“My breast has fallen off. Can you reattach it?”

Atlanta Magazine has an interview with Otis Webb Brawley, M.D., and an excerpt from his new book "How We Do Harm: A Doctor Breaks Ranks About Being Sick in America."

The excerpt tells the story of 53-year-old Edna Riggs, of Atlanta, Georgia. Fear of cancer, medical debt, and losing her job caused her to not seek treatment for her breast cancer until it reached a very advanced state.

(Graphic content, may be upsetting; via @rogersmatthew)

• [Antinous / Moderator]

  We had a patient who came in with a facial tumor that looked like an eggplant.  She just walked around for a decade with her hand held in front of her cheek, hoping that nobody would notice so that she wouldn’t have to.  Also, patients with what would have been highly curable cancers who waited until they were incurable due to financial problems, bad spouses, child-care issues, etc.  It’s enormously frustrating for everyone involved to see someone die because of something that a social worker could have fixed.

  • [Xeni Jardin]

    that is horrible Antinous. So so sad.

  • [Mister44]

     Was it cancer – or neurofibormatosis?

    • [Antinous / Moderator]

      In that case, cancer.  Completely curable, but leaving a massive deformity because it went untreated so long.  Many skin cancers grow for years or decades before they become health threatening.  And people will just let them grow and grow.

      One positive outcome of the narcissism revolution is that not wanting a booger growing on your face for cosmetic reasons will provoke you to treat skin cancer earlier.  My microdermabrasionologist harasses her clients into going to the dermatologist to get things removed.

  • [Richard]

    The last doctor I saw some years ago told me to come back when I have insurance. Otherwise he wasn’t going to do anything for me.

    And that’s not my only good luck with that medical story either.

  • [Paul Renault]

    Antinous, if I can make a small correction: It’s not “something that a social worker could have fixed”.  It’s “something that the voters could have fixed.”

    Join the rest of the civilized world and implement socialized medecine.  Take all those politicians who work for the insurance companies against the electors and put their heads on poles. 
    Edited to add: “Debt Collectors Work In Emergency Rooms, Demand Payment Before Patients Receive Care”
    http://consumerist.com/2012/04/debt-collectors-hanging-out-in-emergency-room-demanding-payment-before-patients-receive-care.html

    I keep hearing that the US is a democracy, but I see so little evidence of it.

    • [unit_1421]

       Heads-spikes-walls for those opposing universal health care would be a good addition to the Democratic Party platform, but the Games of Thrones Caucus doesn’t have the numbers yet.

      • [Roman Berry]

         Not even what passes for the Democratic Party these days supports anything approaching “universal health care.”  Had a chance at it — the ACA was passed under reconciliation and Medicare for All could have been passed exactly the same way — and blew it…’cause (according to the President) it would have been “too disruptive” to the current for-profit system of health insurance we have now, that being the same health insurance system that can and does still leave people with insurance facing financial ruin.

    • [retepslluerb]

      I see plenty of evidence of it.   Just because a majority of voter think that guns are more nifty than doctors, it’s not necessarily not a democracy. 

      After all, democracy isn’t about best politics (whatever those may be) but legitimized politics. 

      • [Paul Renault]

         From the stats that I hear and read coming from, say, the Pew Research Center, a large majority of the American population want socialized medecine and fewer guns.Don’t rely on corporate media for your sense of what the population wants.

        • [retepslluerb]

          I rely on what I see what the majority of Americans votes into office, again and again and again.

          Also, their great pride and joy whenever their young are sent into yet another war.

• [nox]

  A similar story showed up on Reddit a while back; apparently the woman would wear clothes to capture seepage that came out. Her nipple fell off to reveal a ‘fungating mass’, a term that really shouldn’t be looked up on Google images.

  She died shortly afterwards in a nation with the ‘best medical system’ in the world. I’m sure taking out Obamacare will help.

  • [Xeni Jardin]

    I saw that story make the rounds. These really squick me out, and fascinate me.

  • [bcsizemo]

    As an American I find it distressing that a large percentage of people see it as either Obamacare/Not Obamacare.  I don’t think Obamacare in and of itself will fix this nation’s medical issues.  It is a step in the right direction of providing healthcare for everyone, but at the same time it is relying on our current system which is bloated, wasteful, and full of greed.

    • [nox]

      I somehow doubt the parties clamouring to repeal it have a superior option in mind.

    • [Cowicide]

      A single payer system for health care is desperately needed in the USA.

      Doctors (who have critical thinking skills and aren’t in health care only for the money) sure do want it here:

      http://www.pnhp.org/facts/what-is-single-payer

      http://www.pnhp.org/facts/single-payer-faq

    • [Roman Berry]

       The ACA is not a step in the right direction. The ACA is the model that will be used to undermine Medicare and replace it with a for-profit insurance model peddling junk (only 70 percent actuarial value) insurance. And the key here is that the ACA provides insurance via subsidies to for-profit corporations, not health care.

      The ACA is not a step towards universal health care. The ACA just cements the awful, broken, ruinous for-profit system of health insurance around our collective feet…and still leaves millions uninsured…and saddles millions more with junk (70 percent actuarial value) insurance they are forced to pay for but can not afford to use.

  • [Stefan Jones]

    Without Obamacare, she would have been free to barter farm animals for medical care. And she would still have her Freedom(tm)!

    • [pjcamp]

      And the Koch brothers would be unnoticeably richer. That’s gotta count for a lot.

  • [Marja Erwin]

    We’re stuck with one of the most expensive, least accessible, and least effective health-care systems in the developed world. People are dying, and we need a better system. But the insurance companies are a big part of the problem. So I’m a bit skeptical that requiring us to pay off the insurance companies is part of the solution.

    • [sisyphus321]

      Idealism is great and all, but this is a fix-what-you-can situation. Obama didn’t have a sufficiently great margin in the last election that he was free to dictate terms to the insurance companies.

      • [Roman Berry]

         You comment is ahistorical. The ACA was passed via reconciliation. If Democrats really wanted universal health care, Medicare for All could have been passed exactly the same way.

  • [Mister44]

     Sounds to me that the issue was she didn’t seek help – not that our health care system is screwed up.

    • [Marja Erwin]

      Her access to health care depended on her insurance, which depended on her job, which depended on not getting sick and not taking a few hours off to go to the doctor’s office.

      So what was she supposed to do?

      • [Mister44]

         This isn’t an “ignoring a lump or some basic treatment”. This is “controlling seepage” – which takes a special kind of denial. There are options out there before it gets that bad.

        • [Steve Pan]

           wow, you are on a roll today with the idiocy.

    • [desperado]

      Both.  A begets B.

      Have you ever worked in a position where you were expected to come back to work after out-patient surgery?  I have.  There’s not exactly room for healthcare when the job consumes all.

      Edit: and if your reply will be to get another job, think about how difficult and scary that is, when you aren’t able to leave work long enough to do so, and your family relies 100% on you to survive, so you don’t have the luxury of just quitting.

      • [Richard]

        And if you get another job with a different health plan you are not covered for your little pre-existing ‘problem’.

        • [Coderjoe]

           If you were covered before the job change, your previous insurance should be able to provide you with a declaration of previous coverage, which your new insurance is supposed to accept, under HIPAA, to block the “pre-existing condition” excuse.

    • [Mantissa128]

      Did you RTFA?

  • [Mitchell Glaser]

    OMG,  ”Fungating scrotal mass” cannot be unseen!

• [Katherine Smith]

  Thanks for sharing this, Xeni. I hope that by continuing to share these kinds of stories that we will eventually reach some kind of critical mass and minds will start to change about our healthcare. I also feel less foolish about having a small (thankfully benign) cyst removed…

  • [nox]

    You don’t have to feel foolish about obtaining appropriate medical care.

    • [Katherine Smith]

      I’ve internalized the idea that unless I’m bleeding, broken, or can’t breath, I don’t need treatment. And I have decent health insurance! Ugh. 

      • [Cowicide]

        And I have decent health insurance!

        Be sure and examine the fine print like your life depends on it, because it does.  Many Americans are underinsured and don’t know it until something horrible happens.

  • [octolover]

    as someone who’s had… lemme see… at least 6 things removed (both internally and externally) that turned out to be benign (though one was becoming necrotic, yay!), let me say — i’d far rather err on the side of paranoia, particularly with a family history of a non-benign nature lurking behind me.

• [octolover]

  i live near atlanta, and grady scares me — i won’t bullshit you.  like some bogeyman in my subconscious.  but i was born and raised in the white-bread boonies-beyond-the-burbs, and i was always told that white people didn’t go to grady  — unless it was a severe trauma situation, since trauma is something grady is, for better or worse, so well-versed in dealing with.

  so my husband and i were loathe to take a friend (who had no health insurance) to their e.r. after he’d been hit by a car downtown (he was on a bike), but they did right by him.  i don’t know that they ever even bothered with the formality of billing him for their services.

  i can’t begin to imagine how many people would be dead without them. 

  our health care system is SO broken…

• [Shinkuhadoken]

  What’s astounding to me is that it’s the people who try working for a living, who don’t sponge off the system, that are being punished with no affordable medical coverage.  I think it’s a betrayal of the values the United States tries to promote. How does it make sense that a prisoner gets better care than a law-abiding, hard worker who doesn’t pull in 6 digits?

  • [joeposts]

    The fucked thing is that conservatives will use the same argument to cut back on meds and treatment for prisoners. :-/

• [sisyphus321]

  The story is also about working in the US. All the health insurance in the world isn’t going to keep your family together if you’re the family breadwinner and you get fired for getting sick. This is also about labor laws.

  • [Richard]

    Labor laws don’t apply if you work on contract without being an employee.

    • [Martijn Vos]

      If you’re self-employed, you need to get your own insurance for that. It’s not that hard if lots of people do it.

      • [Mati Senerchia]

        At $24,000 per year, with a high deductible?  

  • [Cowicide]

    Why keep it so complicated and expensive?  We should just go with a single payer system for health care and then it won’t be tied to labor crap.

    • [Eric Rucker]

      Except for the fact that the article mentions that people are afraid to get treatments that require taking sick time, when their employers penalize taking any sick time.

      • [Cowicide]

        Sure, that specific health care issue is intrinsically tied to labor laws with any system and should be dealt with.

    • [bcsizemo]

      Like Eric said, I don’t see how paying the government  vs. an insurance company changes how an employer treats you.  And while a single payer system is somewhat of a start, it doesn’t solve all of the price issues for healthcare.  If it was as simple as eliminating insurance and the hassles it brings then I could get a 50%+ discounts by paying directly.

      • [Cowicide]

        I don’t see how paying the government vs. an insurance company changes how an employer treats you.

        An employer will treat you radically different when they know that you are no longer enslaved to the insurance policy they provide you.

        For example, Starbucks is known to use this carrot/stick approach with health benefits to force employees to work more hours, etc. (ironically sometimes unhealthy hours/shifts).

        Many Americans are trapped into jobs they are overqualified for because they don’t want the lapse in insurance between jobs and/or will lose insurance entirely because of preexisting conditions if they venture to a better job.

        We are losing money in this country becaues of lost productivity from overqualified people working jobs out of FEAR.

        As far as what Eric was addressing. I addressed that in my reply to him already.

        And while a single payer system is somewhat of a start, it doesn’t solve all of the price issues for healthcare.

        No one I know of is claiming that a single payer system will “solve all price issues” for health care.

        But, if you look at the overall costs, there’s much that can be saved from wasteful administration costs between the doctors and insurance companies: http://www.pnhp.org/facts/single-payer-faq#bureaucracy

        Also, more preventative care will save vasts amounts of money:
        http://www.pnhp.org/facts/single-payer-faq#costs_down

        Not too mention, it’d be really nice to save the 45,000 Americans that die every year in agony because they don’t have insurance: http://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/

        Some of those 45,000 people that don’t die in agony might even make fine workers when they recover. Plus, the countless others that are not dying, but sputtering along in agony as well.

        If it was as simple as eliminating insurance and the hassles it brings then I could get a 50%+ discounts by paying directly.

        You should take a look at this entire FAQ and learn what a single payer system would really mean for the USA:

        http://www.pnhp.org/facts/single-payer-faq

• [Kludgegrrl]

  Born and raised in the states I am reluctant to go to the doctor unless I sense that I really must.  Now I live in Canada, where I can easily see a doctor for free.  A while back I noticed a dark line on my arm, that seemed to be growing.  It didn’t hurt and only because seeing a doctor was so easy did I get it seen to.  The doctor said that it should go away with antibiotics.  However, he added, if the line did not start shrinking by the next day I was to go straight to an ER.  Because if it reached my heart it would kill me. 

  That is how “socialized medicine” saves lives.  Maybe we do not have the money for all the latest cutting edge machines, but it is so easy to die (or be seriously incapacitated) by so many things that can be prevented easily if they are just seen to promptly.  If I were still living in the states there is no question that I would not have seen a doctor when I did.  At best I would have had to be rushed to a hospital for intravenous antibiotics.  At worse I would have died. 

  • [Cowicide]

    Thank you for your personal story.  People telling their stories may one day saves lives in America as more Americans hear the truth under the din of thunderous lies.

• [Drew from Zhrodague]

   When signing onto one of my last healthcare plans, the health insurance guy was telling me how great the US is, and how nobody can ever get an MRI in socialized countries. I told him I’d been paying insurance for ~15 years, and have been to a doctor three times — and each time had to pay multiple hundreds of dollars for the bill, due to not being continuously covered. He scoffed. A couple weeks later, I had the name and number of a doctor, just to get a checkup. I brought the number with me to work when, go figure, it was my last day, which means my health insurance gets turned off again.

  Another company I worked for had a health insurance plan that I couldn’t find a doctor that would take it.

  I love paying for healthcare that I cannot use. Adding it up, I’ve paid more than a year’s salary to health insurance so far.

  Now I work for a different company, and have supposedly great healthcare – except that it (UPMC) is not available in Nashville, TN, where I live. If we have supposedly the best healthcare in the world, I have yet to see it, and I have lived in the US almost all of my life.

  • [Richard]

    And you will find that IF they determine you to have a problem that existed before you were covered under their health plan, they don’t cover it. Which means that after you are covered again with new health insurance, it’s best to wait a year to go to a doctor unless you don’t mind footing any bill from any related visits.

  • [Tara Jennings Urbanek]

    This is my biggest problem with regional healthcare – I frequently end up working for companies that don’t exist in the state where I actually work, and then have no other choice than an expensive PPO.  Woo?

  • [Mike]

     Actually in the People’s Republic of Italy MRI costs 38,6 € with national sanitary service, except if someone has some specific illness, and in that case it’s free or with a 3 € price.

    A specialist visit costs via national sanitary service with a couple of instrumental exams costs about 70 €. The same visit paid in full costs about 250 €. 

    Having a national sanitary service means that private visits have to cost less than where there’s not a public service to keep prices down.

  • [hab]

    This is part of the problem. It is human nature to want to get at least as much out of the system as one puts into it. I know a lot of people who have gotten more “value” out of health insurance. Trust me, you don’t want to be one of them.

    Most people can afford a doctor’s visit, a mammogram or a blood test. Most people cannot afford cancer treatment, a major trauma or a premature baby with multiple complications. The cost of each of those would be several times an annual salary–perhaps more than that individual would earn in their entire lifetime.

  • [retepslluerb]

    Tell him that my sister is on social security due to severe sickness and she get’s her MRIs just fine, when she needs one.  

• [bluest_one]

  The sacary thing that I always think when I watch the ‘healthcare debate’ going on in the US is how many citizens have internalised the corporate propaganda that universal healthcare equals some kind of communist slavery.

  It’s like turkeys voting against the abolition of Thanksgiving & Christmas and it reminds me of the sort of self-defeating brainwashing that you see in nightmare states like North Korea and China.

  • [Cowicide]

    how many citizens have internalised the corporate propaganda

    The really twisted part is Americans are paying to be lied to with their own payments to insurance companies.  A top man at CIGNA has come forward and spilled the beans.  Every American needs to see this interview.

• [Ultan]

  From the book:
  

  Much of the problem is that poor people don’t get care that would be likely to help them. The reasons for this are complex. Perhaps they can’t get care, or don’t know where care is available, or they haven’t been offered insurance or steady access to care by their jobs or social services.

  Here is the problem: Poor Americans consume too little health care, especially preventative health care. Other Americans — often rich Americans — consume too much health care, often unwisely, and sometimes to their detriment. The American healthcare system combines famine with gluttony.

  (p.11-12)

• [BombBlastLightingWaltz]

  It is amazing these companies do not consider ‘Compassionate Leave’ policies.

  • [snowmentality]

    Why would they? They’ve got a huge pool of desperate unemployed people; easier to just cut loose a sick employee and hire someone who won’t ask for time off.

    (/angry and cynical)

• [Preston Sturges]

  Untreated breast cancer is horrible, just erodes right into the rib cage so the internal organs are visible and the stench can be terrible.   That’s without any sort of chemo.  Obviously you can die without the full body rot also. 

  I had a friend that died from breast cancer last year, and she had to sell her house and work like hell freelancing while on chemo, until she finally just swelled up with ascites fluid (pus) and died. 

• [phuzz]

  As a brit, I’m having trouble expressing quite how barbaric just the idea that you should have to /pay/ for access to medical treatment seems to me.
  It’s just, wow, just horrible.

  Now, I do pay for my asthma prescription, but then I earn an ok wage, and pay taxes so that’s fair.  If I was broke and on the dole then I’d get it for free, otherwise I could just drop dead, and what kind of uncivilised country lets people die of treatable diseases?

  Seriously, please sort it out soon America, we just can’t consider you a civilised country until you do.