Remission’s just another word for nothin’ left to lose

children-singing-md

clip art credit clker.com/

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photo kriskristofferson.com

Kris Kristofferson wrote in Me And Bobby Mcgee: ‘nothin’ ain’t worth nothin’ but it’s free,’ In the midst of so much bitter debate over free universal health care, free is worth a lot. When it came to treatment for a nasty, rare breast cancer, I had ‘nothin’ left to lose’. I selected an expensive course of treatment and, at the end of my years of living medically, no one handed me a bill. They cheered and waved goodbye.

Is this possible – timely, excellent, appropriate health care for ‘free’ or was I hallucinating? The drugs weren’t that type. The policy answer for how ‘free’ timely, excellent, appropriate health care works is that money from everyone’s taxes is allocated towards universal free health care. Blah blah. The human answer is that free universal health care works because people make it work every day in doing their jobs despite the administrative turmoil around them.

On the cancer conveyor belt you meet everyone on the belt around you. It’s like an exclusive club – if you belong, you’ve got the status of everyone else holding the red cancer membership card. It’s a twist on the joke: ‘I wouldn’t join any club that would have me.’ We have a club that doesn’t want members, and no one wants to join. But, if you need it, it’s welcoming and you’re grateful.

Members of the Cancer Club talk all the time. It’s impossible not to. We’re all anxious, naked under thin gowns, lined up for our turn i the schedule, and in need of bucking up. I sit down, the bald lady next to me smiles and the game is on. What flavour is your cancer? What number treatment or test or exam is this for you? How’d your last one go? Who’s your doctor or technician or counsellor? And so on. So, I have a lot of anecdotal evidence that I wasn’t the only bald, underdressed, anxious person who was happy with the care at Alberta Health Services.

Here are two stories, one from the professional aspect of our free health care and one from the personal side of the experience.

The timeline from suspicion, investigation, diagnosis and treatment went without a delay. At first, my partner, Decker, and I thought the hour of specialists’ time at each appointment was extraordinary. But no – everyone had the same experience of doctors who answered every question. We all had the same story – competent, compassionate, high quality care with no delays. And it’s the same level of care no matter the level of income.

The second story was from the Peter Loughheed Health Centre when I woke up from surgery ravenous after almost 20 hours fasting, only to find there was nothing for me to eat. The patient kitchen was closed, Decker had gone home to care for Trail, the 11-week-old puppy, and I was too groggy to walk to the public cafeteria. The ward clerk, who earns a modest salary, heard about my plight. On her break, she went to the public cafeteria, bought me something, and had the attending nurse give it to me. The nurse was the one who told me the ward clerk had done it anonymously.

The debate about Universal Health Care focuses on what’s wrong. Well, there’s also a lot right. For all the extravagance in the administration of the health care system, there’s an employee in the system who pays out of his or her pocket for a hungry patient. The system works because the people on the front line know what to do and how to do it, and know when to ignore the upper layers who are purportedly in charge.

With all respect to the extremely talented Mr. Kristofferson, who wrote a wonderful song, there’s no damn way I’d trade all my tomorrows for a single yesterday. And thanks to the fabulous care I received from the front line workers who don’t let the chaos at the top get stop them from delivering superb care, I have many tomorrows, none of which I’d trade for anything.

There’s a lot of great care happening as well as a lot of conflict in health care. The norm in conflicts is to focus on what’s wrong with everyone else’s system while defending one’s own. It’s easy to sit in judgment of who has the best or correct or right way of doing things, or feel compelled to tell the other persons what you believe is their best or correct or right way they ‘should’ do things. In conflict, people drive the system and the system amplifies or dampens the good things people do.

As a conflict manager, when I’m looking at systemic issues, I start with the people who are doing a good job and ask ‘how do we get more of that?’ That’s the Appreciative Inquiry approach. Instead, the powers that be order expensive public inquiries into what goes wrong and how to get less of whatever that turns out to be.

If, heaven forbid, I slip out of remission, even though there may not –at this time – be anything medically that anyone can do, the personnel in the medical system will persist in treating me, knocking themselves out trying to save me or give me more time or improve the quality of my remaining life. That’s worth something and – where I live – it’s free.

Here’s Kris singing Me and Bobby McGee:

http://www.youtube.com/watch?v=BG2kq-4dM98

 

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