Guaranteed Healthcare

Well, it's Sunday afternoon, and after working four consecutive 12+ hour day shifts in the ICU last week, taking care of the sickest, most vulnerable patients imaginable, I'll confess to being a bit tired and weary.  At home, I've begun sorting piles of laundry, and collecting the coffee cups that never seem to find their own way into the dishwasher.  MSNBC's Meet the Press is broadcasting in the background, and my boxer, Ginger, is dogging my heels and hinting that she'd really like to go for a walk to the park sometime today.   

My mind begins to wander back to some of the more poignant and intriguing memories of the past week. Yesterday afternoon three of my colleagues and I stood by with a 93 year old patient who was taking her last peaceful breaths less than 12 hours after her friends and family had prayed for her and said their last good-byes.  We watched her heart beat slow and then stop as her spirit left her body. We silenced and finally disconnected the monitor alarms that confirmed what we already knew.  She'd suffered a massive stroke just a few days after Christmas, and her family agreed that her wishes did not include aggressive and futile life support.  (Although a transfer to a medical bed or hospice care was ordered, none were available for her placement prior to her death.)

One of my colleagues who was serving as the designated Trauma response nurse was suddenly paged to the Emergency room.  A young man had been stabbed in the neck and was bleeding profusely. Major blood vessels were severed and the vascular team began preparing for immediate transport to the OR. The trauma room doc tried to control the bleeding by placing some temporary sutures and packing in the wound, when the young man began shouting that he didn't have insurance and that he couldn't afford to pay for any surgery. He said, "I don't want an operation, just let me go home."

Yes, he'd had a bit too much to drink, and was a danger to himself and not competent to make the decision to refuse.  The ER doc calmly explained to his young patient that he would die without the surgery.  Phone consent for treatment was obtained from his family. Two large IV's were started, and a bit of sedation was administered and emergency blood transfusions were initiated before the mad dash to the operating room got underway.  He would soon need that bed in the ICU.

And, on Meet the Press, David Gregory continued his interview of Senate Majority leader Harry Reid. Blah, blah, blah, Blagojevich, (the dish water is running), the war in Iraq...General Petraeus...the surge...and then, I heard Senator Reid express his opinion that George Bush is 'our worst president, ever.'

O.K. I thought, we all know how awful it's been. So, what then must we do?  I turned off the faucet; I was curious and began wondering, how's he going to justify his assertion?  What criteria, what example would have led him to that conclusion?  As the show was wrapping up, David Gregory fed Senator Reid a lead-in line, and it gave Reid the requisite opportunity to mention his recent book, The Good Fight.