Wednesday, October 17, 2012
Life at Grady: Killing you softly
A brother was raising his younger brother. His brother with a chronic disease that required frequent lifesaving treatments and that would and could lead to hospitalizations when those lifesaving treatments either didn't work or weren't available. Fortunately for the younger brother, as a minor he qualified for state Medicaid so dutifully that older brother made sure those appointments were kept and those medicines were not only picked up from the pharmacy but taken exactly as prescribed.
A brother was raising his younger brother. But not because they were orphaned in the literal sense. It was more because they were orphaned in that way that many young folks I've seen have landed in that position. One parent AWOL from the start or so close to the start that neither of the brothers can remember a life with that parent in it. The other parent checked out and emotionally unavailable. Maybe because of substance abuse. Maybe because of mental illness. Maybe because of just being tired as hell from slugging it out against the world and left without one drop of anything to give to some kids or anyone else for that matter.
Or just maybe all of those reasons at the same time. Maybe. Maybe not. But yes. I met this brother who was raising his younger brother. And, see, this older brother was born with bootstraps that he had pulled on from as early as he could get his mind around. Because he had only two choices. It was either grow up or die. Which really is no choice at all. So he manned up. Not even ten years older than that younger brother but talking to him and seeing about him exactly like he was his daddy. Sure was. And you'd better believe that that younger brother was looking at him and listening just like a son is supposed to.
So yeah. That part was all fine and good except these brothers had a problem. Even though Big Brother had been seeing about Little Brother for what seemed like 'ever, since that checked-out parent technically lived with them, Big Brother never became his brother's legal guardian. Even though he was. So Big Brother finished high school and trade school and got himself a good job with good benefits, too. But seeing as Little Brother already had Medicaid there was no urgency to make this whole legal guardian thing happen.
Nor anyone advising them to.
So guess what? Bay'bruh grew older. And when he did he outgrew that Medicaid that covered him when he was just a little Peachcare kid. By the time Big Brother realized it, his little brother was uninsured. Turns out that the process of making someone over eighteen your dependent and beneficiary is pretty hard. Oh, and try getting that same over-eighteen person onto your insurance plan with their pre-existing condition and see how that works out for you.
Answer: Not so good.
So here they were. Big Brother and Little Brother. Sitting in front of me at this safety-net hospital talking about this whole thing and asking what they should do. In real time and three dimensions, not hypothetically or out at some campaign rally as somebody's talk point. They were right in front of me asking what should they do. To afford the medicines that keep this young man out of hospitals and emergency rooms. To receive the care that would allow him to go to college as his Big Brother had planned for him. The same college they were postponing because they feared that his uncontrolled medical problems could ruin his chances.
Now, listen. I have carefully listened to some compelling arguments opposing the Affordable Care Act or Obamacare or whatever you prefer to call it. Some of those individuals have been thoughtful and mindful and I've appreciated that.
But some haven't. Like the billboards I saw high up in the sky on interstate 75 over and over on our way to Disneyworld with these shucking-and-jiving cartoon likenesses of our President--the President of the United States--coupled with less savvy arguments. Or rather captions. Which, whether someone is for Obama and his health plan or not, is offensive as hell.
But forget all that. Forget somebody reducing the President of the United States to caricatures and buffoonery on gigantic posts on major highways. Instead let's get back to the fact that there is a man under the age of twenty who is not insured and who can't get insured. And who has a disease that can take his life if he consistently goes without care and medications. Let's talk about that. Let's talk about this uncomfortable fact that killing people softly still counts as killing them. And I don't know if it's just how I'm wired but I see killing them as killing me, too.
Okay. I admit that my view is skewed. Skewed by the countless people like these two brothers who I know for certain will benefit from being able to have health coverage--even if it involves some growing pains for America. And even if it costs me and my privileged life some sacrifice. I'm looking straight into the faces of people like them every day. These are not criminals or moochers or whatever percentage of people that somehow are deemed lost causes. And even if they were, shouldn't we struggle with letting them die, too?
And yes. I meant to use that word "die." Die. As in death. Because when someone has an emergency department as their only pressure release valve, that means they don't get preventive care. When someone is home gasping for air because they can't afford to get their medicines, even when they are on the WalMart list, they can't work. That makes matters even worse. You're damn right it does.
For some, the death is swift like a swinging machete. But for many, many, many people. . .it is slow. Like the slowest deadliest quicksand that you just can't get out of without a helping hand. A big strong arm pulling as hard as it possibly can. Not some slippery finger tip flicking you off and telling you how lucky you are to live in a land of opportunity.
I will quote my patient just as I have many times before: "FOLKS IS LOSING OUT HERE. LOSING! DO YOU HEAR ME?"
Losing. Losing. Losing insurance. Losing opportunities. Losing chances to be all the things that every person with resources gets a fighting chance to be. And I'm tired. Tired of hearing all the sides of it because that makes it too complicated. 'Cause see, for me, it isn't. It just isn't. Not at all.
A brother was and is raising his younger brother. And as sure as you are reading this and I am typing it, unless somebody somewhere does something fast, he won't have to raise him at all.
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