Who Gets Access to Health Care? Part II

A Tale of Two Tails?

So we are out behind the restaurant in the courtyard, and I am preparing to give this kitchen worker an injection in his ass. Mario, the hotel owner, has asked me to do it so that the worker–forgive me, having stuck a needle in someone’s derriere I should at least have the courtesy to remember his name, but for the life of me I don’t, maybe there was a selective amnesiac in that pisco sour I drank–so that the worker will not have to trudge all the way over to the local Puesta del Salud, or health post. Time is money, you know, and for most of Peru, it seems to be in short supply.

Rosemary keeps telling me “If it makes you uncomfortable, don’t do it.” She doesn’t mean dealing with a stranger’s naked buttocks, she thinks that sometime later this year my patient is going to get a boil the size of a bocce ball back there, which will land the patient in the hospital and me in court. Liability, shmiability, I scoff internally, and give the guy his medicine.

Two days later. . .

I am at Rosemary’s house/La Asociación Humanitaria “San Francisco de Asis”, and my patient walks by. He says hello to me, and I greet him in return. He clearly desires to talk to me. With my inadequate Spanish, I learn his story.

He is being sent home descansar–to rest–for a few days. Why? Well, his illness requires it. What, I ask, exactly is the problem? I get a picture of something that has been going on for a few weeks, something that seems to give him some headaches and some vision problems. Hmmm, I wonder, without saying anything, other than the obvious have you been to a doctor? Oh, yes, he says, but I am very poor, he says. I show more consternation on my face–it’s easier than trying to ask detailed questions, and after all, I’m not a physician. I ask him what the doctor said. She said it was my riñones–kidneys–because I have some back pain as well. Did she do any tests, I ask? I am very poor, he says. Did she take any blood, do any x-rays? He repeats that he is too poor. I am wondering if he is having migraines, or something even more serious. Couldn’t she refer you to the hospital in Paita (which is only 15-20 minutes and less than a dollar away)? Again, the poverty.

I know he wants money from me. He doesn’t ask, but the refrain of pobre is too constant, too supplicatory to be mistaken for something else.I’m usually a pretty soft touch, but I don’t want to give in. I don’t understand this situation, my pocket   is strained right now, my time in Peru is unpaid, and if what he says is true then what he really needs is for me to take him to a doctor myself, and see that he is getting his symptoms looked at properly.

I wish him good day and turn away. He walks off to his home. I go in the house and Rosemary asks what he wanted. I tell her the story. Oh, she says matter-0f-factly, he was asking you for money, as if it were an everyday occurrence. And they always say that it’s the riñones here, she  adds. Your head hurts, your stomach aches, you’ve got leg problems, it’s the riñones. Rosemary has had some labor problems lately, and the money issues have her worried as well.

Okay, so who’s tail number two?

Yes, I said that this was a tale of two tails. My patient doesn’t have access to health care, and it’s so easy to rail against the social injustice of it all. (Peru does have a national health plan, but it isn’t adequate.) But then I get home, and our government can’t make sure that we all have access to adequate health care. Two weeks later the news hits the stand that premiums are far outpacing inflation. Some Californians will see an increases of around 40%.  For people of my home state–Illinois, Land of Lincoln and insurance company’s paradise–the situation is far worse than where I live now, in Massachusetts. But we, the bluest of the blue,  just elected a Cosmo centerfold whose promise was that he would be the “41st vote against” health-care reform.

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One response to “Who Gets Access to Health Care? Part II

  1. seems we’ve gone from Italian to Mexican cheese cake. What happened to the bugs?

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