Dr. Albert Sabin was by his own description, pretty full of himself when he managed to temporarily stop the testing of the Salk Polio Vaccine after a bad batch sickened and killed some children early in the first tests in the 1950s. Sabin recounted this in a television interview in the '80s. He was weeping. He had believed he was doing right. He had convinced himself that the fact that Salk's vaccine, the so-called "inactivated polio vaccine," had been chosen for use instead of Sabin's own "live polio vaccine," was irrelevant to his efforts.
He was weeping as he recounted this, too. Ultimately there proved nothing wrong with Salk's vaccine, the one batch had been improperly handled and manufactured. But Sabin and others, delayed all further testing for weeks. Sabin was weeping as he remembered. In 1983, Sabin had contracted a rare disease of his own. Surgeons operated, relieved the intense pain and muscle weakness, and then ten days later it came back, ten times worse, enough for him to be yelling and crying, virtually all the time.
The pain, he said, "made me want to die." And Dr. Albert Sabin suddenly remembered that the stopping of the Salk Vaccine experiments had led to death. Death of children. More immediately, it had led to pain, physical and emotional, for the children, and the parents.
He said it had not occurred to him that the first thing doctors must do, the first thing a health care system must do, is stop pain. He vowed to spend the rest of his life relieving pain. His own searing agony, and paralysis, gradually, inexplicably, faded.
They moved my father this afternoon. I don't mean they moved him to another hospital. They moved him. In his bed. Into a different position. It was agony for him. Agony enough that he could barely see us. Agony enough that they had to give him all the pain-killer he could handle. Then he couldn't talk any more. Another moment when somebody like me wonders about what it would be like if he was going through that, and I was watching it, worrying about whether we could afford the pain-killers.
Or the doctors. Or that hospital. Or any treatment at all. And what kind of society we live in, where millions of us face questions like that, and politicians glibly talk about incremental improvements while they slowly re-shape new laws that are supposed to reduce the number of us faced with pain untreated due to money, into laws that take more money out of our pockets and give it to the corporations who are profiting off health care without contributing one second to the relief of pain or the curing of disease, the pimps of the equation, taking their 20 percent off the top the health insurance cartels.
How would our politicians react if there were millions Americans in pain, getting insufficient care to relieve that pain, because of interference from insurance corporations and those millions had just been injured in a natural disaster, or an attack on this country? How fast would they rush their portable podiums to the driveways outside the emergency rooms? How quickly would the money come?
You know the answer. And you know what the answer has been about rushing to help those millions of Americans in pain tonight attacked not by another country or a terrorist or even a flood but attacked merely by life. Half of the politicians are dedicated to protecting the corporations against having to help our relatives and neighbors in pain.
The other half are calculating how far they can anger our Insurance Over-lords before our Insurance Over-lords stop contributing to their campaigns. Might all their CEOs, might all the wavering political frauds, get ten minutes of Dr. Sabin's pain. Or my father's. That's another part of this story I just haven't seen. The doctors.
For all the jokes over all the years, these guys really are on our side in this, especially the ones in the hospitals, especially the ones without whose skills you'd heal up just as fast in a bowling alley as in the best of the medical centers. The man who took my appendix out two years ago, a messy, dangerous job that took more than two hours, from which I recovered fast enough that I only missed four days of work, and who left three little scars one of which I can't find any more, I wrote all the checks. I know how much he got out of the whole price. About ten percent.
A very good friend of mine is a doctor in California. He wrote me the other day. "You can see why doctors, who want to make a living or cover increasing costs, labor, overhead, etc., have only one choice: see more patients, spend less time, answer fewer calls, because there is no other way to increase revenue.
"Plus," he wrote, "if you order tests, patients think they are getting better care (and) doctors thinking that testing, saves them time in thinking or talking with people. 'You have chest pain?' Instead of asking you questions, why don't we go ahead and do this stress test - that I get paid much more than some little office visit to do - and make sure it's not your heart.'"
And so like us the doctors are slaves to insurance. And that's not even talking about malpractice. We have to help them on that. Maybe we do need to cap damages. But do it where everybody benefits. Set the cap wherever it works out to be now, then lower it each year by exactly how much the entire cost of a patient's health care is lowered in this country. Incentivize doctors to help make health care available to everybody.
We patients and the doctors have to be on the same side again to stop pain, to heal disease, not to be customers and salesmen. And to help, thinking long-term. "People do want to discuss their end-of-life preferences prospectively," my friend the doc says, "and doctors should be paid to have these discussions." And then he wrote something that hadn't occurred to me. "We spend a lot of money on doing things that people would not have wanted us... to do to them."
Oh, that hit home. My mother died in the spring. Bless her, she lived without symptoms till nearly two weeks before she went. And we had all talked about what to do, and when to do it, and what not to do. And so when they said there's breast cancer, and there's five lesions in her brain, and there's nothing we can do that will wake her, but we can do a lot to lessen her pain or we can do things that might extend her life but also won't cure her and also won't wake her, but might be hurting her, we can't tell.
It took five seconds to decide. And then I thought of all the people who never had that discussion with their mother or father, who don't know that those are the choices they might face. And how it might help to have a doctor who says, here it all is. And you say: Doc thanks, I've decided I still want you to keep me alive forever even if I'm suffering and comatose, and he says, you got it.
Only now he could send you a bill and you could have insurance pay you back for it, so your mother and you will know, when the time comes, exactly what each choice would bring. And some buffoon decided to call that a "death panel." On the list of preventable deaths diabetes, stroke, ulcers, appendix, pneumonia we are 19th. Canada is 6th, England 16th, we're 19th. Portugal is 18th. You're better off in Portugal.
Death panels? We have them now. They're called WellPoint and Cigna and United Health Care and all the rest. Ask not for whom the insurance company's cash register bell tolls. It tolls for thee. What you and I might able to do about all this, when my Special Comment continues.
To be continued....
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