Healthcare as a Community

Sunday afternoon with the kids, quiet until the phone rings. "Doc, my old neighbor can't get out of bed, and he's filthy. What should I do?"

"Hold on there. Can you give me directions?" I usher the kids into the car. Wife is out. I respond to calls 24X7; parenting duty and patient care are dual roles. Kids learn early what life can mean.

We arrive to a scene not unusual in the community. Older farmers hanging on at home, depending on the neighbors to check in on occasion. Or not. Used to the facts of life. Birth. Death. Illness. Joy. And Pain. He was dirty when he went to bed and dirtier now. Conscious. Will he accept the hospital? He nods.

The volunteer ambulance arrives. Hydration and food for a few days. A cleaning. He's better but still old.

Neighbors, house calls, volunteer ambulance, a rural hospital several towns away...The community responds, but at what cost? All are struggling. The network of community kindness, the safety net, is struggling. And today, we have new opportunities for reform: the Recovery Act; the healthcare bill. The first major opportunity in my long career. What will we do with this opportunity?

Thoughts to come...In the Footsteps of Galen.