Wednesday, September 23, 2009

NYT on my birthplace

I am just now getting around to reading this report from the New York Times on Memorial Hospital in the wake of Katrina four years ago. It made headlines throughout the blogosphere because it allegedly cost 400,000 dollars. It was most interesting for me, however, because I was born there (it was called Baptist Hospital back then).

There are a lot of sad spots in the story, where bravery and selflessness cross paths with desperation, but I don't want to spoil a great read, so I'll just give you this exchange between a doctor named Cook and a patient named Scott, a man who had by that time spent several days in an intensive care unit without electricity:

Cook thought Scott was dead, and he touched him to make sure. But Scott turned over and looked at him. “I’m O.K., Doc,” Scott said. “Go take care of somebody else.”

For the general public, this report is probably worth the 400,000 because it comes during the healthcare debate. How would you like to be one of those doctors are trying to decide who to evacuate in what order?

... medical workers try to divvy up care to achieve the greatest good for the greatest number of people. There is an ongoing debate about how to do this and what the “greatest good” means. Is it the number of lives saved? Years of life saved? Best “quality” years of life saved? Or something else?

As others have pointed out, we already ration our medical services, but under such crisis circumstances decisions have to be made quickly and with little coordination or preparation:

The decision that certain sicker patients should go last has its risks. Predicting how a patient will fare is inexact and subject to biases. In one study of triage, experienced rescuers were asked to categorize the same patients and came up with widely different answers.

I can certainly sympathize with family members whose loved ones were apparently given an overdose of morphine even though, in retrospect, it seems that some of them -- if not most -- might have pulled through. But all of them would not have, and I do not want to be in the position of the doctor who makes that decision (after several days trapped in the hospital under the same conditions as the patients) and then has to take the heat for it.

And then there is this little ditty from someone at the hospital describing the situation outdoors:

“I figured, What would they do, these crazy black people who think they’ve been oppressed for all these years by white people? I mean if they’re capable of shooting at somebody, why are they not capable of raping them or, or, you know, dismembering them? What’s to prevent them from doing things like that?”

New Orleans, there's no hope for you if you can't live with yourself.

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