Wednesday, August 19, 2009

Terminal Health Care

Late Monday afternoon I reached over and let my friend of 40 years grasp my hand and give it a squeeze as I was leaving.

I had been in the ICU with him and his wife for almost two hours. This was his seventh or eighth visit to the hospital ICU in the last two years. Monday was the 15th day of this hospitalization.

I had watched two doctors come and go, as the staff provide my friend with unit after unit of whole blood and plasma and platelets. Only by doing that could they keep his blood pressure up. The liquids went in his arm and out his internal wounds.

My friend had a strong will to stay alive and had requested that whatever measures needed to be taken to do so should be taken. Fortunately he also had good health insurance coverage and some individual wealth as well. I can not estimate what it cost for him to live that last two years or that last two weeks even. A good guess would be in the multiple hundreds of thousands of dollars.

The owl of Minerva only flies at dusk.

For many, but not most, the most expensive health care we receive is at the end of life. I say not most, because most of us will die suddenly from trauma or 'system failure' if you will. We will not be spending multiple weeks in an ICU.

Still my friend and I shared the same Insurance System and I was amazed that they paid out his cost without hesitation. This is the same company that vacillates between whether I should have the XL (extended release) version of a medication or take four pills a day.

Was the cost worth it. To my friend it was. He valued every second of life. I can say that being able for him to grasp my hand and say thanks for coming during those last few hours were very valuable indeed.

My friend was an alcoholic, and had destroyed his liver and various other organs over four decades of hard drinking. I could tell that the various doctors knew this and were reluctant to pour these resources into to such a patient, but they did. My friend was also a volunteer veteran of the Vietnam War, as am I. Most of my friends from that era are already dead. He was among the last. Did his combat experience in an armour unit in the First Infantry Division have anything to do with his drinking? I don't really know. But in the back of my soul, I see him as a delayed casualty of war. I could be wrong.

The Health Care Reform debate is raging on while this happens. I despise those corporations that are prodding the lesser lights of the population into opposing their own welfare. I despise those politicians that are forfeiting the rights of their own constituents for the profits of the health industry. I abhor the Greed.

Yet you might say that my friend was greedy. Maybe so. I think however his greed for life was of a type so far from theirs for money that there can be no comparison. Still, it is a costly thing to die that way. As we waited Monday, another longer term friend of his and I talked about this.
We both agreed that we would endeavor to try to balance his "excessive" utilization of the system by having our own deaths be quick and non-lingering. Yes, I have a Living Will. Yes, my wife and legally designated health care advocate have signed DNRs from me.

I think about the 64 year old veteran without documentation on the street somewhere dying from his overexposure to drugs and alcohol, and I wonder if he would even remotely receive the level of care that my friend did. The answer is of course not. Providing such a level of care, if they want it, regardless of who they are and from where they came, is by definition "Health Care", Anything else is just selling products to those who can afford it.

I think Health Care is a Right.
In the United States we treat it like a business.

As for the Business of Health Care and their pandering sycophants:"A plague on both your houses...."

Oh yes, and to my friend who passed away Tuesday; Say can you pass that on directly to God's ear and see if he can't, maybe, set this aright down here?


Trixie said...

I had to wait a while to read this. It's beautifully written. I'm sorry for the loss of your friend. I wish you weren't so damned right about health care. I can remember when everyone was taken care of, by doctors that made house calls and followed their calling to help people. The better they've gotten at it, the worse they've gotten at it. Figure that out.

drlobojo said...

Thanks Trixie.
"The better they've gotten at it, the worse they've gotten at it. Figure that out."

I think that is a function of size. Thus whether it is corporate or government big means better but not so caring. The differences between corporate and government is profit and exclusion. Government won't necessarily give us a better health care system, but it will be universal and will cost us less.