous and suggested only as profitable tests. But what strikes me most are the countless patients who are immigrants, uneducated, or simply panicked and give their entire trust and life to doctors, only to be subjected to expensive tests which do nothing to treat and help the patient.
Today, she is much better. The headache is gone, her energy has recovered, and the fevers have calmed. But I only shudder to think what the hospital bill could have been, and probably has been for numerous unassuming, innocent patients.
I made the conscious decision long ago to take my privileged life and devote it to bettering the lives of communities around the world, but in doing so I believe I have fallen into a trap which, at one point or another, we all experience. Global health does not mean developing-world health, and it took this experience to pry the microscope from my eyes and reveal the issues of our local community. So focused on the global perspective, we sometimes lose sight of the fact that the Somali woman denied care at the Minneapolis ER after immigrating for a better life and the old Vietnam veteran denied care for the injury he sustained defending his country are still global issues.
The US may boast unrivaled advancements in health care technologies, the world’s most intelligent and well-trained doctors and the largest percentage of GDP spent on healthcare in the world. But one unexpected emergency can reveal that we still have a long way to go.