- NEWSDAY.CO.TT - A la Une - 10/Jul 07:12

Your money or your health

WAYNE KUBLALSINGH DR JOYCE Lodenquai has died. She died at her home in Lopinot on June 29. She was the physician of both my family and the broader Arima family. From her humble office at the corner of Sorzano and Woodford Streets in Arima, people thronged into her office, mostly citizens of limited means. She always spent a long time with each patient. Making detailed notes, studies, diagnoses. She was thoroughness itself. And she charged very little; she was a physician for the poor. In his book, The Health Gap (2015), Dr Michael Marmot, president of the World Medical Association, states: “Disempowerment, material, psychosocial and political, damages health and creates health iniquities.” To translate, low social status equals low access to proper healthcare. Little or no money means little or no effective healthcare. It means limited opportunities for relieving your suffering or saving your life. Our health system, like most globally, is segregated along money lines. Growing up in a low-income family, eight children, our first port of call, for scorpion sting, accidentally drinking pitchoil, nail jook, mumps, rheumatism, falling from the porch and cracking your skull, was the San Fernando General Hospital. My parents had to battle for our health. My mother’s approach was patience, monumental patience. Not my father. What was his answer to long waiting lines in emergency? To hoggish nurses? To any slight, or imagined slight, towards his pickneys? Cuss. Loud and repentant cussing. Though most doctors were kind, correct, attentive, there were ills in the system. This was the status of free public healthcare. Cuss to get better care, cuss as a substitute for money. I have had the unfortunate fortune to personally experience all our healthcare sectors. My childhood bout of rheumatism only seriously re-emerged in 2012, when the police and soldiers tussled me about in an advocacy camp in Debe. After this my wrists, then my knees and legs froze. A chronic inflammatory flare-up. Since 2012, my health has spiralled into a vortex of complex afflictions. Many private physicians have kindly granted me low-cost, discounted, support. But my experiences at Mount Hope and two private hospitals have been mixed. At Mount Hope I joined the Rheumatology Clinic. Despite the best efforts of doctors, nurses, interns and administrative staff, the system is woefully overburdened. This system is mostly used by dependants or low and middle-income families. And you have to wait. The clinics, emergency facility and lobbies are always almost filled with waiters, mostly children and the elderly. Waiting on appointments, on surgeries, on special procedures or general care. In 1973, at 16, my first letter to the editor was published. It was headlined "Pain on the Faces of Patients Waiting." After 50 years, this pain of waiting still bedevils our citizens at public hospitals. After my double-knee surgery in December 2023, I, as they say, "took in." I was taken to a private hospital. I was told that my blood count was low, eight. The emergency department’s lead doctor told me I needed to get two pints of blood, to be sourced by myself, and that I would have to spend at least one night at the facility. The cost? $12,000, plus medicines, etc. But where I getting this money? From my supportive brothers and sisters again? Nahee. The female manager with the clipboard and foolscap forms had already come asking for my financial details. An elderly woman on a bed behind the curtains was directing hospital staff to her home, this corner and that drawer, to find her money. To pay, to do some procedure. I called my knee surgeon. He told me to go home, begin a course of iron supplements. But, to escape, I had to be firm, vocally, almost like my father. To the chagrin of staff, I signed a waiver discharge form and left. My blood count rose to normal levels again, with supplements, in a couple of weeks. At another private hospital I was told, sympathetically, by the professor doctor, that I was ill because my cortisol levels were low. To test my cortisol levels, I needed to do a procedure, take an injection; whereupon, if low, I would see my cortisol levels shoot up. The procedure would cost $3,500, in addition to an $800 consultation fee. I had to do a before-and-after blood test at the hospital lab. More money. “But doctor, why not await the result of my cortisol levels from my blood test next week?” I asked. This logic did not get very far: “I could see that I going to have trouble with you! I am the expert, not you!” An intern was sent with the kit, needles etc, to perform the procedure. Irrelevantly, she drew me diagrams of the adrenaline glands. Once more, I argued to save myself, got a full refund and escaped. I visited a private lab, did a cortisol test, and my levels were normal. Thankfully, the private hospital protects the well-off from the state’s healthcare shortcomings. However, such customers of good means and income pay through their noses. Pay or perish. Dr Joyce gave exacting and diligent healthcare at little or no cost. To thousands of citizens. With good cheer and a twinkle in her eye. A petite woman, she seems to me larger than a hospital. She was a gravitational force against inflated and arbitrary medical costs. The post Your money or your health appeared first on Trinidad and Tobago Newsday.