Sideways: Observations on Pain and Privilege

Glad you’re doing better, Ben. The Pack needs you at full fighting strength.

“We should all have that privilege – the privilege of advocacy, the privilege of mercy, the privilege of empathy – and it’s my life’s work to see that we do.”

Proud to be part of the pack Ben. Especially today. Be well.

Absolutely. Germaine Greer wrote beautifully about this. All the best for your healing.

Ben, I’m hoping for a quick recovery for you and anxiously awaiting your next essay after your bill arrives.

Thank you Ben. In practical terms this may have been the most cogent text you have constructed. As a young physician at a university teaching hospital I was initiated into the then new system of IPA’s and HMO’s. Skeptical of what I was seeing at the time (?late 1980’s) I decided to pick a random hospital floor and measure the thickness of the medical charts compared with the type of insurance coverage afforded the patient. Patients with Private insurance had literally twice the chart thickness as patients covered by HMO’s due to the number of consultants and tests used in the treatment of privately insured patients. I have volumes of anecdotes of unequal patient care but being white, affluent, and educated confers privileges in care not available to others.

Really incredible writing on this difficult topic. Get well soon.

That caused memories to flood back! First, best wishes for a speedy recovery.

My family was in an emergency situation with my then 17 year-old daughter. After a life flight for her from a Texas lake to the best medical center nearby in San Antonio, my wife and I trailed at 100 mph via SUV to catch up. The emergency doctor on call saw her, and us; and said her hand might be saved with the help of the best specialty practice in the city (on a Sunday evening of Labor Day weekend). Otherwise, it would simply be amputated with the technology they had. He knew arranging an ambulance for the transfer would lose more valuable time so he drove with us, I’m sure breaking hospital policy, to the surgery center. I drove him back while they opened the building, and assembled a team of 4 to operate on her. She was in surgery from 8 pm until 6 am the next morning, and in recovery for the next 6 days there. My family and her caregivers were the only occupants until the center opened its normal weekday practice on Tuesday. The center gave us a free hospital room to use as our hotel, and the nurses and her primary doctor guided us through the harrowing experience. The reconstruction of her vascular system and the reattachment saved her hand. The steps that even made that possible were as remarkable.

I didn’t process it then as a function of our health plan or our whiteness. My flip-flops, bathing suit, and baseball cap conveyed a redneck vibe more than any hint of wealth. Instead, it permanently changed my appreciation for the professionalism, selflessness, and dedication of that entire chain of health professionals. It did ground me on the aspects of life where we are completely at another’s mercy. My daughter became an ICU nurse.

I know that outcomes differ in a non-colorblind US society. That experience instigated a desire to treat each person I meet as someone of value that I might need to rely on some day, particularly in service positions. Reading the quality of these posts is one of the few things I see in the world around me that gives me hope for my kids kids.

As a fellow sufferer of your condition, I can empathize, although I have never been hospitalized or had surgery for that. At least not yet - I’ll tell you, the magic orange powder will forever be your friend. But this essay is spot on and rhymes with the point I have been making with my activist friends and family who are hell-bent on ridding their communities of policing. Law enforcement is just the point of the spear of a spectacularly unjust judicial system. The system is what needs burned. And you can see it in health care too, just as you see it in the justice system, individual outcomes are directly related to what an individual can afford. That is by design. We also have the best public policy money can buy and our individual votes really don’t matter. That is also by design. BITFD

Oh man, Ben, SO sorry you went through such a horrific experience! But so very thankful you’re getting better (at last!!!). The part where you mentioned the liability angle with your surgery when you were in the ER struck a chord, as I lost someone extremely close to me in January as a direct result of what I believe was a botched heart surgery. I’m sure there is great work and care going on (as Patrick described), but in general from my experiences over the years, I have little faith in the healthcare field. 

As an extremely wise man once said, “Don’t let us get sick.” --Warren Zevon

This is an account from a note I wrote at the time of pain ‘beyond understanding’ from, I presume. the same sort of event that Ben experienced. Perhaps it shows our UK National Health Service in a better light than that of the private medicine in the US as I was just a regular emergency admission far from home and was not able to access any privilege.

Nevertheless it was not much fun.

So, having enjoyed 2014 and thinking things were set fair for 2015 I set off for my brothers 65th in good spirits, until 2 pints in at around 9pm I went to the loo, and couldn’t. As bad luck would have it, it was black Friday ie the Friday before Christmas and I was in the wilds of Northamptonshire. Suffice it to say that after a long period of thinking that if I could just relax things would be ok I ended up taking a 15 mile taxi ride at 2am to Northampton NHS walk in centre. Here I was subjected to two unsuccessful catheterisation attempts before being ambulanced to the A&E, after another 45 minute wait first a nurse (2 attempts) then a junior doctor (3 attempts) tried to catheterise me before a consultant urologist arrived who after 2 more attempts said give him some morphine. It was by now 7am, so I was now up to 10 hours of bursting bladder pain. He then introduced a catheter straight through the wall of my upper groin. I should mention that I was still wearing a suit and this was done without any sort of anaesthesia, he just got a scalpel cut through the skin and stuck the catheter through the bladder wall. Unfortunately he had forgotten to put a closure on the other end of the catheter pipe and after 10 hours there was some pressure built up. It was the classic loose end of the hosepipe scenario with everyone grabbing for it and all getting a shower.

After a night in Northampton general I drove back home to London thinking that I would see my GP arrange the necessary hospital appointment and get the prostate drilled out as it appeared was necessary. This was 21st December 2014, eventually after several more trips to A & E and innumerable bouts of infections I was finally operated upon on April 7th.m For the whole time in between I had a pipe sticking straight out of my lower abdomen with a tap on it.

In retrospect it seems laughable but for those three months it was pretty middling.