Wednesday, September 25, 2013

A Phone Call from the President

I was sitting at my desk at work just going through some paperwork when my boss came up to me and said, "hey, we have a conference call with the president to just motivate everybody right before October 1." In my head I: "well, this will be pretty straightforward with Trinity's president."

In college, one of the more interesting discussions was the inherent inequality of the healthcare system. It was an exercise in compassion and moral discussion. But, all the talk was words in vacuum without action. Yes, something can be said about intellectual growth and paradigm shifts, but in the case of actual work, I can't say that I was involved in anything. I tried to understand the work to change thoughts on healthcare as a product to a right. The best I could do was to learn and better equip myself with the right motivations and emotions for such work.

We settle in her office. I reflect on the past few days for a bit. I remember the conference at Lansing. What I've learned about the people who changed careers to become patient advocates: the PhD that left the research world to be a community organizer, the single mother that at age 40 decided to become a JD that advocates for patients, and the RN that faced forced retirement only to start an organization to serve her patients. Where do I fit in?

My work as an Enrollment Coordinator has been focused on learning more about the Affordable Care Act (through classes, conferences, and seminars), help patients apply for insurance, and foster partnerships will local organizations to better serve the communities' healthcare needs. It's been a lot of phone calls and sitting at talks. Sometimes I wonder if my work makes a difference. I feel like I'm just, although out of college, learning and figuring out what are the right tools for me to use. It's the same as the past four years.

The conference call starts. I didn't hear the first speaker's introduction. I think she mentioned something about being a secretary. She begins to talk about the ACA and the battles it had to go through before and after it became a law. So in my mind, I thought she was simply the secretary of Trinity's president.

The only change in my function is the fact that I get to work one-on-one with my patients. Easily, the most gratifying and energizing part of my days is just interviewing people to figure out their needs. In reality, medical care is only one part of a person's health. Hearing my patients talk about the compassion of the people they meet here at Mercy Primary Care Center and how it has been a blessing for them reminds me of what real healthcare is meant to be.

The next speaker is Kathleen Sebelius, the United States Secretary of Health and Human Services. Again, she expresses her excitement over October 1: the Marketplace opening. She talks about the excitement of seeing millions of uninsured Americans finally be eligible or have access to affordable health insurance. I wonder why the Secretary of HHS would be introducing Trinity's president. Then, to my surprise, she introduced President Barack Obama.

The main problem in healthcare is the fact that it is generally paternal and monolithic in nature. It focuses on the proper medical treatment for the proper disease. Patients become numbers. Communication breaks down. Tests are done for the sake of tests being done. Costs skyrocket while patients stagnate. We pathologize health to the point of morphing healthcare into diseasecare. We look for the next sickness. But, the system of a medical home looks at a patient holistically and treats them with dignity. They are not my patients. We are their partners in their health. It is an intimate human endeavor that requires advocacy and compassion and that is what I've learned as I talk to them day-in and day-out.

Suffice it to say, I was shocked to actually hear the president address a nationwide audience of health systems. I was able to listen to his passion for healthcare equity. He spoke of a multi-level effort from the administration to large health systems to health centers to free clinics to reach out to America to teach them about the reform. I realized I was part of a greater system of care: a face to the system. President Obama's passion and gratitude reminded me of this reality.

The biggest part of this experience is learning how to care, how to smile, how to laugh, and how to listen. My role, I've come to conclude, is not just to help patients get the insurance that will help them get care but to remind them, that within the large system at work, there are people that care for them and will advocate for them. The reality is that not all diseases will have a cure. Therefore, our mission should be to care when we can no longer cure. In the end, simply caring is a form of healthcare and that is where I fit in.

Thursday, September 5, 2013

A People and Their City

My first few weeks in Detroit have been quite eye-opening. Prior to orientation, Detroit was in the news due to filing for bankruptcy and the reality of having an Emergency Manager in Kevyn Orr. I have read so much about the decline of Detroit stemming from the inability of local automobile manufacturers to deal with a greater global market beginning after World War II. Most people also mentioned the high crime rates in the city. Suffice it to say, Detroit was as bleak a city as there is in the United States. But, what I've come to realize is that this caricature of Detroit, although having some truth, is ultimately misleading, uninformative, and self-defeating.

All that people hear about is the ugliness of Detroit. This is naturally easy because of our proclivity towards negativity. We, as media consumers, are fascinated by tragedy and failure and dysfunction. This fascination blinds us to the complexity of human experiences. Detroit is filled with broken systems and structural violence, but it is also filled with proud people and vibrant communities.

The first week in Detroit, our community was lucky enough to be welcomed by former JVs, local support staff, and Detroit natives. People are excited for and to serve Detroit. People recounted stories of coming to Detroit for their partner or as JVs and simply falling in love with the city. Their pride is unmistakable and distinct. They stay, not because of economic inability, but because they see the potential and the people of Detroit. They do not shy away from work, but welcome the chance to work for a greater good. But, the city itself is quite amazing.

During our first weekend, I was amazed by Detroit. The Eastern Market shows a local pride for Michigan and Detroit grown produce. Locals see themselves as providers for a healthier Detroit. The Fisher and the Guardian Buildings attest to the potential that Detroit represented in the early 20th century. Buildings of magnitude reflect the power that once resided in the city. The abandoned buildings littering the city are in stark contrast to the mansions in Palmer Woods and Grosse Pointe. Gross inequality reflects the reality that the entire nation continues to struggle with. The Heidelberg Project reflects a broiling dissatisfaction with urban decay that is channeled into unbound creativity. Refuse is used to produce beauty in what many believe to be an ugly city.

In the end, Detroit is like any other city. Chicago, my adoptive city, struggles with growing murder rates, rampant gang violence, school closings, and food deserts. But, it does not dull my love for its people or its communities. Urban centers will always have their problems. All I'm saying is to never judge them simply based on their faults or what we see in popular media. A city is not defined by its politics or its economy or its failures. It is defined by the people that love it dearly with a vibrancy and a passion that allows them to carry on.