I remember some years back, while working as an Emergency Room physician, a patient came in. He was a Caucasian male in his late forties maybe, and sought consult because of chest discomfort. Now any time comes in with such a complaint we’re on our toes and expecting the worst and prepare for the worst possible scenario. But after a while, we realized that this was probably a case of Coronary Artery Disease with episodes of angina. On physical examination one could see the midline scar on his chest, indicating that he underwent a previous thoracic surgery. On history taking he would disclose that he had a coronary artery bypass graft done on him years before. He would also disclose, that he was only able to do the procedure because his father loaned him the amount needed for the surgery. I can remember him saying that he was still actually paying off that loan, with interest. The patient was treated with emergency meds, felt some relief and thanked us profusely. But when we told him that he still needed to be admitted for observation and work up, he regretfully declined.
He said he couldn’t pay for the hospital bills. The hospital, being a privately owned institution, would have our heads if we admit a patient knowing very well that he could not pay. But knowing his current state of health, we advised to make arrangement to transfer him to a government hospital instead, but that too he declined. “I’ll just sign the papers” he said, referring to the hospital waiver that he was being discharged against the advice of his doctor. Reluctant as we were, we let him sign and gave him instructions to return should he feel anything out of the ordinary again. He was what we have termed a “pooreigner” a foreign national staying here in the Philippines because of circumstances beyond his control without the benefit of a stable source of funding, or in this particular patient’s case, “this is the only place where I can be happy” he said. When asked why, his reply was “Back there I’d probably die a long and lonely death”
He lives off the pension he receives, but since he has to pay off his debt to his father, what’s left is barely enough for his daily needs.
I have worked for and in a government hospital before, so it comes to no surprise when patients come in with only the worn down sandals on their feet and the clothes on the bodies and the hope that they can be treated for whatever it is that ails them the most when they come in for medical consult. It pains me to know that sometimes they could not even afford the antipyretic for their fever, much less the diagnostic exams needed to confirm what he has. Here you rely on your clinical eye, hand out a prescription you never know if and when it will be filled and offer a prayer that he gets well just the same.
But I’d like to believe that despite all of this, we remember that are all citizens of the world. Regardless of the colors of our skin, the lands of our birth, it all boils down to basic human dignity and one of the most basic of human needs as well.