“They don’t want to see us live together.” ~ Robert Nesta Marley.
My first official job as a registered nurse in this country was at a large private hospital on Miami Beach. In those days (and perhaps still, for all I know), non-residents had to apply for a police identification when working on the Beach. This you would show to justify you being over there after hours. I am sure that it was a carry-down from earlier Jim Crow days, but in the 70s, when newly drafted civil laws were being implemented, the policy had to apply to all creeds and colors. But it gave me a little chill, a little reminder of how close the US was to its racially divided past.
I had my next lesson in civics at my orientation session. The hospital, we were informed, was a private, not-for-profit hospital. I had recently landed from the UK where health was a right not a privilege; where the National Health Service was still a fully functioning, fully free service for all, without regard to ability to pay into the system or not, and I was flummoxed. Who could possibly want to profit off ill-health? Did I mention I was young and naïve? It took me a while to become acculturated to the US system, but 40 years later I still feel it is the profitability of health-care which is its sickest feature.
Back in the 70s, before HMOs and DRGs and all manner of cost-saving innovations, the average person (with commercial insurance, or even Medicare) would be admitted to the hospital for 4-5 days for diagnostic work-up. There was no such thing as prepping yourself for an out-patient procedure. No, be admitted, start your clear liquid diet here, the nurse provided the prep, you rested comfortably overnight before and after, it was room service with a twist! And in the hospital on the beach, the views were excellent! And your insurance company paid in full.
Fast forward to the present day. Now you are on your own, in charge of following instructions, getting to the out-patient facility on time, and you are very effectively and efficiently processed and recovered and ready to hit the road in no time! My experience on the drafty side of the hospital gown was one for reflection. When you are stripped of your personal effects and reduced to a name band and a gurney, you have time to think about life and health. Although health (or rather ill-health) is a great equalizer, the experience of healthcare is markedly different for those will insurance and those without.
When ill-health strikes, someone who has insurance schedules a full work-up, gets a diagnosis and begins treatment. The fears and worries are the same, but for someone without insurance a juggling act begins. What workup can they afford out of pocket? Do they go to an emergency room and hope to get enough of a workup, diagnosis and initial treatment to at least get the symptoms under control? What if it is a chronic condition? Even with insurance there are co-pays and deductibles, out-of-pocket expenses that soon add up. This country does not make it easy for those with health issues.
I observed my sisters, the professional nurses, in an objective way as they went about their tasks yesterday. The quiet air of confidence, the relaxed manner of putting the patient at ease, the kind efficiency as they joked about the IV start being the worst part of the procedure, the caring as they provided pre-warmed blankets, anticipating the patient’s comfort needs. I listened in as they conversed with my neighbors, remembering times I had joked with people to put them at ease. I was proud of my profession, proud of the fact that we work hard to treat everyone equally, seeing through societally imposed divisions to the patient beneath, a human being worthy of being treated with dignity. I was reminded of our Code of Ethics which begins with the provision that the nurse practices with: “…compassion and respect for the inherent dignity, worth and unique attributes of every person.”
It is not by accident that our current leadership has decided to prey on and highlight the differences between people in this country. It is disheartening to recognize that so many are willing to suspend rational thought and follow the inhumane policies that are being implemented daily; it is discouraging to watch as regulations ensuring the health and wellbeing of the planet are dismantled; it is downright scary to imagine what is happening long-term to the environment at a time when urgent measures to correct past damage need to be put in place. But so long as we are being misdirected, so long as poor (white) people are being misled into thinking that their interests are being protected by money-hungry manipulators, those in power win.
It may seem overwhelming or even impossible, but we have to believe that love conquers hate; that unity overcomes divisiveness; that we all have way more in common than we are different. We may have interesting cultural differences, but we all want health and wellbeing; we all want our children to do better than we did; we all want a home we feel secure in, and some money to spend on nice things. But so long as we keep on ‘fussing and a-fighting’ we have no power. We must see ourselves as one human race, in this together, for the ship we sail in floats or sinks with all of us in it.
On this Friday morning I wish you health, and if you have to experience the ‘ill-health’ system, I hope your nurses treat you with the compassion and respect you deserve. Sending out divine love to all of my brothers and sisters, have a wonderful weekend!