It was one of those days in the AIDS clinic – when all of society seemed to be trying to tell us that people with AIDS just don’t count for diddly squat when an interesting event happened that helped put things back into perspective for me. Helped me appreciate the essential vitality and resilience of the human spirit. One of life’s little “kicks” in the ass that says to you, “Hey honey, get over it – your shit ain’t all that’s important.”
First, let me do a bit of a commercial, actually a redundant statement of fact – if you are poor in this country and in need of health care services – watch out you’re going to get fucked. If you are old and poor or a person of color and poor or female and poor you’ll probably get fucked twice. Anyway this is a story of a man who is old and has HIV disease and NO INSURANCE -not even medicaid. Poor sucker lived too long and qualified for medicare – i.e. “We really don’t care at all anymore.”
Well the fellow got up the other day and was not at all well. Some serious stuff with his heart. Being wheelchair bound and living alone he appropriately called 911. Living in central Denver this usually buys you a ticket to Denver General Hospital.
It just so happened that Denver General was on medical divert. This can mean several things but you can bet if you are an AIDS patient it means a trip to some other hospital which may not necessarily be a bad thing mind you.
Now, if you were a “trauma victim” – preferably automobile with insurance – the door is always open! But he wasn’t.
So our friend who was old and has a bad heart, no insurance and HIV disease does not get to come directly to Denver General Hospital. He goes elsewhere, spends the morning and then gets sent over to the AIDS clinic at Denver General – what better disposition – and to be fair the acute problem that caused the call to 911 had been addressed in quite a thorough and professional manner at the other hospital.
So he winds up in the AIDS clinic, where I work, to get checked out further – and it all checks out!! Now the real problem occurs – it’s time to go home. Here is a man in a wheelchair who has undergone a busy day of medical intervention to his body and he has NO MONEY. Hmm – who to call? Well, we started by calling a company that has transported this man in the past and after several very personal questions about his ability to pay they do dispatch someone to come and get him.
The first thing the driver asks is “Does he have a medicaid card?” Well, no, because he doesn’t have medicaid! So they say they’ll bill him for this ride.
It was at this moment that the fateful words were uttered that put into motion a significant life-learning lesson for me. He said “I can’t pay you anything for the ride.” Oh my God!! Well this sent the driver right out the door! Now mind you it’s 4:30 PM and I have been doing AIDS clinic since 7:30 AM and I’m in no mood to have this man send away his only ride out of here! I mean I can’t just leave patients in the clinic over night and pickup in the morning where we left off the night before. Although I must admit I thought of putting him on the couch with some food, a urinal and a promise to return in the morning. Several other attempts to get this gentleman returned to his home proved futile, he was in a wheelchair.
You see, he was living pretty independently in his own apartment refusing nursing home and/or hospice care. If he had been in either one and not so fucking independent he would have had a ride home and I wouldn’t have been stuck trying to get him out of my clinic.
Well, by 5:30 PM with absolutely no success in finding a ride it became quite apparent that if the man was to get home I would have to take him. Boy did I become indignant. Hadn’t I done enough already today for the cause? Do I have to take you home too?
At a quarter before six I rolled him downstairs and to my truck with the help of a leading local AIDS doctor/researcher. I loaded the man into my truck – put his wheelchair in the back along with the local AIDS doctor/researcher, who did an admirable job of keeping the wheelchair and himself from flying out the back.
As we slowly drove through rush hour traffic towards the man’s apartment chatting about sites along the way all my anger and sense of being put out began to fade for some reason. He became more relaxed and I did too – as we neared his home. It was a nice building on Capital Hill that may cater exclusively to the elderly – I don’t know. As we rolled up to the main door and he was chattering away about the place, my bullshit about not being able to live on his own began to slowly melt. As we wheeled into the lobby and to the elevator, with his warm greeting of several people on the way, I realized we were heading home. I could literally feel his excitement, relief and happiness through the wheelchair handles!
When we reached his apartment and I opened the door and wheeled him in it really felt like home and he was ecstatically grateful. It was a bit cluttered but it sure was center for him. We wheeled him into his bedroom – he wanted a nap – and helped him into bed. I said – ever the nurse – that he should eat something. He said he had plenty of food but a nap was more important. All I saw were Cheese Bits and Kool-aid. But hey, this is Amerika 1991 -what more can you ask for – we can’t all be eating lobster in Kennebunkport.
It is so important for all our dignitaries to maintain some control in our lives. For those of us struggling with HIV or just struggling our primary goal is survival. We do not have a responsibility to be “good patients” or “good research participants” or “cooperative.” Do be kind though and stay at home as long as its at all possible. Probably nobody cares as much as you do.