[ID 1 to 8: tweet thread from Sayed Tabatabai, MD @/TheRealDoctorT dated Sept. 16, 2020. thread reads:
βWhy do you want to be a doctor?β
I answer without hesitation, βI want to help people.β
βThere are many ways to help people.β
βI want to save lives.β
βThere are many ways to do that too. So Iβll ask you again, why do you want to be a doctor?β
βBecause I believe in it.β 1/
I think about that exchange now and then, some times more than others.
Why do we do the things we do?
What do we really believe in?
My next clinic patient is one Iβve known for many years. He is visiting me today via Zoom.
I always look forward to talking to him. 2/
As soon as the visit begins, I notice that his camera is angled off-center so I canβt get a clear look at his face.
I ask if he can adjust it, but he says heβs having technical issues.
It isnβt just the camera though.
Something feels off today. 3/
Almost immediately I can tell that he sounds subdued. He isnβt cracking his usual jokes.
Iβm comfortable with silence, even in the heart of a busy clinic day.
Silence is often where the healing happens.
After asking how heβs doing, I let the silence between us grow. 4/
The question, when he asks it, is one I donβt expect.
βDoc, which kills you faster? Blood pressure you donβt control, or blood sugar you donβt control?β
The surprise on my face must register, because he explains further.
βI just canβt afford all these medications anymore.β 5/
βThe way I see it, doc, I only need to stick around 4 or 5 more years. Thatβs how long my pet dog has left, then I ainβt got no more family and itβs me all on my own. So I figure maybe take the diabetes ones and skip the blood pressure? Or every other day?β 6/
As I review his meds and start discussing our options with him, he adds one last remark.
βAnd Iβm real sorry doc. I know we go back a ways, but I canβt afford my co-pay. Iβll pay you later. Promise.β
And just like that, I understand why his camera is angled. 7/
And just like that, Iβm again struck by the cruel illusion of what I do.
The system Iβm part of.
This patient did everything right; got insurance, paid his taxes. And he still has to barter years of his life.
And he canβt bring himself to look me in the eyes as he does so. 8/
Our healthcare system is too often unethical, immoral, unsustainable.
The insurance paradigm is focused on revenue generation. It strips the basic human dignity from patients, to the point where they canβt even make eye contact anymore.
I know that Iβm part of this system. 9/
Heβs old enough to be my father. Some part of me imagines that he is my father. Tears threaten my vision, as a hot anger floods me.
Now I wish I could angle my camera away.
I ask him if I can write about him. Because people need to know.
His response lingers with me. 10/
βSure you can doc. But people already know. Lots of people deal with this. It ainβt that people donβt know. Itβs just that nobody cares. Nobody gives enough of a damn to change anything. Nobodyβ¦ cares.β
His window closes too. 11/
Thereβs something insidious here.
A casual cruelty weβre all complicit in.
βI canβt go to rehab, insurance wonβt cover it.β
βInsurance wonβt pay for that medication.β
βI canβt afford any of this.β
This isnβt right. None of this is right. 12/
Twenty years ago, I gave a medical school interview.
I wore my best suit. I sat up straight.
I said I believed in medicine. I meant it.
Some part of me once burned brightly, but that fire is down to flickering embers.
Our lives mean more than this.
More than this.β /end tweet thread
ID 9: tweet from Albert Lee @/AlbertLee2020 from April 29, 2021 reading, βIn America, you and your doctor can both agree that you need a surgery but you have to get permission from a third-party for-profit insurance company or it canβt be paid for. Itβs called freedom.β /end ID]
link to sayed tabatabaiβs tweet thread
link to albert leeβs tweet thread
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