Nobody, including the patient, was entirely sure when the last time was that she had been able to walk unassisted. Was it when she hit the 350 pound mark? Probably not after she reached 400. Now that she was just below the 500 mark, she knew and we knew, that it was no longer possible.
She came into the hospital with a list of medications that was 12 pages long. Much of the list was tranquilizers, anti-depressants and pain medications. The size of the dosages was enormous. But then dosages are often calculated on body weight. She was also on four different types of anti-diabetes meds — three of them various forms of insulin.
It took 4 staff members to move her from the gurney to the bed. After a few attempts, it became clear that starting a peripheral IV on her would be impossible. No needle was long enough to penetrate the fat and reach the vein below. A PICC line (longer catheter placeed in a deeper vein) insertion, done by an interventional radiologist was scheduled.
The attending doctor ordered an 1800 calorie diabetic diet. The patient ate it all and then ate another meal brought in to her by a “friend.” After all, there was always more insulin to “cover” the blood sugar elevation that would result, wasn’t there?
The doctor did deny her request for a Foley catheter, though. He felt that the small movement from the bed to the picnic-bench sized commode we placed in the room (since the toilet ten feet from the bed was too far to walk) would be about the only exercise she would get, and she badly needed it.
The pain in her knees, hips and shoulders? Well, getting rid of the weight would have relieved a great deal of that. But instead she said: “Can’t you just give me enough pain meds so that I don’t feel it any more?”
About now, dear reader, you’re probably saying: “My, my, aren’t you the judgmental little witch!” And I answer: “I’m not a witch. I’m not any of the things you’ve heard. Because she is us.”
My patient is a human being with intrinsic value. And she is America — or at least a segment of America — at the moment.
She says: “Please — don’t ask me how I got this way. Please, don’t tell me I’m going to have to do anything hard to fix things. You don’t expect me to be patient for the years it will take to get back on track, do you? Surely there’s some brilliant person out there who will — any minute now — invent a pill that will fix all this.”
In the mean time — someone else has to do the heavy lifting. Someone else has to plan, to think ahead, to try to ward off the consequences of years of bad management.
The problem is, there are getting to be fewer and fewer of those “someone elses.” People who step in and rescue when things go haywire. People like Barack Obama.
And there are getting to be more and more “you-do-it” people…who think that paying taxes is for suckers, and siphoning money from the pockets of the working class into those of the idle rich is what capitalism is all about.
A nation can only support so many 500 pound Wall Street boys, Fox News commentators and Rush Limbaugh fans. People who want the goodies without the price tag attached. Beyond a certain point, when these guys push the call button — there won’t be anyone left to answer.