Caring for the Neediest
Every now and then, the reality that I am a social workers overpowers my (usually) better judgment re what to post here. I am also influenced today by the fact that this is a long holiday week-end, so it is possible that you have more free time than usual to read. Hoping that is the case, or that you will remember and return to this, I am introducing you to this marvelous article from The New Yorker. The author, Atul Gawande, writes beautifully. Here is the beginning and then a link:
THE HOT SPOTTERS
Can we lower medical costs by giving the neediest patients better care?
by Atul Gawande
JANUARY 24, 2011
If Camden, New Jersey, becomes the first American community to lower its medical costs, it will have a murder to thank. At nine-fifty on a February night in 2001, a twenty-two-year-old black man was shot while driving his Ford Taurus station wagon through a neighborhood on the edge of the Rutgers University campus. The victim lay motionless in the street beside the open door on the driver's side, as if the car had ejected him. A neighborhood couple, a physical therapist and a volunteer firefighter, approached to see if they could help, but police waved them back.
"He's not going to make it," an officer reportedly told the physical therapist. "He's pretty much dead." She called a physician, Jeffrey Brenner, who lived a few doors up the street, and he ran to the scene with a stethoscope and a pocket ventilation mask. After some discussion, the police let him enter the crime scene and attend to the victim. Witnesses told the local newspaper that he was the first person to lay hands on the man.
"He was slightly overweight, turned on his side," Brenner recalls. There was glass everywhere. Although the victim had been shot several times and many minutes had passed, his body felt warm. Brenner checked his neck for a carotid pulse. The man was alive. Brenner began the chest compressions and rescue breathing that should have been started long before. But the young man, who turned out to be a Rutgers student, died soon afterward.
The incident became a local scandal. The student's injuries may not have been survivable, but the police couldn't have known that. After the ambulance came, Brenner confronted one of the officers to ask why they hadn't tried to rescue him.
In Camden, New Jersey, one per cent of patients account for a third of the city's medical costs. Photograph by Phillip Toledano."We didn't want to dislodge the bullet," he recalls the policeman saying. It was a ridiculous answer, a brushoff, and Brenner couldn't let it go.