Mind Over Miller: Don't socialize medicine
Our decisions in life are made to a degree by our personal experiences. I want to share some experiences I've had and why I oppose socialized medicine.
1954: I'm a veterinary student in Colorado. The school provides free medical care. I have a torn rotator cuff, misdiagnosed as a bicipital bursitis. The physician tells me he'll inject the bursa with ACTH. I say that I was taught in pharmacology that corticosteroids may be injected intrabursally but that ACTH is administered systemically. He stares at me for a while and says, "No. I always use ACTH in the joint or in the bursa." He then injects me.
1979: I'm in England with my family for a national veterinary congress. My 16-year-old son is uncharacteristically tired and complaining of fatigue. It turned out that it was simply an adolescent growth spurt, but I was concerned. I express my concern to the owner of the bed and breakfast we're staying at. "I worry about things like leukemia. I wish I could get a blood count run on him. We won't be home for another two weeks." The lady says, "You could go to the local hospital and get that, but you're traveling. All lab work goes to Manchester, and it takes four days to get the results back.""No," I explain. "I'm talking about a simple blood test. It's called a CBC, and it can be run in a few minutes. I'm a veterinarian, and we run a CBC while a patient is on the exam table." I'll never forget her answer: "And I'm a registered nurse, and I'm telling you all lab work goes to Manchester and you won't get the results for four days. My mother has leukemia and nearly died because of that delay."
1989: Once again, I'm speaking in England. My wife develops a bilateral photophobia. Fears of glaucoma run through my head. I discuss it with a British colleague, and he suggests I take Debby to the hospital in Harrogate to see an ophthalmologist. We go to the hospital and we're told that first we need to see a general practitioner. So a doctor checks my wife's eyes with a penlight and explains that she'll need to see an ophthalmologist. But the specialists in Harrogate are too busy, so we're sent to Leeds, a long distance away.
The next day, we drive to Leeds. We sit in a crowded waiting room for hours. A sign on the wall says, "Patients who are profane or express rage will be asked to leave." A 6-year-old comatose boy is on a bench near us, waiting the whole time we are there.
We finally see a general practitioner in the emergency room. He arranges for an ophthalmologist to see my wife the next day. So the next day we drive back to Leeds. A nice young resident conducts a thorough exam of Debby's eyes. "I see something that worries me," he says. "I want my superior to see her."
Eventually, a gruff older man comes in. I haven't told anyone that I'm a veterinarian and that I can understand the conversations going on around me. He tells the younger doctor that Debby has a meibomian gland inflammation and recommends one drop of baby shampoo in each eye every six hours. I'm stunned.
The resident explains that the gland in the edge of the eyelid is inflamed and that she should buy baby shampoo and use it as directed. We do so and I treat Debby's eyes. She tells me that she'd rather go blind than go through another treatment.
Back in our hotel, I place a long-distance phone call to my ophthalmologist. Shocked, he says, "When do you get home?" I tell him in two weeks, on Sunday. "Bring her in on Monday morning," he says. "Meanwhile, do you have any ophthalmic ointment?"
"Yes," I say. "I have a veterinary ointment with neomycin, a corticosteroid, and a topical anesthetic in it."
"Great!" he says. "T.I.D!"
Of course, Debby's eyes improved immediately, but I came to a decision:
Here I am in England, one of the most civilized countries in the world. I love British civility, courtesy, efficiency, respect for the law, and impeccable manners. But I pray that America never socializes medical care.
Robert M. Miller, DVM, is an author and a cartoonist, speaker, and Veterinary Medicine Practitioner Advisory Board member from Thousand Oaks, Calif. His thoughts in "Mind Over Miller" are drawn from 32 years as a mixed-animal practitioner. Visit his Web site at http://www.robertmmiller.com/.