CEO CORNER
Mike Maples, MD/CEO
You would probably guess that I am a numbers person. Before I make a decision, I want to gather the data. I want to see the evidence. It has a lot to do with how I form my opinions.
Over time, I have come to appreciate the power of storytelling.
The last full week that I was the attending for our Family Medicine Service we began the week by admitting BJ. She is a young, healthy woman. So, there was no reason she should have been very concerned when she stepped on a tack. It was a minor puncture. She doesn’t have diabetes. When, after two weeks, it was still draining, and she was starting to see red streaks coming up her foot and ankle, she went to the ER.
BJ doesn’t have insurance. Like many people without insurance, she doesn’t have a doctor. And, like many, she delayed the visit. She was diagnosed with lymphangitis. No problem. That’s quite treatable with an antibiotic prescription, which she got, and which could have been purchased for about $10. She had $10 at the time, but only $10. Her son wanted to go to the movies with his friends. That was the choice that she prioritized.
Eight days later, she is back in the ER, and that’s when we meet. The streaking got worse. Now she has terrible pain and swelling in her groin and vulva. She’s been having fever for a few days. She’s pretty sick. We hope that it’s still early enough for antibiotics to do the job. We try it….high dose….broad spectrum. We’re encouraged when the wound culture does not grow MRSA, at least. But by the third day, it’s clear that the infection is not responding. The surgeon attempts an incision and drainage. It’s beyond that. BJ has to undergo a fairly extensive surgery to filet open her groin and vulva and place drains.
After eight days, I rotate off the service, but BJ is still there…. getting better, but not ready to be discharged. We hope that she won’t have any permanent injury from this infection and its treatment.
This is a tragedy on so many levels. The people out there like me, the “numbers people” will read this and complain that it’s “anecdotal”, an “n of 1”. I know the criticism. I make it often enough. But BJ, and stories like hers, are not unusual. They are commonplace. Did BJ make poor choices? Yes. Did BJ fail to exercise appropriate personal responsibility? Probably so. She paid the price for it…but so did we all. Instead of a $10 cure, she needed a $10,000 cure. She can’t pay for it, but it wasn’t free. Sometimes living in a society just means that you have to help people who cannot help themselves. I hope we can find a way to do that in a smarter and kinder way.
Mike Maples, MD
CEO