Money Talks

Ah, what a refreshing morning.  Well, not really, considering the sun was blazing at 8am and the humidity is approaching 100%, but it was nice to get a little work done around the apartment, tidying up.  I managed to get my beard clipper working (a couple sharp whacks and a little olive oil for the rust) and trimmed this mangy thing hanging off my chin.  The better to not look the part of a conquistador.

Took out the recyclables (they turn the glass into paving bricks for the roads, which is pretty cool), oiled my chain on the bike (again, olive oil), and then headed out on the eternal search for internet connectivity. 

Carolyn and I have had an amazingly difficult time to connect.  We’ve tried Skype (the best), gmail chat, cell phones, and I’ve even tried shouting across the oceans a few times but to little effect, although I did feel better.  The frustrating part is getting charged for really poor connections. 

But that’s just how it goes when you’re traveling. 

My real challenge, as previously complained about, is trying to provide for continuity of care for the patients I have seen in the clinic, to whom I was promising “we will be here in the long-term”.  A few weeks ago, I changed tack and began encouraging patients to take our recommendations to local doctors and establish long-term care with them.  Although that didn’t feel very good, especially considering that our clinic and the emergency room are the only places on the island to receive care gratis. 

Now, with our new agreement with the municipal clinic and the enthusiastic team there, I am again telling patients that we will be there for them.  Nancy, the nurse, Jessica, the new general doctor, and Sandra, the gynecologist have been very accommodating to our presence and receptive to our management plan.  With some simple suggestions, I think the medicine will take care of itself.  What I worry about is the will to provide patients with encouragement and support.  It can be a daunting job.  Patients don’t follow instructions (mostly because they didn’t understand, and often because they can’t read).  They don’t follow-up.  They can’t afford medications but are too embarrassed to admit it.  They shop around for different doctors and confuse advice and medications.  None of the patients that I have seen have much confidence in the local doctors, and unfortunately, the feeling is mutual.     

The health professions were built on a foundation of dedication to service, but today many healthcare professionals are more concerned about earning money.  Which is legitimate, I mean, who isn’t?  That suffering home-schooled hermit thing worked for Yoda, but I'm guessing his dental plan didn't cover whitening and obviously there was no decent parking in his neighborhood. 

Healthcare providers should not have daily worries about their income or their crippling debt.  And they shouldn't be able to make millions of dollars annually, either.  Let's keep those business tycoons out of medical schools!  Healthcare providers should be able to focus on patients’ problems.  And society, patients and all those potential patients out there should provide a reasonable measure of financial and job security in exchange for expecting selfless, uncompromised service.  



Las Cascadas
My Barrio's namesake
and the first time I've seen it wet thanks
to all the recent rains



Of course, the same should apply to elected officials, public service employees, and heaven forbid, teachers.  But we get what we demand.  In a society obsessed with material wealth, how can we expect altruism to spontaneously appear?   I have had the privilege to be present with many people facing the last days of their lives, and those experiences have provided a new perspective on things.  I’ve never seen a commercial on T.V. selling what these people talk about.  Family, friends, lost love, love found anew, companionship, relationships.  Unfortunately, many of us realize too late the importance of these forces in our lives.  Money may talk, but it has an extremely limited vocabulary.