Pneumonia

The Affordable Health Care for America Act won’t kill the elderly, as some allege, but misrepresentations about the law and medicine in general absolutely do kill.

Recently a friend of my boss died from pneumonia. He was an uninsured alcoholic who had been sober for 15 years, ate well and spent time in the gym. He delayed going to his doctor until his temperature was rising quickly, then refused to go to the hospital. He apparently believed the antibiotics and his strong body were enough.

In the night his fever increased. His landlady saw him out in the snow, she thinks, trying to bring down his body temperature. She found him dead the following morning. As near as anyone knows, when he lay down he fell asleep and his lungs continued to fill until he couldn’t breathe.

The week before, the mother of a friend died from pneumonia in a nursing home after her father had refused treatment for her. It was bacterial in origin, possibly caused by a piece of food that had become stuck. The woman suffered from dementia and either didn’t notice the irritation or couldn’t explain it. She died less than a day after my friend heard she was sick.

Bacterial pneumonia is treatable with antibiotics. Patients with the viral form usually survive when they’re given intravenous fluids and monitored during the crisis.

As near as the daughter and my boss know, both people weren’t treated because men believed they couldn’t afford the treatment. The eighty-five-year-old woman was covered by Medicare. An emergency room would have had to treat the fifty-something man, regardless of his income or insurance status.

I don’t know if the man was uninsured because, as my boss believes, he was one of the many who have the money, but believe they’re too healthy to need insurance, or if he’d tried in the past and been refused. Perhaps being a recovering alcoholic, for Alcoholics Anonymous says you are never an ex-drinker, is itself a disqualifying pre-existing condition. The new law, with its demand for universal coverage, phases out such hurdles to medical treatment, though it can do nothing about the bitterness created by rejection.

False perceptions arise from the health care debate that emphasizes the high cost of treatment and the plight of the uninsured. We’re constantly told emergency rooms are overwhelmed as a result. The subtexts are that treatment might have become substandard and that people who use them are parasites. We certainly are told the costs are greater.

What people don’t hear is that there are new alternatives to emergency rooms, the urgent care centers. If the man had gone to one, instead of waiting to see his doctor, he would have been diagnosed faster and they probably would have begun treating him immediately because they had the necessary resources on site.

When people hear about the cost of treating the elderly who will never recover all their capacities, they don’t hear there’s a difference between treating a disease like cancer, which may kill anyway, and treating a temporary infection.

The ignorance about the dangers of out of control infections also comes from the same media sources, the ones who deny climate change and evolution. In making their arguments, they treat scientists and science with contempt. That attitude, in turn, reinforces people’s natural fear of disease and distrust of doctors who can’t treat the common cold. It makes some people less likely to listen to the medical programs that do appear on television that try to educate about diseases like pneumonia.

The media would deny its responsibility, in the same way it denied there was any relationship between its words and the actions of Jared Loughner who shot Gabrielle Gifford in Tucson on July 8. They would say they are not responsible for the individual actions of a one-time drunk or a man tired of a marriage. They would say individual actions are just that, individual, and not part of a social pattern.

They might also suggest the solution was eliminating malpractice laws. Regulations and contracts may have dictated what an institution or physician could have done in these situations.
However, I do wonder what ethics can condone a nursing home that doesn’t begin treating a treatable infection immediately or a doctor who doesn’t call the ambulance or send a nurse with a man obviously in need of treatment. I wonder what is their moral obligation to seriously inform people of their choices when they can see the people there are talking to are laboring under serious misunderstandings of medical situations.

Ideas, diffused through an atmosphere of misrepresentations and paranoia that feeds of people’s instinctive fears of the unknown or uncontrollable, indeed can kill as swiftly as the infections they abet.