What, exactly, does it mean to be “in critical condition”?
According to the infallible Wikipedia, it’s used to describe patients in whom “[v]ital signs are unstable and not within normal limits. Patient may be unconscious. Indicators are unfavorable.”
This, as well as the alliterative qualities of the phrase, mean it’s as good a term as any to describe the current state of health care in America.
Of course, Wikipedia also notes that the term is “most commonly used by the news media and [is] rarely used by [doctors], who in their daily business prefer to deal with medical problems in greater detail,” – which might explain why it’s also a good a term as any to describe the current state of the health care debate.
Another good word might be “nebulous” – what seems like months into the process, and even after what even critics concede was a rather good effort by the president, we still lack a single definitive bill (not that that’s ever stopped its protesters from claiming it will throw us into poverty, despair, and creeping socialism, or fascism, or something).
Various news sources have made credible attempts at explaining it – Meet the Press gave the debate a full hour – but even these efforts too often seem to get bogged down in a morass of questionable numbers and debatable facts.
That’s why it’s refreshing to see a new television documentary – also called Critical Condition – on PBS’s POV series, which does an unusually good job of humanizing the debate.
Roger Weisberg’s hour-long documentary, which is available free on the Web site for the rest of the month, is unapologetically pro-reform, and at time, due to the tinklingly ominous music and lists of pathos-inducing facts, borders on the cheesy. But for the most part, it’s excellent.
The film follows several uninsured Americans and their families as they struggle through the physical and financial consequences of their illnesses. Their story are clearly carefully handpicked from among the tens of millions of uninsured to avoid the usual right-wing strawmen – all are legal citizens, all hold jobs and many, before their illnesses strike, count themselves as tenuously among the middle class.
Their stories don’t need any of the film-making tricks Weisberg employs to be heartbreaking. They are rich with painful dramatic irony: the Mexican-born man, so proud of his adopted country, who must return south of the border to seek cheaper medical treatment; or the the high-school sweethearts, now grandparents, who lose their golden years to debilitating, preventable illness. In an extra video, a couple watches the American Dream fly by in reverse – small-business owners, they lose their store and home when their insurance refuses to cover their developmentally disabled children. Their children, they worry, will have a worse life than they did.
Perhaps the most startling is the account of Hector, a hard-working warehouse manager who describes himself as the first to arrive at work and the last to leave. When his foot is infected, doctors tell him it can be saved – as long as he stays off of it. But with his remaining sick days ticking down, and afraid to lose his job – and the insurance that goes with it – he opts to have the foot amputated, hoping he can get back to work. Instead, delays in the making of his prosthetic limb means he loses the work anyhow, and the insurance company retroactively declines to pay for the leg. Out of a job and deeply in debt, he is reduced to attempting to fix the leg itself when it breaks, and eventually is forced out of his home.
The series is full of such preventable tragedies and Hobson’s choices: Joe, who has diabetes and liver conditions who can’t afford the medications to control his disease ends up in the emergency room, sicker – two days before his death, he becomes eligible for Medicare. Karen, who is battling Stage 3 cancer, recounts knowing for a long time that something was wrong, but being unable to find a doctor who will see her without insurance. Many seem more stressed by their mounting medical bills than their illnesses.
The videos are often uncomfortably intimate – tracking the patients through the inner workings of their checkbooks as they bargain with collections departments and their bodies as they undergo surgeries. Perhaps most privately, it chronicles the moments when each finally breaks down – Hector admits that for the first time in his life, he’s lost hope, while Karen, bald from chemo, admits that “the stress is getting to her,” before stoically adding that it “could be worse.” We see the moment where Joe, paralyzed from a fall, tells his shell-shocked wife that he’s “finished.”
What makes these stories so gripping, however, is that they are not particularly uncommon - I suspect it’s the rare person who hasn’t known someone touched by illness in a similar fashion, or seen the devastating effects, or the desperation, sickness can bring.
Is it the be-all-and-end-all to the health care debate? Clearly not – it’s designed as advocacy, not policy or objective coverage. But by representing the faces of those actually touched by the overblown rhetoric, it provides a stark contrast to the screaming mobs and scheming politicians.
It’s a reminder of a promise made long ago to Americans, that we are a “city on a hill,” an example for the world; and a refuge for the tired, the poor, and the wretched. If those people are walking, invisible, among us, in the richest nation on earth, then we are failing them.
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