As I write this evening, I am keenly aware of the seven legislative days Alabama has left in our regular session. So much is left to decide, especially about the budget. I hope you are also alert and continuing to make contact with our state senators, representatives and Governor. It puts me in mind of watching a storm front approach and expecting a tornado watch—we hope it will dissipate into nothing much, leaving no paths of hurt and hardship across our beautiful state. What will it be? Seven days of creation—creation of new revenue and hope for our future? Or seven days of destruction?
Searching for inspiration, I’ve started to read “The Impossible Will Take A Little While: a Citizen’s Guide to Hope in a Time of Fear” by Paul Loeb. The title comes from a lyric in a Billie Holiday song. I’m only at the beginning—I usually plow through a book in no time flat, but I plan to draw this one out. In the opening, the author recounts how a group of women at a peace gathering in the rain were disappointed at the small turnout, only to learn later that Dr. Benjamin Spock had seen them and was inspired by their determination, their standing in the rain, to speak out himself against the Vietnam War.
Are you a bit weary of fighting or verging on despair at what’s happening in Montgomery? If so, maybe we can take a moment to encourage each other, at the verge of this somewhat Biblical-feeling seven days. If you have a small and hopeful story to share, please add it to the comments for this post.
Here’s mine. Two days ago, my last patient of the afternoon had an eye injury. It’s the Murphy’s Law of Friday in pediatrics—the child who needs the most urgent evaluation requiring more than just a history and physical always comes last, and we go into mad scramble mode trying to line things up. I hate to send kids to the ER just because it’s Friday afternoon.
I examined the child and found a significant looking injury to the central cornea—because of the mechanism, I was really concerned that eye drops and reassurance might not be enough. I crossed my fingers and phoned the ophthalmologist on call. Her nurse relayed Q &A back and forth between us—she wanted to know the age of the child, whether he could cooperate with an exam and whether he had any other injuries besides the eye. Then the nurse said those blessed words every pediatrician longs for—“send him straight over to the office and we’ll take care of it.” I told the nurse to please give her boss a big hug from me and tell her we were grateful for her kindness.
It was only after I had given the mom instructions on how to get to the office and she had left that I realized there was one question the ophthalmologist hadn’t asked. Do you know? Try to think before you go down a paragraph, and don’t cheat.
The question she did not ask me was the question consultants ALWAYS ask me, occasionally even before deciding when/ where to see a patient: “What insurance does he have?”
I asked our staff to fax the insurance referral so the consultant could get paid, and then I sat and smiled for a few minutes before typing his chart note. She didn’t ask! At that moment, late on a Friday afternoon when she probably was hoping to go home for dinner with her family, all she wanted to know was whether he could be still for an exam without ER sedation.
And that is how it should be, isn’t it? No wallet or insurance card biopsy needed. Just children, parents, and doctors, figuring out how to do the right thing.