The ‘hypothetical’ young man
I didn’t watch the GOP debate, but before I went to bed Monday night, I checked the headlines.
There it was: video of people cheering, “Yeah!” at the prospect of letting a “hypothetical” young man die rather than care for him. No one, not the candidates, not the moderator, not anyone in the audience reprimands them.
There is nothing hypothetical about it. About 45,000 people die every year — one every 12 minutes — because they don’t have insurance. The vast majority of them do not CHOOSE to be uninsured; they either can’t afford the premiums, or like my son, the insurance companies won’t sell to them.
My son had a birth defect, which is a pre-existing condition. It left him vulnerable to cancer, so he needed colonoscopies every year. He couldn’t get them, though, because he didn’t have insurance and he didn’t have the money to pay cash-up-front for them.
So, here is how it went for my not-hypothetical 30-year-old son:
First, he gets stomach pains. Eventually, they get bad enough so he decides to go into debt to see a doctor, who informs him he can’t have the medical tests he needs because he’s uninsured and he can’t pay the full cost, in cash, up front. The doctor writes in his medical record, “Patient needs a colonoscopy but can’t afford it,” and bills the patient for the appointment.
A week or so later, the patient goes to the Emergency Room, where he’s told it’s persistent gastroenteritis. Still no colonoscopy. The patient is unable to move his bowels and wonders why it would be diagnosed as gastroenteritis. He is billed for the ER visit.
A little more time goes by and the patient is still suffering, so he goes back to the ER. This time the doctor says he has an ulcer and gives him an antibiotic. He is billed for the ER visit and the medicine.
Still a few more days and by now the patient has lost 30 pounds and is still in pain, still unable to move his bowels. His family is frantic with worry, but no one has enough money to pay cash up front for the colonoscopy. He goes back to the ER and is told he probably has diverticulitis. He is given a strong laxitive and sent home. He is billed for the ER visit and the medication.
The next week, the original doctor agrees to do a colonoscopy and bill the patient, who will be allowed to pay over several months. The patient is sent home without hearing any results. What he doesn’t know is that the doctor didn’t even finish the procedure because the colon was completely blocked. He never told the patient.
Three weeks later, the patient is down to 112 pounds. He is 6 feet tall. He is vomiting fecal matter and his kidneys are shut down. He is hours from death. The doctor realizes he probably could get in trouble for neglecting the patient so badly, so the patient is admitted to the hospital, where it takes five days to stabilize him.
By now, the patient’s cancer is Stage 3. It has spread. A charity pays the hospital, the doctors and the pharmaceutical company for chemo and radiation, so he at least gets treatment.
But six months later, the patient again is in pain and vomits up everything he eats.
This time, the doctors take a wait-and-see attitude, even though they know the radiation has caused another blockage. The patient drops to 104 pounds and family members threaten to take the story to the media as his doctors refuse to feed him intreavenously. They finally agree to feed him and a few days later, he is wheeled into surgery again.
The pathology lab finds “a few viable cells,” and the patient is told he will die. The doctors don’t bother to come talk to him about further treatment, even though he is on the oncology floor for another week. They don’t bother to treat a life-threatening infection in his incision.
The family searches and finds a doctor who will consult with the patient for about $400; as soon as he sees the patient, he knows he has to adopt him to give him any possibility of even short-term survival.
There’s more chemo — the patient has to leave his wife so the giant pharmaceuticals will get paid for his meds through Medicaid. The patient has no income because he has yet to be approved for disability, as though someone with his medical records might be scamming the system.
His family and friends gather round to support him, both financially and emotionally, but he was neglected too long, and he dies on April 1, 2009. His first disability check comes nine days later.
The doctors got paid by the charity; the pharmaceutical companies made hundreds of thousands of dollars from his chemotherapy. But the patient spent three years in horrible pain and in abject poverty. He was treated as though he wasn’t worth saving until he was adopted by a doctor with a heart, although by then it was too late.
His family still grieves, and always will. His friends still tell stories about his amazing courage, his gigantic heart and his decidedly off-kilter sense of humor.
He was not a bum; he was never lazy.
He was my son, and he didn’t deserve to be left to die.
For those whe cheer the thought of his death, I just want you to know I would never wish the same thing on you or anyone you love.Leslie Boyd, a former newspaper reporter, is president of the health care advocacy nonprofit, WNC Health Advocates, founded in memory of her son, who died in 2008 because he couldn't access health care. E-mail her at leslie at lettersfromtheleft dot com or follow her on Twitter @leftyletters1, visit Letters from the Left on Facebook. For more information about WNC Health Advocates or to read Boyd's health care blog, visit wncha.org.