Friday, September 26, 2008

a day late and. . .

Yesterday was day two of the Medical Grand Rounds for Clergy program at the VA Hospital. We've been taking in a lot of information--the first day, last Thursday, contained introductions from geriatrics, pediatrics and ICU. Yesterday we got tours of a rehab unit, the prosthetics lab (I couldn't help but think of The Fugitive), and the surgery suites.

To go into surgery we had to put on paper "bunny suits" and put on head and shoe coverings. One of the funniest moments of the day was all 16 of us standing in the hallway, putting on our new outfits, when the hospital staff wheeled a man by in a gurney, taking him to one of the operating rooms. The look on his face as he checked us all out was priceless. Something like a cross between "are those medical students?" and "I'm in so much trouble." Then we were escorted through the surgical area and allowed to peek into the active operating rooms. It was wild to see stuff for real--to be just the other side of the glass from heads bent over draped bodies, operating room lights on in dark rooms.

A theme that continued to come up over and over again yesterday was money. We had a presentation from a surgeon about the changes in his field over the last one hundred years. He spoke about how medicine in the US had advanced the way it had because medicine had basically been given a blank check. And so there are huge machines (one anesthesia machine in the OR cost $350,000--of course that machine keeps people alive at an incredible rate.) and new drugs--but the costs of health care in our country are spiralling out of control.

In contrast, he spoke about being on a medical mission trip to Bolivia, and performing a cervical cancer surgery on a patient in a bare bones hospital, where cauterization was done with a Sears Craftsman soldering iron (or, rather, he decided not to use it) and suction was powered by some giant machine outside the window. The nuns who ran the hospital toted up some costs and decided to charge $300 for the surgery, which the mission team all chipped in to pay.

Thinking about the costs of it all on a day when my prayer focus was on the success of the Millenium Development Goals made my head spin. What's the answer? What price is health? Is life? A prosthesis made for a below the knee amputation down in the lab (carbon-fiber) was about $8000. What price the ability to walk again for a veteran?

I didn't write this to have an answer, but spending the day looking at hugely expensive machines to keep us alive (and who doesn't want them) while thinking about those who have no medical care, no prenatal care, no clean water--it was something that made my head spin.

I pray that we may have grace to realize our privilege and sort out our economic issues while not forgetting those billions around the world who have nothing.