Homework #27: Visiting an Unwell Person

This holiday, I was in Texas. Every day was planned out so there wasn’t really any time to visit someone who was sick. Instead, I interviewed my mother about her experience in visiting my good friend’s dad in the hospital. He’d had a long term illness that weakened him so about 4 months ago, he had a mild stroke. He was admitted into the hospital and it turned out that the stroke had damaged his ability to swallow. Through this new disability, mucus got backed up in his throat and he soon developed pneumonia. After a week or so, he was left over night, unattended, and went into a sudden crisis. My mom thinks it’s because he wasn’t being watched closely enough by the nurses and he didn’t have anyone around to comfort him. They took him to the ICU and did a tracheotomy which means putting a tube into his throat so he could get food. However, on IV, he still went a week without food.

When my mom went to visit him, he had been in the hospital for a month. She says that his whole situation was very scary. After his surgery, he was put in isolation. So when my mom went to visit him, she had to put on gloves, mask, and gown in order to see him. Because of the lack of food, he had lost tons of weight. He looked skinny and frail. On top of that, he couldn’t talk. So their whole conversation was through him writing on paper. Although he couldn’t speak, he still tried. However, he could barely make above a whisper so when he did, my mom had to ask him to write it down because she couldn’t understand. This embarrassed her a lot because she wanted him to be able to speak. At some points during this visit, he would ask her to pound on his back to loosen up what was in his throat. The same thing happened in Tuesdays With Morrie. Once he was well enough, they took him out of the ICU and put him in an isolation room. However, there were no isolation rooms at the standard treatment level, so they moved him to the luxury suites that celebrities and presidents stay in. The amazing part is that he didn’t have to pay extra for the room. When my mom went to visit him for a second time, he looked much better. He had put on weight and seemed more aware of his surroundings. In fact, he became frustrated that he couldn’t go anywhere or move around at all. My mom took this as a sign that he was getting better because it showed that he knew how to express his feelings and say what he wanted. The third and final visit happened at his house. He was mostly better and able to be discharged from the hospital. He’d had his trachea removed and could breathe on his own. My mom kept commenting on how much his wife had been through and how well she was doing with 2 kids in high school and college, bills, her job, and her husband who got very frustrating at times.

When my friend’s dad was in ICU, his wife raved about the amount of care and attention he got. However, once his case was less serious, his amount of care went down considerably. These were mostly physical realities. I think that hospitals base all of their care on the emergency patients and leave almost none for the long term patients. At some points, this is reasonable and makes sense. However, there should be some balance between helping a patient when they’re in crisis and following up with attention and care after they’ve stabilized.

In Tuesdays With Morrie, Morrie discusses how when we are sick, most people complain about their pain and it all about how they can get better fastest whereas he just gives to others and tries to do anything he can to help other people. According to Morrie, as long as you’re around people who you love and love you, it will be OK. My mom thinks that the reason my friend’s dad went into crisis that one night was because he was around people he loved and no one was there with him.

Homework #25: Sicko Response

Michael Moore’s provocative and controversial film, Sicko, takes on the disastrous US health care system. Moore looks at sick people in the US who are denied coverage despite having health insurance and compares it with countries that have universal and public health care coverage including Canada, France and the UK. He talks with former health insurance industry workers about how the system works to maximize profits by denying claims. He also describes how congress members are bought off for their silence. Moore also uses his typical, confrontational filmmaking style – taking 9-11 first responders and other sick US citizens to Cuba to receive free health care. One of his final proposals is that the US should change and bring in universal health care.

Moore has created a website to support facts that he sites in the movie, in response to numerous critics. [http://sickothemovie.com/checkup/]. As an example, the movie claims that “Canadian "wait times" are not nearly as long as some try to allege.” Moore’s site references the Canadian Institute for Health Information, [January 2007. http://www.cihi.ca/cihiweb/dispPage.jsp?cw_page=reports_wait_times_bulletins_e], which says that, “A recent study of emergency care in Ontario found that overall, "50% of patients were seen by a physician within 6 minutes and 86% were seen within 30 minutes of arriving at the [Emergency Department].50% of patients who were seen most quickly waited an hour or less; while 1 in 10 waited three hours or more.”  This is important to Moore’s thesis because many critics tend to attack any kind of government run health care system and cite Canada as an example of bad care. Moore gives evidence that this is not the case and Canada actually gives good care.

A central point of the movie is Moore’s claim that “The government initially refused to pay for the health care of 9/11 volunteers, because they were not on the government payroll. It remains difficult for the volunteers to access the $50 million fund that has been appropriated for their care.” In response, Moore’s website refers us to Robert E. Robertson’s statement to the US Government Accountability Office. The US “provided a total of $175 million for workers compensation programs - $125 million to NYS Workers Compensation Review Board, and an additional $50 million to reimburse the NYS Uninsured Employers Fund, including for benefits paid to volunteers. However, there have been major delays in getting money to volunteers.” This was central to Moore’s aregument because it’s playing on people’s sympathy that even the heroes that stepped in at a time of great crisis can’t get the right health care that they need.

Moore’s film was challenged by the media and politicians. For example, Dr. Sanjay Gupta of CNN said that not all of Moore’s arguments are correct. [http://newsbusters.org/node/13866] This was picked up by websites who wanted to attack Moore’s thesis. Gupta noted that Cuba is ranked below the US in overall health care as one false claim in the movie. These people would like to discredit Moore on small points to undermine his larger thesis, which I believe is correct, that the US healthcare system is flawed and needs fixing.

 As a result of this controversy, I have sought to check one piece of evidence that Moore cites. Moore’s website, http://sickothemovie.com/checkup/, gives evidence that insurance companies were willing to spend millions to block Hilary Clinton’s health care reform proposals in the 90’s. I found two independent sources that back this up.

·         "In 1993-94, the Health Insurance Association of America, a trade group, spent about $15 million on advertising to defeat Clinton's proposed overhaul of the nation's health care system." John MacDonald, "Proponents, Opponents Join Battle Over Drug Price Limits," Hartford Courant, June 21, 2000.

·         Harvard professor, Theta Skocpol, cites the Center for Public Integrity in saying 100 million dollars were spent to bring down Hilary Clinton’s health care plan. “Well-endowed and vitally threatened groups (such as the Health Insurance Association of America [HIAA], the association of smaller insurers that the Clinton plan might have put out of business) also could fund public relations campaigns designed to influence public opinion against the Clinton overhaul.  In the end, according to a study by the Center for Public Integrity, health care reform would become “the most heavily lobbied legislative initiative in recent US. history.” During 1993 and 1994 “hundreds of special interests cumulatively . . . [spent] in excess of $100 million to influence the outcome of this public policy issue.” [T Skocpol. The rise and resounding fall of the Clinton plan. Health Affairs, 14 no. 1 (1995); 66-85]

Moore claims there are four times as many health care lobbyists as there are members of Congress. According to the Center for Responsive Politics (www.opensecrets.org),“in 2005 there were 2,084 health care lobbyists registered with the federal government. With 535 members of Congress, that's 3.895 lobbyists per member.” This is independent support for his claim.

As I watched the movie, Sicko, some of the more important parts to me were the scene where Moore went to other countries see how much better their health care was in comparison to ours. I watched this movie with my whole family during the break and every time Moore went to a different country, we all made comments like, “Ok, pack your things. We are moving there.” This showed that because health care is so good in other places, we wanted to move there and out of this country. My older cousin is a 29 year old single mom of two. She kept staring in awe at the things Moore said because she has to pay medical bills for her 5 year old son with asthma. She kept saying how grateful she was that her epileptic daughter of 11 is covered by Medicaid, so all of her bills are covered. Otherwise she would have to pay a whole lot more than she could afford.

Throughout the movie, the main feeling I felt was shock. I was in awe that our insurance companies could be so dense and actually keep people from surviving at certain points. One part that made me laugh at the insanity was the part where a woman was in a car accident and was driven to the hospital in an ambulance. Later, she got a bill for the ambulance saying that she needed to pay for it because she didn’t pre-approve it. My question is, ‘At what point was she supposed to pre-approve an ambulance after a car accident that rendered her unconscious?’ Another part that was less funny and way more shocking was the scene where a hospital in LA left a disoriented woman on the street because she couldn’t pay. She didn’t know where she was or how she got there and they didn’t care. This came as a surprising to me, that hospitals and insurance companies can be so hell-bent on making money that they don’t even care long enough to get a patient to safety.

My perspective on the dominant social practices has changed because of this movie. I am now more aware of how poorly the people in this country are treated due to the money-driven insurance companies. 

Homework #26: Looking back and forward

There are six key insights and ideas that I have learned during our study on illness and dying. These are:

1.      -Health care in the US is not all its cracked up to be. Even if you have health insurance (and many don’t) it may not cover you when you get sick [Sicko]

2.      -The US healthcare system is driven by the incentive to maximize profit for insurance companies; pharmaceutical companies; hospitals and doctors. [Sicko]

3.      -Most people fear and deny death. Others don’t know how to respond to sick people because they are scared of confronting illness and death. [Tuesdays With Morrie]

4.      -People expect heath care like the kind on TV. They want to be treated with top-notch medicine and machines. Hospitals may not have the machine or feel it’s needed but the people demand it. They feel  they should be guaranteed good health outcomes. [Art as medicine 12/10/10 – WNYC Radio – Studio360.org]

5.      -DNR orders may cause conflict between patient and families or families and doctors. [Grey’s Anatomy – TV show on ABC]

6.      -People take different approaches to health care such as preventive care and homeopathy (acupuncture, tea, bed-rest) vs. antibiotics and meds. US healthcare tends to overmedicate patients. This is partly driven by profits for pharmaceutical companies. [Class discussion; Sicko]

Some helpful sources in gaining these insights:

·        -Sicko helped me see what our country’s health care system is all about – money is more important than people.

·        -Tuesdays With Morrie helped me see that death is a part of life and if we understand that, it helps us live better lives.

·        -People’s experiences – Talking to people I know about their experiences has helped me learn the experience of being in healthcare institutions. This includes my grandmother in a nursing home; a family friend in intensive care; and a family friend who had to fight for DNR.

·        -Class discussion helped me to see that there are different approaches to healing.

An area that I would like to explore in the rest of this unit is ways people are trying to find to die with more dignity and respect. We can try to seek out examples of this.

Homework #22: Illness and Dying Book 1

Albom, Mitch. Tuesdays With Morrie. New York: Doubleday, 1997. Print.

In Tuesdays with Morrie, there isn't much that I can connect to because I've never had this type of relationship with someone either dying or very ill. However, on page 34, Mitch describes his life as emotionless, technological and boring. He had lost all of his ambition and adventure and was feeling old in that particular section as he sat with his old professor. I kind of identified with this because I fell like my life is consumed by technology and my age has made me care less than when I was a little girl dreaming other worlds and new things to do each day. I feel those two things are connected because the technology is what took all that imagination and freedom away from me. 

"'So many people who come to visit me are unhappy.' Why? 'Well, for one thing, the culture we have does not make people feel good about themselves.'" (Pg. 35) This stood out to me for two reasons. One was that Morrie insinuated that the people who visit him feel obligated to be sad around him due to his condition and this is due to the way our culture perceives death. The other reason was more in the writing style. More often than not in this book, as far as I've read, the author does not put his words around his quotes. By doing this, I think he is detaching himself from the story. Because he is focusing the story on Morrie's life and experiences, the way I read his lines are more of a presence or spirit of the author instead of him actually being there. 

In my opinion, the way this book portrays how people deal with being sick and dying is a type of acceptance. The main character, who is the one dying, decides to continue living his life as best he can instead of getting depressed and giving up. To me, this is a very healthy way of going about dying. I feel that if you don't try to live while you can, you'll end up dying sooner than you wanted to. People who maximize that necessity to live are, in my opinion, more likely to live longer than expected because they tried. In Tuesdays With Morrie, Morrie was the kind of person who didn't just sit there and feel bad for himself. He used is illness as a final lesson and an opportunity to teach someone else about what he was feeling.

Homework #21

Insights:
1. If you always work hard to get something, no matter how long it takes, it will benefit you later in life.
2. Always keep a positive attitude and your life will be filled with more life than without.
3. If you go into details and ask questions, the knowledge you gain can keep you grounded when times are tough.
4. Always give gifts to those who help you; it might give you access to thing you wouldn't have had otherwise.
5. If you treat people with humanity and respect, you will get treated the same way.


When Ms. Bernett described the way her husband looked in his bed after he came home for the last time, it reminded me of the way my grandma looked in her bed. She described him as skeletal and around ninety pounds and had to bring him back and forth to the bathroom which she didn't mind at all. When I went to visit my grandma in the nursing home we had her in, that was exactly what she looked like. At 97 she weighed a total of 89 pounds and had basically no body fat. Her hands looked like bones with skin on them and the rest of her body wasn't much better. When I first saw her that way, it scared me to think that her body would make her end up like this. But after a while I just blamed it on old age and I started to feel slightly better given the circumstances. However, when Ms. Bernett described her husband in the same way, it forced me to realize that it isn't just old age that can turn a person's whole appearance into that of a skeleton. 


Ms. Bernett gave gifts to everyone who helped her and her husband. By doing so, she opened up ties and connections that might not have otherwise been obtained. She showed kindness to people in a workplace that doesn't always get too much of it. During the final year of my grandma's life, she had a caretaker named Regina who would come and visit her from day to day to check up on her and help her out. My grandma and the rest of our  family all treated her like she was part of our family. We visited with her during our visits and went out to dinner with her. Once my grandma was in the nursing home, one would think it unnecessary to have a caretaker, but Regina stuck through. She would talk to the people who worked there and make sure that my grandma was getting the best care the place could provide. She continued to visit regularly when we were back at home even with all of her other jobs and kids. Without her care and hard work, I don't think my grandma might have lived as long as she did. I like to think that Regina did so much for our family because we showed her that we loved her as much as she loved us and we constantly showed her how grateful we were for everything. 

The one question I have is "Why does Hollywood romanticize death and illness so often when it only results in false hopes and heartbreak when the real thing actually appears?"

Homework #18: Health, Illness and Feasting

This thanksgiving was small for my family. We used to have a big meal with over 15 people in our apartment. Some were family members and others were just friends from the neighborhood. It was big and loud. This year however, we had just my family of four and my friend's family of three. Although it wasn't as big as it used to be, my mom still went all out with the cooking. She made two types of each side dish including stuffing (sausage and veggie), cranberry relish (sweet and tart), and potatoes (sweet and finger-link). The food was fantastic and we sat around for at least three hours just talking and eating. By the end of the night everyone was full. My friend's dad made Tiramisu which was delicious. Afterwards we sat, watched football and listened to the guys discuss the politics behind all of it.

In my experience of this holiday, the anti-body practices are outweighed by the bodily practices such as eating enormous amounts of food and sitting on the couch watching TV. Although part of it involves the electricity of TV, most of it consists of sitting, eating, drinking, and talking. For four hours, we ate and talked which dominated most of the day. The other part was spent cleaning and cooking for this occasion.

Although the company was small, we were supposed to have another couple guests. My friend Moise's dad is currently in the hospital. He had a mild stroke and came down with pneumonia. He is currently undergoing heavy amounts of physical therapy because one of his illnesses caused him the ability to swallow. Because of this unfortunate incident, we decided to invite Moise and his mother to join us for thanksgiving so they didn't have to cook or clean. However, they decided to spend it with family. In the end, we all suffered from health issues this holiday. Maybe not as severe as Moise's dad's, but as I looked around, most of the food we were eating was starch and fat. The healthiest thing on the table were the fried Brussels sprouts. It certainly says something about our culture when the whole country has an entire day dedicated to eating.

Homework #17: Illness and Dying

          When my grandma started to get older, we knew it was the beginning of the end for her. She was about 94 and most of it was just senility. We would have a conversation with her and she would forget about it the next day. Or she would ask the same question again and again as if it were brand new. It made my brother and me very uncomfortable at first because we would have to repeat ourselves and we weren't used to it. After a while we got used to it until last year when she fell and broke her hip. She lived alone so we had to move her to the town senior center. At first when we came to visit, she would sit up and talk to us and move around the place in her wheelchair. But after a while, she eventually stopped and didn't move from her bed. We tried out best to be there but because it's in Missouri, we could only really visit during Christmas and the summer. Last Christmas we went to visit her again. It was hard because she didn't really speak anymore either and looked very sick and frail. At only 90 pounds, she was beginning to lose it. My mother told me that she just liked having us be in the same room, but after a few days of it, it just turned into silent visits. On June 8, 2010, I came home from school to find my parents in a somber mood. My mom hugged me and I knew. We had been getting updates from my aunt who was there with her and they weren't good. My grandma had died of old age just the way a person should. 

          In the cases that I've experienced with illnesses, I've been taught to look at it in an optimistic point of view. So that a cold is just strengthening your immune system, not causing your body to hurt you. I see it as a way of thinking scientifically instead of emotionally because it helps me to feel better and not give into the negativity that illness brings. Dying however is harder to process scientifically without being emotionally stunned. When someone you know dies it takes a couple days to really notice something is wrong. your body automatically shuts down in order to protect itself from the pain. So when I see illness on TV, it doesn't affect me as much as when I see someone die on TV.

          In the american culture, modern medicine has made it so that even the common cold is treated with chemicals and antibiotics. The view of illnesses are that they are just something to be cured. Only the occasional doctor or scientist will really analyze the disease and research the source. Most people, when they get sick, go to a doctor and ask for the medicine that will lead to the fastest recovery. Although that is most desired for the general public which makes a lot of sense, no one really cares about what they're taking as long as someone has told them it will make them feel better. When it comes to dying, people in our culture tend to just accept it. At first, they will try to find a cure, but if a doctor comes in and says "you're going to die," there's a momentary shock for a few days and the one lives their life out to whenever it is they're supposed to die. People rarely say, "that's not true. I refuse to believe it." and then get up and walk out without thinking twice about it. It's generally accepted that if you have a fatal illness, you should prepare for an early death and deal with it to your own preference. My own family acts on these views in a pretty standard way. They don't do anything out of the ordinary as far as I can tell. However, I don't know how any of them would react to hearing that they were going to die but I do believe that it would result in much crying from multiple parties. This is just another form of acceptance.