Western medicine....We will make you sick (if you want)

Clinical Staffing, July 19, 2010...Kimball walks in late as usual, because she would rather be out running on this beautiful day. Meets Dr. W., psychiatrist from the University of Nevada, Reno. Kimball has the presence of mind to make sure her cell phone is on "silent." I ask Dr. W if it possible to diagnose a child of 12 with schizophrenia. I ask this because of a case I have taken on, mentioned in my last blog, involving a 12 year old girl. Her mother talks about her thusly, "Oh yeah...she's schizophrenic AND bipolar AND ADHD." I suspect Munchausen by Proxy becaus ethe mother has the system wired. The mother has simply given up and I, in my idealism, am certain this misperception of herself can be fixed. The mother needs to be sick, and she needs her daughter to be sick, and so far, psychiatrists from the county have cooperated nicely. This kid has been on Lithium, Depakote, Abilify and Zyprexa interchangeably for several years. She doesn't really know who she is. She's been told who she is, but she really isn't sure. Her definition of herself gels only in a quiet stare into her lap. "I'm crazy." she says, scraping at the blue nail polish on her chewed nails.

"Well...rarely." says Dr. W. "In fact, NAMI is looking for case study subjects right now because childhood schizophrenia is very rare." I am not seeing symptoms of schizophrenia in this child I see on ce a week way out in the desert. Instead, I see a child with a marvelous imagination who is desperate for human contact. She hears voices, but her mother actually hears voices as well. And it's not like the voices are harmful, just dead relatives who want to stay in touch. She tells me that her grandmother appears at her door every now and again just to say hello. I am more curious than alarmed. Her grandmother was a full blooded Cherokee. Lithium and Zyprexa silence the voices. Yay for Western white medicine. Medical community colludes with mother in giving up on herself and her children. Therapist wants to know more about the mother's spirit animals and what the grandmother says when she comes out of the desk at night. Therapist secretly wants to work at strengthening the mother's connection to her ancestry thereby eliminating the need to "be sick." Therapist wants to go to the psychiatrist who prescribes unececessary meds for little girls and smack her face until it's purple.

My son needs a lot of dental work. No dentist in the area will agree to a payment plan. I cannot afford to spend $4,000.00 on dental work and neither can he. At 22 years of age, he does not qualify for state medical benefits, nor could he be on my insurance because he is not in college. And at 22, he makes all of $12.00 per hour, which is barely enough to live on never mind medical expenses. So Transitional Age Youth (TAY) as they are called in psychological research are the most underserved population in this nation. Young men and women from 18-25 are more likely to go untreated for medical, dental and psychological problems than any other sector of the U.S. population. These young people will replace us when we are all dead if they live that long. They may be toothless, diseased and slightly off center, but they will replace us. those who serve the underserved are few and far between, especially in affluent communities like the Lake Tahoe area communities. There is a three month wait list at Placer County Public Health Clinic for those needing dental work. The wait list in Nevada County is about the same. My 67 year-old sister recalled a time when her children were young that she paid her dentist $10.00 per month so her children could receive dental care. She wonders why I can't just set that up now. "Are you for real?" I ask her. I decide to try, so I call 17 dentists in the Tahoe area. Not one is willing to work out a payment plan because they don't have to. Why take the risk when you can have guarantees? Oh I don't know...maybe because it's the humane thing to do.

My dad used to make house calls on snowshoes when I was a kid. I know that getting paid was important to him, but it never seemed to take precedence over caring for the people he would run into at the grocery store. Maybe that's why we never had much money.

My ex-husband, bless his heart, took care of people when they were having hard times. He had his own physical therapy clinic and pretty much did what he wanted. He'd see people who couldn't pay but could get him free basketball tickets or a year's worth of free ice cream for his kids. He sold his clinic to a corporation because he thought it would be easier just to be a PT and not an owner. I was helping him manage and we decided that our PT aides should get paid more because they were so valuable to us. He wanted a dollar more per hour for each and the corporation balked. Since he sold the clinic on an earn-out agreement ($80k over three years if he made EBITDA), he stood to lose a lot. But when the corporation told him he couldn't pay his aides a dollar more per hour, he told the regional director to go fuck himself and walked out. He left $160,000 of potential gain on the principal that people deserve to make enough to live on and the corporate belly should shrink in order to support that.

I loved him for that. There were plenty of things I didn't love, but I really loved him for that. And I loved my dad for that, too. He cared for people first and that is the mark of a healer whose heart is in the right place. I have never forgotten that.