Few sounds can cut through the halls of an emergency room and demand attention, but one is always capable of doing it. A scream. Even after working in an Emergency room for 3 years now, there is still something viscerally churning about a scream. When you hear a scream coming from down the hall, your chest tightens and your mind races. A scream will send a cold shudder down your back. People scream for all kinds of reasons in the emergency room. Some patients scream out of confusion; not knowing where they are or how they got to this strange sterile setting. Others scream in anger; the stress of their situation coming to a boiling rage. But not her. She screamed in pain.
The woman, who appeared roughly in her fifties, was brought by stretcher through the big sliding glass doors of our entrance by two EMTs; just as many others are. But this woman was in pain. Writhing pain. A sickening to see kind of pain. When she made it through the doors, she let out a yell that silenced the rest of the emergency room and made heads spin. The two unconcerned EMTs slowly wheeled her towards her room. The charge nurse caught up with them and asked the women about her pain. In the emergency room, we assess what a patient’s pain level is by asking them “On a scale of 1 to 10, 1 being not that bad and 10 being the worst pain you have ever experienced, how bad is your pain?” It is rare for someone to be a true ten. A ten is fist-clenching, skin shearing agony. But she was at a 10.
When she arrived at her room, in my wing of the ER, her two sons followed closely behind her. They were both quite young, seemingly, only a bit older than I was. They were visibly shaken up walking through the halls. Seeing a loved one in such a state is quite unsettling, and it was apparent that they had never seen their mother like this before. I followed them into their room to introduce myself as their technician and to set the woman up on a heart rate monitor and blood pressure cuff. As I wrapped the cuff around her vibrating arm, I could see that she was sweating heavily. The type of sweat that pours off patients who are in dire pain. I looked at the women’s face. Her eyebrows furled deeply and tightly. She winced with any slight movement.
Suddenly, the curtains slid open and in came the doctor. The doctor entered the room, made a brief introduction, and quickly proceeded with his examination. As the doctor examined her abdomen, the woman clenched her stomach and clutched the rails with an iron grip. The veins in her hands popped and the muscles in her wrists strained to keep her grasp. A long examination was not needed before it was clear to the doctor that the woman was going to need a CT scan to examine her abdomen more closely. When the doctor relayed this information to the patient, this woman did something I had never seen before. She refused the CT scan. Confused, the doctor questioned why she didn’t want to have one done? I have seen people refuse CT scans for a multitude of reasons. Claustrophobia. Thinking it’s unnecessary. Not liking the doctor. But not this woman. She clamped down on her already squinting eyes, trying to hold back the tears as best as she could, but her grasp on them was faltering. Still clenching her stomach, doubled over in pain, she said something I’ll never forget. “I can’t have a CT scan. I can’t afford it”.
A 2019 study, published in the American Journal of Public Health, found that roughly 60% of people filing for bankruptcy in the United States agree that medical bills were a factor in their decision. (Himmelstein et al. 432) More and more Americans are feeling the hardship of exorbitant medical costs in our country; yet, little is being done to help solve the issue. Why hasn’t the United States switched to some sort of single-payer healthcare system like many other countries around the world? People cite many reasons why the United States shouldn’t switch to a single-payer healthcare system; most of these reasons pertaining to economics. However, while this issue hides under the guise of economics, a simpler question is at its heart. The question arises from a simple philosophical argument, “Is healthcare a basic human right?”.
After the woman hollowly informed the doctor that she couldn’t pay for her test, a brief quietness took over the room. As healthcare workers, we are used to helping our patients with a myriad of issues, but this, we couldn’t help. It was a strange feeling. There was nothing that I could do. As her technician, there was no amount of personal attention I could give her that could help her financially. This was out of my realm. The weight of what I was witnessing started to hit me. We often hear of the issues people face affording medical treatment, but here it was, right in front of me. An uneasy sadness took over me after that; one that stuck with me for a long time after she left our emergency room.
After the brief silence, the doctor attempted to persuade the woman due to the severity of the situation and how helpful a CT scan would be. But the woman held strong. She refused. I looked at her sons. The look in their eyes is one that is hard to forget. Their eyes were soaked with defeat; they too couldn’t help their mother as she cried in pain. Defeat in knowing all of the love in the world wouldn’t help her right now. They looked straight at her. They had shame in their eyes. Shame from thinking there is something they could’ve done to prevent this. Their eyes told me that all they wanted to was see their mom get better. Behind the defeat and shame, was fear. Fear for what would happen to her. Fear for their family. Fear for their future.
Lack of access to healthcare can be viewed as a form of oppression to lower-income individuals who often cannot afford extensive medical treatment. In this case, the oppressors are those with access to healthcare via their job, family, or personal means who oppose others being given access to healthcare. They believe that others should have to do as they did to “earn” their right to healthcare and that health is not an inalienable right. In his book, Pedagogy of the Oppressed, Paulo Freire explores the interactions between oppressor and oppressed. Freire views oppression as a sort of “dehumanization”; and that is exactly what has been done by our current healthcare system (Freire 44). Our system dehumanizes those without steady work or who can afford their own insurance; our current system allows this group to slowly die instead of helping them. Our current system sees those without health insurance as “less” and allows them to deteriorate. While our government does provide programs such as Medicare and Medicaid to assist these people, the issue is that no one should have to be given a handout and “helped”; we should all start on the same playing field to begin with. This could be accomplished by The United States Switching to a single-payer healthcare system. Freire discusses this idea of the oppression that lies in false charity, he states that “True generosity consists precisely in fighting to destroy the causes which nourish false charity. False charity constrains the fearful and subdued, the “rejects of life” to extend their trembling hands. True generosity lies in striving so that these hands — whether of individuals or entire peoples — need be extended less and less in supplication, so that more and more they become human hands which work and, working, transform the world.” (Freire 45) The oppressed shouldn’t be grateful that the government is giving them aid to receive treatment. Only when everyone is allowed to be on the same playing field that the oppressed will be able to fight their oppression.
Before laws can be enacted, people helped, or minds changed, as a country, we have to change our views on what it means to be allowed to be healthy. This story isn’t an argument about government handouts, the virtues of hard work, or the importance of preparation. This story is a call to attention; a story reminding everyone that not everyone in this country is allowed to be healthy. For millions of Americans, healthcare isn’t a right, but instead, a choice, one between health and financial security. It is by making Americans make this choice, health or security, that forces some Americans to be barred from a healthy life. Our current system holds that healthcare isn’t a right, but I would wager those who claim it is not have not seen the defeated look in a son’s eyes while his mother writhes in pain. Eyes that call out for help, that know isn’t coming. Eyes that would’ve broken every rule of economics to help his mother. I want a critic too look into eyes like those, and tell me healthcare isn’t a right. Until our entire system is restructured, and the dehumanization of our current system is stopped, those eyes will never rest.
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Works Cited
Freire, Paulo. Pedagogy of the Oppressed. The Continuum International Publishing Group, 2000, Academia, http://www.academia.edu/5349251/PEDAGOGY_OF_THE_OPPRESSED_30TH_ANNIVERSARY_EDITION_PAULO_FREIRE?auto=download.
Himmelstein, David U., et al. “Medical Bankruptcy: Still Common Despite the Affordable Care Act.” American Journal of Public Health, vol. 109, no. 3, Mar. 2019, pp. 431–433. EBSCOhost, doi:10.2105/AJPH.2018.304901.
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