Thursday, May 18, 2006

The Eye of the Tiger!

You know, invariably this blog lends a voice to that which is wrong with this world. Today I would like to focus on what is right. I spent last weekend in Los Angeles visiting a friend who is recovering from a very serious motorcycle accident. It is the aftermath of accident that proves the strength and resilience of human beings as well as humanitarian arm of our public health establishment. This story isn’t perfect good news. Perfect good news is a myth. It is our ability to see the silver lining that assures our happiness. This story isn’t a harrowing tale of overcoming all odds to win the big one. This story is about the ability of humans to cope and cope well.

My friend’s name is Carl. Carl is best described as “perfectly non-traditional.” He has lived his life following his own compass. By and large, in this writer’s opinion, that compass has served him very well. Carl took what Robert Frost called “The Road Less Traveled.” For most people, the purpose of life is to get from point A (birth) to point B (death) by going in as straight a line as possible. We are all guilty of this, to a certain extent. Carl has deviated from the path more then anyone else I know. It is what I truly admire about him. Deviation from the set path is not easy. We are dissuaded from doing it by our society of “conspicuous consumption.” Their sales motto is: “don’t BE alternative, BUY alternative.” That way they can still control us. It is bullshit, and Carl taught me that!

Last fall while riding his motorcycle through the streets of Los Angeles (a chore which even drivers of automobiles will tell you is a pretty harrowing experience) Carl was involved in an accident whereby a car jammed on its brakes and he crashed into it from behind. It was this weekend, for the first time since the accident that Carl shared with me those first few moments following the accident. Laying on the cement doing an inventory of his body: neck, arms, legs. It was at this point that he realized that his right leg was severely injured.

At this point I should mention that one of the less positive bi-products of living an untraditional life in the United States is that often one lacks health insurance coverage. Such is the case with my friend Carl. He worked a job that did not provide him with benefits. He did not work full time and enjoyed the flexibility of his job, but was forced to sacrifice health care coverage to achieve the flexibility that he desired. According to the Kaiser Family Foundation, in 2004 there were 45 million Americans under the age of 65 that faced the challenges and hazards of everyday life without even basic health insurance. This figure doesn’t even include the many, many millions of Americans that have insufficient health insurance coverage that would not financially protect them in the case of catastrophic injury or illness.

Other key facts:
1. Eight out of ten uninsured Americans comes from a working families.
2. 59% of the uninsured have gone without coverage for over two years.
3. 30% of the uninsured are children

This piece is not meant to be a rant on our health care system. It is broke. There is no need to debate that fact. No reasonable or rational argument can be made to defend the status quo and no one does. Let me tell you about how social services (welfare, as it used to be called by Republicans) have helped my friend Carl.

Carl was very fortunate to have been taken to the Emergency Room at UCLA Medical Center, one of the finest hospitals in the western United States. It was in this ER, in the early moments after the accident that doctors saved his leg. Carl was subsequently transferred to Harbor UCLA in Carson, California to receive his care, also a very good hospital. In the early days after the accident it wasn’t quite clear whether he would be covered by the state MediCal system or the County of Los Angeles public health social services. It turns out that my friend Carl was eligible for both and the process of putting Carl back together again began.

Federal law mandates that enrollment in Medicaid funded services (of which MediCal is one) may take no more than 90 days. Shortly after completing his paperwork Carl received a letter from Governor Gröppenfuhrer informing him that it would take upwards of 10 months to process his paperwork and get him covered. This is, of course, the loophole in the Medicaid law. A letter from a state governor explaining the delay is all that is required. But let’s put aside the bureaucratic BS. Eventually the bills will be paid. That is the miracle! Of course, Carl will have to go back and repair his ravaged credit rating after the delays in paying his bills, but that is doable if one has the patience and legal support.

I won’t get into the many operations or the clinical aspects of this recovery. Suffice it to say that Carl went under the knife more times in a six month period then most people do in their entire lives. He is past all that now. Carl is at the point where he is re-growing leg bone with a gnarly looking contraption attached to his leg. To watch him, it amazes that he can move around as ably as he does. He has also begun physical therapy to regain flexibility and strength in his leg. He says that this is an exhausting process; just to have it explained leaves one panting for breath.

Carl has always been a utilitarian wunderkind, but the set up of his bedroom would impress even MacGyver! From his bed hoisted on cinderblocks, to his bed side computer table, to the fact that everything that he needs on a daily basis: medical supplies, books, his computer. Everything is within arms reach. He may as well be in the cockpit of an F-14 tomcat with all his implements of destruction at his near command.

The doctor says that the prognosis for Carl’s leg is still to be determined. At this point it seems promising that he will walk again with only a modest limp. I told Carl that he would make quite dapper gentleman dressed in a seersucker suit with a cane.

In our talks this weekend Carl talked about wishing that they had taken his leg. His word were: “you can climb Mount Everest with a prosthetic leg.” That may be the case, but if anyone could overcome this and climb Mount Everest it’d be Carl! In all likelihood Carl will never run the Boston Marathon, it is probably safe to say that he won’t climb K2 but I wouldn’t put money on it, if I were you. Carl is a pretty ornery guy sometimes and lives for proving you wrong! To my mind it is always better to have your own flesh and blood then have a piece of plastic and metal. Plus, Carl, save the prosthetics for the bullet sponges (as you call them) coming home from our foolish war.

So, that is the medical re-birth of my friend Carl, but to tell just that portion of the story is to ignore that which is most compelling. I have always known him to be a man of great personal strength and mental fortitude, but to see his confidence in the face of such challenges should leave even his oldest friends awed. As one of them I can say: it does!

Most people would be ready to quit. Depression is not uncommon when dealing with major health issues. Certainly, Carl isn’t happy about what has happened, but he has not allowed it to ruin his life. In talking with him, it is clear that Carl has plans, things that he wants to accomplish. The better of half of his life obviously lies ahead of him. The part where he takes his many obvious gifts and talents and focuses them onto that which is his natural calling and leaves the world stunned.

Perhaps the biggest problem with the old Carl was his clear belief that he was invincible. We all have that to a certain extent, but few people are as alive as Carl and thus few people were as invincible as he was. The illusion of invincibility is gone now. What is left is the clear understanding that everyday is a gift and the next one isn’t assured. We must make the most of each day. I think there are few people in the world that better understand that now then my friend Carl.

I look forward to watching Carl move through his life. The first 30 years seemed to have entertained everyone that knows Carl. I am sure that the many to follow will not disappoint!

Happy Birthday Carl!