As Tia Phyllis, herself a nurse, pointed out in the Comments section, the response of the doctor to Fani’s attempt to get more information about the possible change in Gabrielito’s echo was outrageous. With the assumption that the people who are taking their rotations in the charity care level of the medical system are not all bad people, I try to understand how overstressed they must be every day, trying to get through the patient load.
There are two sources of stress, at least. One is the sheer number of patients hoping to be seen. I got a glimpse of that at the hospital where Minga was receiving dialysis — a facility one rung above where Gloria and her family receive care. At the entrance is a large room where maybe 50 people sit on hard plastic chairs waiting to be called for the various clinics. They will have gotten there early in the day, and taken a number. There are no advance appointments; you simply wait. There is no triage based on severity of condition; you simply wait. Not everyone will be seen before the clinics exhaust their numbers of openings for the day. Years ago, when Gloria’s son Luis had on a full leg cast, a piece of metal from one of his club foot surgeries had worked its way through the skin and was rubbing under the cast, causing pain and bleeding. She took him to Panama City, arriving at the clinic at 6am, having left Rio Hato at 4am. They sat there all day, and were not seen. If they had returned the next day, the’d have had no priority, just whatever number they were able to get. I called in favor from a wealthy client I was then working with in Panama City, and got them into a private orthopod. The fact that young Luis was in pain and bleeding meant…. not much until we got him into the private system for that one time.
The other source of stress is the limitations of the system. I asked Gloria what happens if Gabrielito needs expensive medications. She said that if the seguro social has them, he will get the meds for free. If the seguro social doesn’t have them, because they are too costly or rare, the family will have to pay in full or he will go without. Period. Even if he dies as a result. Imagine being the provider who has to look a young mother in the eye and tell her that.
It’s a lot of stress to work with every day. I still think the response to Fani was outrageous, agreeing with Tia Phyllis on that, but I hardly know where to direct my anger.