The Scariest Thing About American Health Care

Last night I heard a story about a 57-year-old man who was visiting a relative at a local hospital and unfortunately had a heart attack while he was there. It happened around 11:00 PM while he was standing on the sidewalk just outside the door of the emergency room. Of course no one wants to have a heart attack, but if you're going to have one, this is probably one of the better places you could choose.

Or maybe not. When an employee discovered the man passed out in the bushes on her way in to work, she called the emergency room, identified herself, and asked for someone to bring out a wheelchair (she didn't try to move him herself because it's against hospital policy). After the receptionist lazily asked questions for several minutes (from 30 feet away) in order to assure herself that it wasn't a hoax, the employee was finally allowed in. There followed still more questions, an eventual call to the night watchman, and some confused haggling over who should find and haul out the wheelchair. After more than ten minutes, the ER staff at last made their weary way outside to pick up the patient...who was now dead.

Since I only heard this story because I know someone who was there, I have to wonder how often things like this happen. It reminded me of the excellent article "How American Health Care Killed My Father," in which the author, David Goldhill, talks about some of the built-in disincentives to excellence that exist in our health care industry. But as I talked to my friend who saw the whole thing, I also thought about another factor that's much simpler and more disturbing, at least for me. The whole half-assed endeavor was really just another example of the ubiquitous phenomenon that I've called post-modern capitalism--an economy based on goods (or services, in this case) that are designed for appearance rather than function. No doubt the hospital staff went home in the morning with their McGriddles and coffee feeling that they'd done their jobs. A life may not have been saved, but they had in fact staffed a hospital. What more do you want?

For me then, the scariest thing about American health care is that it's run by us Americans--the same people who run the DMV, the cable company, the fast food chain, and every other establishment where the employees treat you like a menace to their God-given sense of entitlement. Despite all the ideological battles over the merits of private vs. public enterprise, this is one thing they will always have in common. Some blame the government for our faults, some blame the capitalists, and some blame a lack of religious faith. I don't know all the answers. Everyone's probably right to some extent. The question is, how do you reform a system in which we all seem trained to think like cattle, going from the milker to the pasture and back again, with no sense of purpose and no concern for anything that may fall in our way?

Neverland

I.

As if he were put together each day

from a box of pieces, carefully

stored in his locked room,

guarded at night by large,

black men with bulging shoulders

and dark, shiny glasses.

He appeared occasionally. His skin looked

unprepared for the sun, as if it had been chosen

without a thought of natural light.

In his bathroom mirror, when the large black men

finished brushing the powder onto the cheeks,

setting the wig straight above his forehead,

balancing the sunglasses gently

with thumb and finger on the vertical

bridge of his nose, his complexion

seemed more than perfect.

Marble, like a goddess of antiquity.

But which goddess? Not Aphrodite,

with her long red hair and woman’s

hips. Or Athena, with the iron warrior’s

eyes, or Diana…even she was too rough.

Too mannish, in a way. In the end,

it didn’t matter. One deity is always

as good as another, one name as sturdy

as another, to hang an image on.

As the ancient media scholars observed,

the marble is the message.

II.

He appeared to us constantly, like a playful sprite

on heavy rotation in a child’s daydreams.

Like all the spirits, he was sexless.

But he played at sex, and sang at us,

and made us wonder where he came from

and what he wanted from us.

Pinnochio was on TV

with one hand on his crotch, dancing

like so: spin, kick, masturbate;

spin, kick, masturbate,

as if one of our toys had come to life

and started making lewd gestures at us.

We watched and wondered in our bedrooms

and in the record store at the mall as he spun

around the graveyard. Wooden limbs, straight

like a doll’s, but seemingly inflamed.

III.

After the first few tunes, it was less about the music

and more about the reality. He was told that

he was Michelangelo and Peter Pan and Einstein rolled into one.

He transcended himself. This was his trap--

to be known for being known, loved for being loved.

Then it was about who, if anything, was behind the costume.

After the universe’s secrets are opened

come the sleepless nights. Even Einstein

has to figure out how to be Einstein.

After relativity, something has to be next.

IV.

All the pieces went back into the box.

It was solid gold, or it seemed to be,

in honor of his status, his rank.

Death almost seemed the logical extension

of his fashion sense. At last he was

preserved, ageless, untouchable.

His brother is due to speak.

He is famous, too, in his small way. He wears

a red rose in the lapel of his suit.

He sings what brothers always sing

on these occasions. His voice is

clearer, his pitch more perfect,

and we expect to love him more

because his grief is somehow more pure.

But it is not more pure. It is angry. He cries

for a few minutes over his brother’s veins,

angry that the undertaker’s job

was stolen, that they were drained too soon

and filled with poison. He is angry

that sleep took hold and left his brother

frozen. For a moment, the music is

the reality. There is no pantomime

of sex, or death, or any other ecstasy.

No reaching for childhood.