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(32,295 posts)
Sat Apr 13, 2024, 12:51 PM Apr 13

Many Patients Don't Survive End-Stage Poverty - NYT op-ed - no paywall [View all]



He has an easy smile, blue eyes and a life-threatening bone infection in one arm. Grateful for treatment, he jokes with the medical intern each morning. A friend, a fellow doctor, is supervising the man’s care. We both work as internists at a public hospital in the medical safety net, a loose term for institutions that disproportionately serve patients on Medicaid or without insurance. You could describe the safety net in another way, too, as a place that holds up a mirror to our nation.

What is reflected can be difficult to face. It’s this: After learning that antibiotics aren’t eradicating his infection and amputation is the only chance for cure, the man withdraws, says barely a word to the intern. When she asks what he’s thinking, his reply is so tentative that she has to prompt him to repeat himself. Now with a clear voice, he tells her that if his arm must be amputated, he doesn’t want to live. She doesn’t understand what it’s like to survive on the streets, he continues. With a disability, he’ll be a target — robbed, assaulted. He’d rather die, unless, he says later, someone can find him a permanent apartment. In that case, he’ll proceed with the amputation.

The psychiatrists evaluate him. He’s not suicidal. His reasoning is logical. The social workers search for rooms, but in San Francisco far more people need long-term rehousing than the available units can accommodate. That the medical care the patient is receiving exceeds the cost of a year’s rent makes no practical difference. Eventually, the palliative care doctors see him. He transitions to hospice and dies.

A death certificate would say he died of sepsis from a bone infection, but my friend and I have a term for the illness that killed him: end-stage poverty. We needed to coin a phrase because so many of our patients die of the same thing….

*****What is the saying …. The measure of a society is how they treat their most vulnerable …..
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Situations like this shouldn't happen in a country as wealthy as ours. Elessar Zappa Apr 13 #1
You're right, of course... slightlv Apr 13 #8
totally agree gopiscrap Apr 13 #9
St. Ronnie Raygun also eliminated free college education in California OMGWTF Apr 13 #22
It has been nearly 50 years since Reagan was governor MichMan Apr 14 #29
Republicans were in charge in California NanaCat Apr 14 #32
No, but it doesn't hurt to recognize failures. How can we improve without that? I'm pretty sure we haven't fully done KPN Apr 14 #37
Billionaires want for nothing. Mr. Evil Apr 13 #11
The "I've got mine, fuck you" attitude isn't limited to the extremely wealthy, unfortunately. ShazzieB Apr 13 #14
You're so right. Mr. Evil Apr 13 #21
It's about sharing. Something we learn at three. Joinfortmill Apr 14 #26
Why point to Bezos/Gates and not Musk, Ellison, Kochs, Yass, Mars, Crowe, Uihleins..Paulson, lostnfound Apr 13 #24
100% We must keep fighting for the Nordic Model here in the USA. OrlandoDem2 Apr 13 #13
Yes, especially healthcare and affordable housing. Elessar Zappa Apr 13 #16
Exactly. OldBaldy1701E Apr 13 #18
While the country might be rich when you look at GDP and other large measures Warpy Apr 13 #20
Kicked and recommended Uncle Joe Apr 13 #2
YW Uncle Joe. Powerful stuff..... Diamond_Dog Apr 13 #6
Kick dalton99a Apr 13 #3
We are the richest country in the history of the world. Irish_Dem Apr 13 #4
Yes, and our maternal death rates are horrifying Easterncedar Apr 14 #27
K&R Docreed2003 Apr 13 #5
My partner and I are both on "Medi-CAL" CA's medicaid... FirstLight Apr 13 #7
And you have it way better NanaCat Apr 14 #34
Weeping irisblue Apr 13 #10
The fucking richest country in the world does this!!! I am beyond niyad Apr 13 #12
K & R with... JoeOtterbein Apr 13 #15
Yes senseandsensibility Apr 13 #19
It isn't even a matter of "should we share" IbogaProject Apr 13 #17
... Faux pas Apr 13 #23
Thank you for all you do. Society can do so Joinfortmill Apr 14 #25
Appalachian Health Care Pop-ups Delarage Apr 14 #28
I have volunteered for Remote Area Medical markodochartaigh Apr 14 #36
This is just the beginning of the end. Hope22 Apr 14 #30
DURec leftstreet Apr 14 #31
We have a safety net Puppyjive Apr 14 #33
Yes and if he can afford an attorney and can find free everything for year while he waits.... Hope22 Apr 14 #35
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