Tuesday, January 12, 2016

A medical dilemma or a horror story?

Not a week goes by without Félix, with his usual uninflected delivery, tells us a shocking life-in-Mexico story that strikes Stew and me with the force of a blow to the side of the head.

"How can that happen?" we ask, while Félix's response to such day-to-day tragedies and outrages—a reaction I find quite common among poor Mexicans—goes far beyond sangfroid or steely determination. It's closer to profound impotence and fatalism: Life is shit and then you die. 

Félix' most recent story arrived yesterday and involved his twenty-three-year-old niece, Veronica. She had gone into premature labor and was rushed to the local hospital where she delivered a tiny, but very much live-and-breathing baby about five-and-a-half months old.

Rather than place the baby in an incubator to keep it alive, possibly to be transferred later to a more sophisticated facility, the attending physician told the father that the newborn, apparently normal except for its size, could not be saved. It was left lying on the crib while the father watched. The baby gradually turned blue, Félix said, and two or three hours later died without any further medical intervention.
I don't know the full medical details but when we heard that Stew and I felt a similar sadness and outrage gripping our hearts and guts: How could that happen? 

The hospital is but two or three years old and in my exposure to the facilities, when we've taken friends to the emergency room, including Félix' dad, who suffers from diabetes, alcoholism and generally a very hard life, it seemed to be well equipped and staffed. Félix said that his last two babies spent their first few hours with an oxygen mask around their tiny faces, and that there are incubators available.

Yet given the baby's chances of survival, and the medical and financial limitations of the hospital and the government-financed healthcare system on which people as poor as Félix and his family rely, perhaps the doctor had no other options.

Stew promptly said such a thing wouldn't happen in the U.S., that the baby probably would have been kept alive in a neonatology unit even if the medical bills reached hundreds of thousands or even millions of dollars. I'm not sure.
Stew may be only partly right. If this drama had unfolded at a private American hospital and the parents carried full private insurance, that baby likely would have survived. America's private health care system is justifiably renowned worldwide for all manner of medical heroics—as long as there's plenty of cash to pay for them.

A private Mexican hospital in a larger city also might have saved the baby, assuming the parents had the means to pay for the treatment. Indeed, private Mexican hospitals have a particularly draconian reimbursement system: You have to leave a substantial deposit, in cash or with a credit card, before you're treated at the emergency room or admitted.

If Veronica had shown up at a private hospital in Chicago with premature labor pains and no insurance, she would have been efficiently bounced to Cook County Hospital, a public facility dedicated to treating indigent patients. And at taxpayer's expense, she would have received first-class attention at this multi-billion-dollar version of government health care, precisely the big-government monster conservative politicians love to loath in the U.S.
But what if Veronica, indigent and thus with no health insurance—just like millions of Americans—lived in some Podunkville, U.S.A., where there's no public hospital? What would have been her and the baby's chances? I prefer to think somehow the baby would have had better chances of survival, but I wouldn't guarantee it. Maybe Medicaid? Some "charity fund" at the hospital for patients who can't pay?

And in the U.S.—this is Stew talking again—just the fear of a multi-million negligence or malpractice lawsuit against the doctor, the hospital and anyone involved in such tragedy, if nothing else, might have prevented it. I'm not sure of that scenario either. You'd have to have sufficient reserves of rage and money to hire a competent attorney to do battle with the law firm representing the hospital.

For my part, I would not have waited for the lawyers to do their work. Whether in the U.S. or Mexico I would have throttled the doctor right then and there, or worse.

But Félix and his family don't seem capable of such anger.

"Sí, me sentí molesto," was his response when I asked him this morning how he felt. "Yes, I was upset."

"Pero la vida aquí en México es muy canija," he muttered after a few seconds, looking at the ground. "But life here in Mexico is a real bitch." 

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