Heaven Help Us All
What will the future of health care in Western New York look like?
In the following four stories, an interwoven cast of patients and health care providers - Barry Glover, Miranda Trimble, Don Castle, Laura Castle Clark, Felicia Johnson, Tony Tomasello and Anita Wallace - interact with each other on a single day in 2018, Friday, June 22, to be exact. The date is the same in each story but each Friday has been reached along a different path, with distinctly different outcomes for all involved.
As the recession of 2013 echoed the recessions of 2008 and 2010, Congress was unable in 2010, 2012, and 2016 to enact any kind of health care reform:
- By 2016 even service companies were abandoning North America for Asia.
- Many Americans took low-paying jobs overseas.
- The burden of supporting American health care grew heavier on those who remained behind.
- The price of insurance increased so much that fewer companies chose to provide health benefits.
- More workers joined the ranks of the uninsured.
It was nearly ten p.m. Barry Glover lay on his back on a gurney in a large general treatment room in the ER. To his right sprawled another man, and Barry could hear the pneumatic hiss of the stomach pump. On Barry's left two doctors worked on another man, who'd been wheeled in with the shout, "Gunshot wound!" just before the drug overdose on the right. Across from him a doctor kept saying, "Stay with me, Miranda!" to a large woman who'd had a heart attack. Barry was glad he couldn't see any of their faces. It was enough to listen to doctors exchange words he did not understand, to hear tears and coughing and tired voices and the sounds of machinery, to know that here, amid all this confusion and noise and stink, because he had been laid off and could no longer afford insurance, control of his diabetes had got away from him. Now he would lose his leg.
He closed his eyes against all that was happening around him and tried to shut down his mind, which had been racing since the ambulance had brought him in. Try to sleep, he told himself.
And sleep he did, despite the alternating pain and numbness. When, finally, someone called his name, the sound had to reach deep beneath the surface to pull him awake. Blinking, he was unsure how long he'd been out but he lifted his head and saw a weary woman looking down at him.
"Mr. Glover," she said. "I'm Dr. Wallace and this is Nurse Tomasello." She gestured to the dark haired man who stood behind her. "We'll be examining you." She lifted the sheet and winced at his leg, which, he knew, must look even more unsightly to someone unaccustomed to dragging it around.
"I couldn't always get insulin - or needles," he said, as if apologizing.
"And there aren't many places left where you can learn to use them." Dr. Wallace sighed. "Nurse Tomasello will take you to another part of the hospital," she said. "I'll join you there shortly."
Tomasello got behind the head of the gurney and began to push, skillfully angling past the other gurneys and chairs that littered the corridor. Barry looked from side to side, at people waiting to be seen, standing or leaning or sitting, some holding crying or sniffling children, others pressing gauze to open wounds. At the far end, some of the gurneys had bodies completely covered with sheets.
Barry was silent until the nurse pushed him into an elevator and the door closed behind them. "Are they going to stay out there all night?"
"No," Tomasello said. "Somebody will move them to the morgue when things slow down. We're short-staffed tonight."
"Is it always like this?"
"Not always. Fridays are bad." Tomasello shook his head. "More and more folks don't have a family doctor, so they come here and we have to stabilize them, even if they never pay the bill. A lot of people drive in or get helicoptered in because the rural hospitals are so poorly equipped."
"I bet the guy who runs this hospital has a doctor," Barry said. "And I bet he can afford whatever he needs, probably at another hospital."
"Maybe even in another city," Tomasello said. "Most people have doctors. It's just that the number of those who don't seems to be growing."
For a moment neither spoke. Then Barry laughed.
"What's so funny?"
"I'm going to lose my leg," Barry said, "because I got laid off and couldn't get what I need." He laughed again, bitterly this time.
"If it means anything, at least you'll be alive," Tomasello said. "A man I saw this morning? Hopeless. Stage four colon cancer. His daughter's expecting, and all he wants is to last long enough to see his first grandchild."
Then the bell sounded, the elevator jerked to a halt, and the doors slid open on a corridor with lights already dim.