The Unquestioned Questions
As a young child my father used to take me with him to the hospitals when he made his rounds. He would leave me in the doctors’ lounge in order to go see his patients. Alone with nothing but chocolate chip cookies and the giant boxes that we once called televisions, I would get bored. On one occasion, I decided to walk outside and into a stairwell that ran on the outside of the hospital. As I left the doctors’ lounge, the door locked behind me. Being the wimpy little kid that I was, I realized that I was now trapped in a stairwell, and started crying my eyes out. I began to knock as loud as I could on the door, and continued crying away like a scene from the Notebook. After a few minutes, a nurse heard me and ran to open the door. Today, I walk up that same stairwell as I make rounds in the same hospital. The same nurse that rescued me still works there.
Life is full of seemingly brief moments where someone gives us an escape from our prison, and those moments participate in shaping the people we become. This is part of the beauty of healthcare, a doctor or nurse sees patients who are sick and does their best to help them get better. Unfortunately, much of that beauty is lost or at least tarnished in the practice of medicine in the United States today.
Too often when I walk into a doctors’ lounge or turn on the “news,” I hear talk about how this society has become a “welfare state.” Doctors complain about patients who have Medicaid insurance, but also have an iPad or a fancy car (they never complain about hedge fund managers on Wall Street, unless it makes their stocks go in the wrong direction). On television all the chatter is focused on “Obamacare,” and how it is cracking the very foundations of our society. As we start 2015, the real question is, are we as a society asking the right questions?
When I see a sick child who has no health insurance, it is one of the most frustrating things in medicine. Not being able to provide the appropriate care to a child, especially when it is otherwise readily available, seems criminal. Often, the people who don’t have health insurance are people who aren’t poor enough to qualify for Medicaid, but aren’t rich enough to afford the exuberant prices that are associated with our healthcare system. In the last few years, many have constantly encouraged the public to question Obamacare. The problem is that the question shouldn’t be about Obamacare at all. We should instead be asking how we can establish a healthcare system that delivers quality affordable healthcare to as many people as we can. Our system was broken before the Affordable Care Act, and it continues to be broken under it. Repealing “Obamacare” isn’t a discussion about fixing the healthcare system, rather it is an argument to create divide.
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The most common diagnosis in my pediatric office these days is obesity. It is the hardest thing to attempt to treat as a doctor because the truth is nutrition, like healthcare, needs a societal fix (in addition to an individual effort). We as a society should be asking critical questions about how we can make all of us healthier. Instead, we do not ask these questions and often blame each other. My friends who are physicians and I often blame bad parenting and hot cheetos for the high rates of obesity, but we often fail to ask why these causes exist in the first place.
On a similar note, I work in an underprivileged area of San Diego, and when I drive past the public schools I wonder how any of my patients actually even want to go to school. The schools look on the outside much more like a dreary prison than anything a child would want to attend. Yet, when is the last time we heard a real focus on education in a presidential campaign? Wouldn’t improving our education system be something we could all support?
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We live in a society that is much more oriented toward slogans and eye-popping headlines than it is focused on meaningful discussion about how to improve each other. Things like “welfare state,” “Obamacare” and “vaccines causing Autism” are easy to (superficially) argue about, but they do not really create anything of value, especially given that very often those who are arguing have already made up their minds. It is easy in today’s times to blame the end product, i.e. the poor, the uneducated, or those with poor diets. The reality is the much larger and more productive discussion we should be having is how do we improve these conditions as a nation. Practicing medicine is hard enough, but practicing medicine in an environment that consistently produces a larger burden is emotionally draining.
When I was a little kid stuck in a hospital stairwell, someone helped me out. It is the nature of our humanity to need help, and we can produce “help” on a larger societal level, it makes us better people not worse. Today I asked a child in the office what he wanted to be when he grew up, he replied: “A grown up!” Sometimes I wonder if that is a worthy goal. I hope it is. Hopefully, we all start asking the right questions, because it is then and only then that we can start to find answers.
I'll stare straight into the sun And I won't close my eyes Till I understand or go blind- Thrice