Great physicians and nurses, skilled, caring and unparalleled in their training, intervened in my life and probably saved it. I was lucky but other Americans are not. It is time to speak again and stand again for the ideal that in the richest nation ever on this planet, it is wrong for 41 million Americans, most of them in working families, to worry at night and wake up in the morning without the basic protection of health insurance.
It's not easy to diagnose because depending where the endometrial deposits are, the symptoms can be quite different. It's an unrecognized problem among teenage girls, and it's something that every young woman who has painful menstruation should be aware of ... it's a condition that is curable if it's caught early. If not, if it's allowed to run on, it can cause infertility, and it can really mess up your life.[Author Hilary Mantel on being asked about being a writer with endometriosis, Nov 2012 NPR interview]
If there is one thing I'd learned about hospitals, it's that they aren't interested in healing you. They are interested in stabilizing you, and then everyone is supposed to move on. They go to stabilize some more people, and you go off to do whatever you do. Healing, if it happens at all, is done on your own, long after the hospital has submitted your final insurance paperwork.
Poor health was not just the result of random acts, bad luck, bad behavior or unfortunate genetics. Deliberate public policy decision about housing, education, parks and streets were the key drivers of racial differences in mortality. Crime kept people off the streets and limited their ability to exercise. The lack of grocery stores limited dietary choices. The lack of primary care doctors and specialists in these communities made chronic disease care more difficult. The degradation and loss of hospital services in these communities affected hospital-based outcomes. The chronic underfunding of critical health services at Cook County Hospital and other safety-net providers contributed to these poor outcomes as well. The deleterious impact of social structures such as urban poverty and racism on health has been called 'structural violence.
What sticks with me now is that this man said he needed to get to a hospital. He probably needed to reach his destination more than anyone else on the bus, yet he lacked the capacity to ride without getting kicked off. Maybe he reached the hospital eventually, and maybe he was connected with social workers and housing specialists who will help him transform his life. But I fear he got on another bus, and another bus after that, without going anywhere at all.