Agraphia Medical Tragicomedy


Free Care

I was reading Enrico's latest post and figured that I'd weigh in on a patient that I saw just today.

I, like 'rico, am unabashedly left-wing when it comes to almost everything. My facebook "political grid" lumps me in squarely with crazies like Ralph Nader†. On the other hand, when it comes to medical issues, I tend to gravitate more towards the "do nothing" side of the "do no harm" in the Hippocratic oath. I mistrust the hospital and think most people should be at home, most of the time, and not sucking up vast quantities of expensive medical care that does nothing for them.

My patient today is a 17 year old latino male from Guatemala, who was supposedly border crossing to the mystical oasis of LA with a bunch of his friends. After being in the desert for a whopping 15 days without water†† and having finally fallen out of a tree while being chased by a wolf that was 6 feet tall, he was found down by an ambulance who brought him to our most esteemed Hospital.

He was in the ICU for 2 weeks with rhabdomyolysis, acute renal failure, massive dehydration, electrolyte imbalances, and a whole bunch of other stuff. He finally came to our service once the acute life-threatening stuff was resolved.

My immediate first thoughts on this kid were that a) he's never going to pay, b) not only is he never going to pay, but his hospital stay is going to be far more expensive than most, and c) this is why Republicans get all up in arms about illegal immigrants.

He doesn't legally exist here, so there is no way the hospital can track him down to pay for this - nor would he have the funds. We can't sign him up for Medicaid, because if we did, Border Patrol will find out and deport him... again resulting in the hospital not getting paid.

And so, I find myself frustrated by this kid. On the one hand I understand the desire to get to America, land of opportunity. On the other, I wish he had brought some damn water. And on top of everything I find myself frustrated that we don't have Universal Health Care††† and a well-implemented guest-worker program. Or something. Because as the situation stands now, we have a system of enforced charity which piggybacks on the doctors, the hospitals, and ultimately, the tax-payers.

†I still haven't forgiven you for Al Gore, you asshole.
††Admittedly, some of his story is a little... hard to believe.
†††And I've already told you all that I don't really like the idea of Universal Health Care, but hey, I'm fickle.

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