Saturday, June 30, 2012

My Childhood Experiences of Having Public Health Care

Some of my friends didn't become disabled until they were adults. I envy their relatively healthy childhood experiences. For me, there was just a generalized sickliness from as far back as anyone can remember. I was the weak one, the underweight one, the one who had to be protected from everything. If we didn't have a public hospital in New Orleans (i.e. Charity Hospital), I'd never have reached the age of 18.

I spent many nights in the waiting room of the Emergency department, while the triage nurses juggled sick children, gunshot victims, prisoners from the local jail, and people with chronic conditions. I could never quite figure out how they decided who needed to be seen the fastest--it wasn't a matter of who would be first, because the people were always coming 24/7.

Between keeping track of who was next in a manner that wouldn't make anyone think they were ignored or looked over in favor of someone else, they had to deal with the paperwork associated with being the only hospital used by thousands of people across the state. Just getting your records brought to the Emergency department accounted for a large amount of the time you spent in the waiting room.

It wasn't exactly a free hospital. They certainly asked for your financial information. If you had Medicaid or Medicare or some kind of private insurance, then they processed that. If you didn't have any of these, they asked about your employer and whether you had any other financial resources at your disposal. Even if you were flat broke, homeless, completely destitute, you were treated just like everyone else. They did send you a bill for your care, but if you didn't pay it, nobody came to arrest you or punish you. When my parents could afford to do so, they paid the bills. After my parents divorced, my mother couldn't afford the hospital bills she received and we were just doubly thankful that we could still get care anyway.

I spent so much time in that Emergency department waiting room, that I have a lot of memories associated with Charity Hospital. Saturday and Sunday visits were only for near death problems. That was because of the frequent violence that took place in the city over the weekends. It was not unknown for people to have sat in that waiting room 16 to 20 hours on the weekend and, over my beloved grand-mère's grave, I promise you that's no exaggeration.

Weekday evenings were bad, too. People who had jobs that didn't allow them to call in sick, even for a day, went in the evenings right after they got off of work in order to have enough time to be seen before their next shift. It was almost always late at night when we arrived. If you could suffer through your problem until Monday around midnight, you'd get in and out the fastest. Near midnight, there weren't as many people arriving and the evening folks were already being processed. By that time, fresh support staff had clocked in, so they weren't lethargic from the exhaustion that must have tugged at them all toward the end of their shifts. It was years before I saw the workings of Charity during the day. Now that I've experienced both, I can compare the two, but the nights are the most memorable.

I saw the worst of what this city could do to folks: domestic violence spilling over from the outside, mothers without childcare support who had to take all of their children with them whenever one got sick, older people who were forced to come back whenever their chronic conditions became uncontrollable because they couldn't afford their maintenance medications.

The worst, though, was the listless shuffling of the homeless people who wandered in just to sleep for a few hours, before security officers forced them back onto the streets. When one set of officers would clock out and the next shift started, the same people would come back in and get a couple more precious hours of sleeping indoors. Everybody minded their own business about it. It was the strictly-enforced unspoken rule. Most people didn't see it as hurting anyone. If the homeless person was threatening or menacing, the police who filled the security jobs could have them hauled off to jail (another place where the homeless could get a few more hours of indoor sleeping). If they were delusional or nearly catatonic, they were in one of the only places where they could get treatment.

Despite this gloomy-sounding description, it was the best hospital in the state. Everyone knew this. When Methodist Hospital or Ochsner couldn't figure out what the hell was wrong with you, you came to Charity. Your socio-economic status didn't matter. Even if you had private insurance that was wonderful for primary care and specialists at the fancy hospitals, when it was your life on the line, you went to Charity.

There was no shame associated with being seen at Charity. When President Bill Clinton visited the city, security precautions necessitated that he have an emergency surgery room arranged at all times, just in case something happened. Guess what hospital they used. It wasn't Touro, Tulane, Ochsner, or Methodist. They chose Charity and it was no surprise to anyone here.

Every New Orleanian that I know had been treated there, at one time or another. They could get to the bottom of what was going on with complex cases that private doctors simply had no experience with diagnosing. I have heard innumerable accounts of the public hospital saving someone who was nearing death's door and had checked themselves out of a private hospital to be treated at Charity. Heck, they're the ones who diagnosed MY cancer and it's so rare that most oncologists will go their whole career without seeing a patient with it.

You know, I didn't really mean for this to be so long. At first, I was just going to write a few sentences on my facebook wall. Then, I figured that I might as well post it here and link to it afterward. Somehow it turned into this trip down medical memory lane. Anyway, I guess this has to stop somewhere, so this is as good a point as any. I just want to reiterate my initial point. I wouldn't have lived this long if not for public health care.


kortney z said...

Hey, how can I email you?

kortney z said...


Family Home Care said...

This is a very good trip back to medical memory lane and thanks for allowing us to have a glimpse of it. I am also thankful that there is public health care. It sure is a lot of help.