Thursday, July 18, 2019

Disparities and My Experience as a White Guy

Nothing feels terribly normal and routine about medical care in this house of late. A post op consult with my surgeon a month following surgery seemed like a good time to dive into some disparity research that I'd been putting on hold. The energy was there is read and think a little.

We arrived at the hospital early, did all of the check in stuff, and settled into a wait. The May-September, 2018 issue of The American Journal of Economics and Sociology provided much depth and breadth. Louis Lee Woods' article, "The Inevitable Products of Racial Segregation," Teron McGrew's "The History of Residential Segregation in the United States," and "Ruqaiijah Yearby's "Racial Disparities in Health Status and Access to Healthcare" all provided useful material that would inform and distract from the consult to come.

In short, health disparities lie within the middle of a confluence of forces that make for life in America. African American's home ownership, wealth, employment status, ability to purchase insurance, availability of medical care, affordability of medical care, and a number of other variables give rise to the notion of systemic racism. Everything is connected to everything else, and all is explained by the fact that the advantage goes to the white person.

And then my surgeon came in. He looked at the two bags, sat down, opened up his computer on the adjacent desk in the corner, and began to ask my wife and me questions. I am an anomaly to him. It is seldom the case that one of his patients wrestle with such  complications. Dr. Caddedu has some decisions to make about my healthcare.

I am struck by what I am experiencing and what I have been reading and what I have heard through the years. I realize that I am a privileged white male. Medical care is readily available to me. No hospitals have been closed in my immediate area.  My wife and I can afford insurance. We can afford for the supplements that cover everything else. So far, my medical bill is $0.00. You do not want to know what has been charged out. Those numbers are truly staggering.  The hospital and physicians are Medicare providers. Whatever the physician prescribes I will take. I have read abstract of some of his publications. I do not have to decide between paying the rent, or food for the week, and medical treatment.

I get in to see the physician or one of his residents or fellows almost immediately. Some have to wait and wait and wait.

My physician seems relatively unhurried, taking his time, exploring options for what to do next.

He sits, rubbing his face, contemplating things of which I could not understand, and lets my wife and me know that it is complicated. How many poor folks have physicians who take time and effort to make decisions? I don't know, but my suspicion is that overworked physicians in some hospitals have a limited amount of time for each patient.

The physician gives us the plan of action. The PA comes in and removes one device. A procedure is scheduled for some time tomorrow and the doctor's team will call with confirmation.

While we drive home, stunned at what we just experienced, the phone rings. It is the urologist's office setting up a time for tomorrow for the procedure. Then another call. It is the anesthesiologist's office setting up details for that person.

Then, and now, I think about my friend in NC whose health is in decline because of his medical condition, and I wonder if he is getting the care that he needs. I think of the farmer I met just recently whose blood sugar is occasionally out of control, something that endangers him. Then I think about the gentleman in Dawson, Georgia several years ago who was dying of cancer and worriation. There are others. Perhaps you know them. Perhaps they are you.

Those are just people I know.

Disparities are for real. In a just world, disparities are not so drastic. We can work for a more just society in which people do not have to decide between rent and medications.

In a just society, people will not die prematurely.

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