‘Who’s the president of the United States?’
Last night, we had an encounter with the US healthcare system.
Your editor’s mother, 94, was having trouble breathing. So we took her across Baltimore to an outfit called Patient First on the campus of The Johns Hopkins Hospital.
This was probably your editor’s fault.
On Monday, he had wheeled her all around town. She might have gotten a chill.
The old hood
The idea was to explore the old ‘hood’ by pushing her around in a wheelchair.
Mother grew up on Park Avenue in Baltimore, only about eight blocks north of where we live today.
We made our way up Charles Street…then over to Cathedral Street…and then across Martin Luther King Boulevard…finally turning up Park Avenue. She had been slumping down in the wheelchair, but as we neared the familiar streets, she perked up.
‘I remember this house…and there’s the church where we used to go. Now, it’s a Presbyterian church. It used to be Episcopal.’
This was the Bolton Hill area of town — an area that had somehow kept itself together through the riots of 1968…the ‘White Flight’ of the 1970s and 1980s…the corruption…the murders…the drug wars…the poverty…the inept government…
‘Oh, look, there’s the drug store. I used to get ice cream cones there 80 years ago. And it’s still open!’
Ghost of the Great Depression
These days, the corner store is labelled a ‘pharmacy.’ But it is little changed from long ago.
The houses and shops in the area — dating from the late 19th century — were well built. Still standing today, they are handsome townhouses, four stories high, made of brick. A few are double-wide mansions, with brownstone fronts.
‘And there’s our house. It hasn’t changed one bit. On one side, down the hill, lived the Sullivans. They were rich. They had a full-time maid. On the other side, up the hill, were the Hollins. I don’t think they were so well off. It was the Depression. A lot of people were out of work.
‘It was hard… my poor father. He didn’t say a word about it. He was always cheerful. But he lost everything. My mother didn’t find out until her sister sent her a letter of sympathy. She’d read about it in the paper. My father had to sell the house. That was how we ended up down on the farm.’
In the middle of the street is a wide, grassy strip with a pool in the centre.
‘That’s the fish pond,’ said Mother. ‘We used to play around it. And we made scooters out of boxes and roller skates. The big boys would fly down the hill. We had such fun.’
Somehow, the neighbourhood resisted the Great Depression, and then both urban blight and urban renewal. Fortunately for Bolton Hill, the improvers focused their efforts elsewhere.
Down the street, for example, there’s a large apartment and shopping complex. Nearby, too, is the Maryland Institute College of Art, which seems to have grown by leaps and bounds. But at least this section of Park Avenue remained untouched, unimproved, and un-messed up.
Much of what passes for progress is a fraud.
Like mutant animal species, the fruit is often sterile…an evolutionary dead end. One building is torn down. An even uglier one is put up in its place.
‘And look how pretty it is here. I’d forgotten,’ Mother continued.
‘I remember this from when I was 16 years old. But it hasn’t changed. Look, the cherry trees are blooming. And the wisteria is almost out. Nothing has changed. It’s lovely. I haven’t been back here for 40 years. I’m glad to see it one last time.’
But the outing had a price. Mother began coughing the next day.
Yesterday, it was time to seek professional help.
‘Your mother has a very irregular heartbeat,’ explained the doctor, an attractive, self-assured woman whom we took for an immigrant from India.
‘And her breathing is very strained. We better check her into the hospital. There may be nothing we can do, but we better run some tests.’
‘Hmmm… let’s ask her first,’ we replied.
‘Mom, the doctor thinks you should to the hospital. Your heartbeat is irregular. She thinks there is a chance you could have a heart attack at any time.’
‘I want to go home,’ came the answer.
But that wasn’t the end of it…
‘Yes, but your mother is 94,’ the doctor continued. ‘She may not be thinking clearly. This is very serious. When I see an EKG like that, I get very nervous.’
‘Sounds clear enough to me,’ we insisted. ‘She wants to go home.’
‘Yes, but maybe you should reason with her.’
‘I think her position is very reasonable. It’s not as though you are going to cure her of old age. She wants to be with her family as long as possible and then make a graceful exit. She’s told me that many times.
‘Mom,’ we tried to clarify matters for the doctor, ‘the doctor thinks something bad might happen if you’re not in the hospital.’
‘Like what?’ Mother asked in feeble voice.
‘Like you might die.’
Mother smiled. ‘Is that all?’
‘Well…’ the doctor wouldn’t let go, ‘we can’t let her out of here unless she signs a waiver of responsibility. She has to recognize that she is leaving against our medical advice. And I don’t know if she’s mentally competent to sign that kind of waiver.’
‘What? She’s perfectly competent.’
Mother had listened to this conversation warily. She wanted no further medical intervention. But she didn’t want to make a fuss about it.
‘Doctor…just ask her a few questions to satisfy yourself about her mental state,’ we suggested.
‘Okay…Ms Bonner…what is your full name?’
‘Anne Billard Bonner.”’
‘And what year were you born?’
‘What year is it now?’
‘Who’s the president of the US?’
‘…just kidding. It’s Obama.’
For The Daily Reckoning