This past weekend, I came face to face with Ron Paul’s world of ‘let him die’. As a sociologist, I already ‘knew’ that world as a statistical and theoretical phenomenon…in which people without resources, and living on the fickle grace of the state…obtain inadequate and late healthcare that shortens their lives. This time, it was a part of my personal circle that it touched…and in a manner that illuminates the moral vacuousness of the worldview of ‘me, myself, and I’ all justified in ‘just work hard(er)’.
A close friend and business associate (aka ‘Ismael’ – not his real name) last week was called to the home of his cousin (aka ‘Kahlil’ – not his real name), who was reporting a high fever, near paralysis, diarrhea and vomiting blood. Ismael reached Kahlil’s home, and on assessing the situation, called 911 and asked for an ambulance.
Kahlil is an immigrant. Ismael had helped convince and make possible for Kahlil to immigrate to the States some time ago, where he has struggled to find enduring employment. Kahlil, now a college student, went back to school, when his previous degree was not generating employment. He is, in his sixth decade of life, in college again, to help him find work. Kahlil’s situation leaves him covered by Iowa Care, the state health program meant to cover people not eligible for Medicaid.
Like many immigrants, Kahlil left his unstable country to come to the US to have an opportunity to build a better life. His immigrant community has a higher educational level than the US in general, but in their migration, for many, their degrees have languished as they struggle with immigrant issues of language, customs and the residue of the Great Recession. Kahlil is not one of the ‘illegal immigrants’ which gives broad moral license to some to ignore their plight. Legal immigrant…but now without resources…and rebuilding.
The vomiting of blood was very concerning to Ismael, and Kahlil’s lack of being able to walk was also scary. Upon arrival of the ambulance, Ismael is approached by a woman who begins asking him questions on insurance.
This is healthcare in the United States…where emergency healthcare must first ask…”who’s paying”? Don’t ever confuse your ‘emergency’…with someone else’s pre-eminent need to know…who’s paying. Let’s talk money…then we can talk about yer right to life and well-being.
When Ismael explains that Kahlil’s covered by Iowa Care, the woman’s irritated response is that Iowa Care does not cover the ambulance. “Can he walk”? asks the paramedic.
“No…he cannot.” She insisted that Ismael make Kahlil get up and walk, rather than place Kahlil on the gurney (no clarity on the money yet). So Ismael and a friend of Kahlil’s, lift Kahlil, and start dragging him to the door, feet and legs dragging behind him, draped as he is over the shoulders of Ismael and Kahlil’s friend.
Remember…this is the best healthcare system in the world! Not a temperature taken, blood pressure, pulse…anything. No assistance offered or given. BUT…an attempt was made to ‘diagnose’…where’s the money?
Ismael is not the healthiest guy. He is on disability from brain trauma suffered from a car accident in which he was a passenger of a car that was T-boned in an intersection by someone running a light. He is still slowly improving…4 years later. He lost three small businesses due to his injuries and the incapacitation of his ability to work. Also in his sixth decade, an immigrant citizen, he too is struggling to rebuild, and he has a number of health issues. He can’t carry people easily.
In leaving the apartment building … with Kahlil…Ismael notices that the ambulance is parked at the far end of the building. He informed the woman that he cannot carry Kahlil that distance…and she said she would pull the ambulance to the other, much nearer end of the building.
After doing so, as Kahlil is being pulled towards the ambulance, she comes and asks again for insurance information. Ismael responds again that Kahlil is covered by Iowa Care. In a sharp response, “I told you guys before Iowa Care does not cover the ambulance! Do you guys have money because this is going to cost a lot of money!” My friend tried to get her to focus on his cousin, and suggested now is not the best time to try to figure out the money…Kahlil needed help immediately.
“This is going to cost at least $700!”
The weight of his cousin had reached Ismael’s limit for trying to carry him, so he and the other friend dragged Kahlil to Ismael’s car sitting very nearby, where they opened the back door, and laid Kahlil down in the back seat. The paramedic instructed Ismael to drive to the emergency room and they will follow (towards what end?). Confused, panicking, deeply uncertain of what to do…Ismael and friend help get Kahlil to fit, lying down, scrunched up in the small back seat, and Ismael jumps in and starts the car and starts to back out.
Kahlil, moaning, groaning, pleading for something to stop his pain…taps Ismael on the shoulder, and indicates, with mouth filling with fluid, that he needs to vomit. Ismael jumps out of the car and opens the back door to allow Kahlil to vomit once again, more bloody fluids. Panicking worse, Ismael ran to flag down the ambulance turning to leave the parking lot. Informing the ambulance crew of Kahlil’s sharp pain and continued vomiting…the woman, undaunted, offers “Ok…I’ll give you a vomiting bag” and proceeds to hand Ismael a bag with which to catch the vomit. Window back up.
Ismael jumps back in his car and giving the bag to Kahlil, assures him to go ahead and vomit and don’t worry about the car. Quickly, Ismael drives off to the Emergency Room. He runs inside and gets a wheelchair and struggles to place Kahlil in the chair…finally succeeding…and then proceeds to roll him inside and get registered.
Late at night, quiet…no one in the waiting room. No one being treated that Ismael can hear in ER. Nurse comes and puts a blood pressure monitor on Kahlil’s finger, takes his temp, and leaves. In lots of pain, Kahlil keeps pleading for a pain-killer of some kind. Pleads for water. Feverish. No one will address his pain, or his thirst. A group of medical personnel sit nearby, laughing, working on computer. No one giving any attention to Kahlil.
It takes more than a half hour, to get attention from a doctor. Quiet ER…and it takes more than half an hour.
Different deliberations occur. And then finally…one suggests…he thinks Kahlil is having a heart attack. Something that could have been diagnosed by the ambulance crew…resulting in a cardiac-arrest team waiting and ready when they arrived. Instead…nothing…no intervening action…for more than an hour since the ambulance first showed up at Kahlil’s apartment.
Now, shortly after they begin treatment…Kahlil has a second heart attack. CPR is given for almost two hours.
And now…Kahlil is a cousin in memory only.
Ismael thought of suicide a couple of times over the weekend…as he feels he failed his cousin, his family, himself. His confrontations with the institutions of healthcare, disability and poverty have been deeply wearing. A proud and resourceful man…he finds his adopted society…doing everything it can…to do as little as it can. Healthcare is wearing on people with good insurance…who find out the limits and the fine-print conditionals that meet one at so many turns. Ismael is seeing more and more a face of this country that he finds incomprehensible…and brutally ugly.
Time for someone to remind him…best healthcare money can buy! That face should also remind Ismael that ANYONE (which is not synonymous with ‘everyone) can make it in the US…which is how you fool yourself into thinking you’re guaranteed good healthcare…and all the while, that patronizing, reminding being offered from behind that smug, anxious smile of ‘I got mine…try to get yours’.
And for all the Coliseum crowd cheering on Ron Paul and the ideology lions…not to worry.
They let him die.
Tags: class, classism, conservative, conservatives, emergency, ethnicity, health, health insurance, healthcare, hospitals, immigrant, libertarian, libertarians, medical care, medicine, moral, one-payer, race, racism, right to life, Ron Paul