Bitter Defensive.

Bitter Defensive.

Over and over and over. It happened again. I
want to lay it out for you clearly: this
situation that seems to play out over and over and over again.

Mother and father come to hospital with extremely
sick child. They pay for the
consultation. Doctor tells them what the child
needs to get better. Blood. Pills. Perfusions. Hospitalization.

Parents say,

"We don't have the MONEY. "

This response is almost everyone's
response. Because really, honestly, the money
could EASILY go to another basic need of
theirs. Food. Clothes. Schooling. They have
money, but not much of it. There have been
parents that after they see that noone is going
to pay for them, will pull money out of their
pockets and put it on the table.
It is SO hard to tell who really needs the
money. I'm learning that to pay for everyone's
child's hospital bill would take away all
responsibility of the parent to their
child. It's true. If parents learn that they
don't have to take responsibility for their
child, families will fall apart. And that's not what we're about.

However.

When someone really DOES NOT have the money, when
do we give them a break. When do we say, "Hey,
you need help." Do we step in only when their
right about to die of starvation? Do we wait
for them to walk out of the doors of the hospital
because they can't pay and then run after them
and say…"ok ok ok so you really don't have
money…come back in here." It is just hard to
distinguish when everyone is struggling.

I was presenting the patients to Dr. Jaque for
rounds the other day and the baby in the first
bed was sick with malaria but even sicker because
he was malnourished. Fever, respiratory
infection, and lack of appetite coupled with
vomiting. The doctor took a look at the chart,
wrote for what needed to be done further and I
explained it to the man. He said, "This is too
much. I don't have the money for this. We want
to be discharged from the hospital…to go
home." Dr. Jaque instantly laid into him. "You
want to leave the hospital when your baby is like
this?! Do you understand that he will
die?" The man simply said, "We don't have the
money." Dr. Jaque said, "Do you want your child
to get better? Do you? Do you?!" My heart
went out to the man because I honestly think he
was telling the truth. The man said in a low
stern voice, avoiding contact, "If I had the
money, this would be that simple. But it's not
simple." The doctor was frustrated I could
tell. He sees so many people scamming to get
free care at the hospital. People who can pay
but just don't want to. The doctor said, "Ok,
give me your carne. I will discharge you. If
that's what you want!" Then the man just slowly
handed the carne over. The doctor said, "This
is on you! This is not my fault. This is not
the hospitals fault. YOU are deciding to
leave!" The man just took it SADLY. He hung
his head and frustratedly said, "YES. I know. I
understand. It's on me. It's all because of me."
I asked the doctor if I could talk
to him. We left the ward and I asked him if he
really thought he actually had money. He said
yes..maybe. I said I didn't think he did. The
man was handicapped with no feet…just knobs and
his clothes were really low end. The doctor said
he thought the man had money. I said ok. He
knows these people better than me I suppose. He
went back in and discharged the man. The family
went home. It still gets me. Are we so bitter
and defensive that we can't recognize need? It
is one of the hardest things about this place.

A second story. Same principle. A
young Arab girl comes in with a hemoglobin of
2. She's weak as can be. Frail as ever. She
needs to get blood. She gets checked for blood
type. Then each of her family members are also
checked. The policy here is that we check the
family. If they have matching blood, then it is
their responsibility to give it for their
daughter. So when noone has a matching blood
type, then the volunteers, SM's, and hospital staff volunteer.
The only matching donor was the
girls father. They told him that he should give
blood for her or she would die.

He said, "I don't want to."

WHAT!? It made me so angry. I don't even know
Arabic, but I marched over there to where he was
sitting next to his curled up daughter and gave
him a piece of my mind. It's amazing what hand
signals and facial expressions can do. He just
sat there and stared off into the distance. (Ok,
so I guess they don't do that much) I went back
over to Augustan who had sent away the family. I
said, "Augustan, I am A positive blood
too. Let me give." He said, "No. This is the
family's responsibility. If the families learn
that they can just be irresponsible and that
someone else will pick up the responsibility,
everyone will do this." I REALLY respect
Augustan. But at the same time, I couldn't
justify it in my mind that the little girl would
die a preventable death. It wasn't her fault
that her father wouldn't give blood. That was a
really hard night. There has got to be a better
system. Systems, systems, systems. I know they
are necessary…but I sure am not a fan the ones I've seen lately.

What if the right thing in a situation was not
the right thing most of the time. Are we so
rigid and structured that when God says jump we
say , "oh no Lord, we don't jump…it's
dangerous…we know how this world works God, take
it from us." I don't know what the right thing
is. It's a sticky place here. Lots of sticky situations.