Guaranteed Healthcare

As a nurse, I am often asked to come to the aid of worried friends who are undergoing medical procedures or medical visits with their doctors. Usually, its very routine. But nothing preparded me for the experience I was to have at a local East-Bay ER on the afternoon of October 22nd. The call came from a dear friend whose Domestic Partner of 2 years, Nena Cameron, our family attorney in private practice, had been experiencing two days of burning in her chest, fatigue and lastly, a seizure that morning that necessitated an ambulance ride to the closet ER.

Nena did not have health insurance because she was self-employed and domestic partner benefits locally did not at the time include access to her partner's insurance. She did have care and was being treated by a gynecologist locally for uterine fibroids and anemia which had improved with birth control pills prescribed by her MD. She also had a primary care provider. Nena paid out of pocket for her care and once the anemia improved, surgery to remove the fibroids would be done.

She tried to get insurance but had been turned down because private insurance excluded her based on a "pre-existing" condition. Her age didn't help either. Being 51 and an African American woman were in my opinion also exclusionary. Upon arrival that afternoon, Nena was about to be discharged by the ER doctor with instructions to return if the seizures returned as her driver's license was taken away. A CT scan had been done indicating no brain tumor. When I asked about her medications, the birth control pills and iron pills, as a contributing factor, the ER doctor was uncovinced.

We were now on our way back to her home. As Nena emerged from the car, it was immediately clear she was having difficulty breathing and struggling for air. She collapsed and seized again once inside. We called the ambulance again and phoned her doctor. We took her back to the hospital that had just discharged her with the understanding that she would be admitted immediately. It took over an hour to readmit her. Nena, the lawyer that she was, asked me directly what her "rights" were given she didn't have health insurance. I said clearly to be admitted to this hospital and not to agree to taking the last doctor's advice on taking a loading dose of the anti-seizure medication dilantin and just return home.

My nurse practitioner mind was suspicious of a more serious problem and brain tumor had already been ruled out. She wasn't anemic because she had had a blood test the day before and the result was normal. In addition, per Nena, no other testing had been done up to that point. As expected, another ER doctor without ordering more tests including blood gases or a simple chest x-ray, offered a loading dose of dilantin and a prescription for an oral anti-seizure medication. Without hesitating, Nena refused both and asked for a chest x-ray and more testing before consent on this treatment plan. The doctor looked stunned and threatened to call her GYN doctor to get her to accept his plan. I was ordered out of the ER to sit in the lobby with her family.

One family member called her GYN directly. The GYN said it was "out of her hands" and to follow the orders of the ER doctor and go home. Not feeling comfortable with that, Nena's primary care doctor was notified of my suspicions that this wasn't a seizure but a serious and life-threatening condition of the lungs. We waited two more hours in the lobby. At around 6pm, a nurse requested a family member bring in some new under-wear for Nena. They seemed to be gone for hours and returned with the bad news that Nena had seized again falling into the bed in acute distress. Now things were much worse. The ER doctor had received a call from her primary care doctor an hour prior and they were now aware that things were much worse than originally thought.

After now, six hours in the ER lobby, a code blue was called to the ER around 9pm. By 10pm, we were told that Nena had died of a massive stroke. The autopsy the following day showed massive pulmonary emboli or blood clots in the lungs. These were probably brought on by use of birth control pills, whose dose was doubled two days prior by her GYN.

That is what was put on her death certificate but in my opinion that is not what killed her. Nena died because she didn't have access to care. She was denied that access by several health insurance companies who excluded her. One denial, ironically, came the day of her autopsy.

I have no doubt that Nena would be 58 years old today if HR 676 or SB 840 had been approved several years ago. She, like many others, is a casuality of our corporate controlled health care industry that puts profits ahead of decent care. She was deemed a poor credit risk by the hospital even though she paid her health care bills out of her own pocket. We need to stop thinking health insurance companies care. This experience taught me they really don't. They care about money and lots of it. They have to be stopped and soon. Nancy Lewis, RN FNP