There are no accidents. I first met Pamela Wible, M.D., more than four years ago at a publicity conference. I was there as managing editor of a magazine and she was on a long line of people speed-pitching stories to the tick-tock of a stopwatch. The main things I remember were that we greeted each other like old friends, her face felt like full sun on a perfect summer’s day, and I begged the woman with the stopwatch to give her more time because I knew what I was hearing was important. I wanted to know more about how she’d started a compassionate, patient-centered medical practice in Eugene, Oregon, and how other doctors could do the same thing, and how patients could feel cared for at a fair price. Although I can't remember exactly what Pamela told me, I do remember being absolutely certain that she was a revolutionary and I wanted to support her revolution in any way I could.
Jump cut to the present. I am no longer employed. I work as a freelance book editor. I have lousy catastrophic insurance, and I have just completed an odyssey that began with a month-long nightmare at a radiology center that treated me like a member of a herd and, with no information or face-to-face contact or returned phone call from a doctor, tried to steer me down a chute where some person—I know not who—would stick a needle into my left breast for unexplained reasons. I've never been a herd person, so I refused, dug in my heels, and in my best former legal secretary voice, wrote a letter protesting, among other things, their refusal to send me my medical report . . . resulting in the instant return of my records right before Hurricane Sandy hit.
Many faxes and phone calls later, I came out of the hurricane, out of dark ages of medicine, and into the arms of the magnificent doctors at NYU Langone Medical Center's Cancer Institute where I was treated like a human being who is entitled to learn about her own body. (Cut to conclusion: I'm fine; no cancer; probably no need for a biopsy in the first place, except for the fact that neither the breast surgeon nor the radiologist were willing to nix the dark-ages radiologist's recommendation. It's called erring on the site of caution.*)
But as I said, there are no accidents. This entire imbroglio erupted just as Pamela Wible launched the book I've variously edited and proofed, Pet Goats & Pap Smears: 101 Medical Adventures to Open Your Heart & Mind (Foreword by Patch Adams, M.D.). In the introduction, Pamela describes her first medical job: "I felt like a factory worker pushing pills into patients as they flew past me on a conveyor belt." In a whole chapter called "Factory-Farmed Physicians," she lists names for the kind of medicine my left breast just escaped, including: Assembly-Line Medicine, Production-Driven Health Care, Cattle-Car Clinic, What Drive$ Our Care?, and Premature Consultation.
Then she goes on to show, through anecdotes—serious and pee-in-your-pants hilarious—how it simply doesn't have to be this way. How doctors can choose to practice compassionately and make a very satisfactory living. How this choice must be personal—doctors must choose to get off the assembly line and patients must insist that they be treated as people. (And while I'm at it, I'd like to mention that, IMHO, animals, too, should be treated like fully sentient beings . . . but that's another blog.)
Had I not once been an employed person with fairly good insurance and largely good experiences with doctors, I might not have had the perspective to recognize that the "health care for the poor" that my left breast was receiving was "poor health care." In terror, I might have blindly heeded the two registered letters and two phone calls from non-doctors saying that it was absolutely urgent that my lovely breast be speared right now!
The attempted assault on my left breast in tandem with the launch of Pet Goats & Pap Smears, along with the protection of Obamacare, plus Hurricane Sandy feels like the crescendo of some kind of symphony. The music has galvanized me, and here is my aria:
Health care without compassion, without care, is an assault on all of us—rich and poor, insured, uninsured, and lousily insured. And it is soul suicide for the doctors who do it. In her recent blog, Health Insurance Isn't Health Care, Pamela writes:
. . . health care can never be mandated. Most people suffer ill health from poor lifestyle choices. Legislation can support healthy behavior, but laws can’t force people to care about themselves—or anyone else. Compassion comes from the heart, not the pen. No amount of legislation can force me to care about my patients. Caring happens when I sit face to face, heart to heart, with a patient. And listen deeply. Without interruptions from bureaucrats or middlemen.
The assault on my left breast catalyzed me to fight for Obamacare. I'm so glad we have it, because it mandates a nonprofit health insurance option. But that is no guarantee that if I can find good nonprofit doctors, they will care for me. So what can I do? I can scream, I can beg, I can blog. I can refuse to be assaulted, I can recognize good medicine from bad, and trusting in the power and wisdom of the crowd, I can invite you—yes, you who are reading this right now—into the revolution for compassion.
To learn more about Pamela's book, go to Pet Goats & Pap Smears.
To learn more about Pamela, go to: Ideal Medical Care.
*As of April 2013, this entire debacle has cost me more than $10,000. Although the NYU Langone doctors were wonderful, they, too, are embroiled in the mess that is our American medical system. Fifteen minute consults were billed at a rate of $500+/hour. And the procedure, which took no more than twenty minutes, and was never necessary (the pathologist told me, because I asked, that he had never seen a cancer in an old cyst, and the results of my report were 100% consistent with what would be expected in an old benign cyst) cost more than $9,000. The good news is I've made my catastrophic insurance deductible, so if I'm hit by a truck later this year, I'm completely covered.