Perspectives of Physicians with Third-World Experience

Another female physician had a brilliant idea recently. She wanted to get some of the other women physicians together to talk and have dinner. No spouses, no kids, no drug rep, no lecture. Just women with similar interests, similar problems, similar dreams, and similar backgrounds.

But who knew how similar our backgrounds were? It just so happened that the one and only Caucasian, U.S.-raised woman who made it to dinner had to leave early as she was on call. That left four of us. Four women from four different countries and four different religions. And yet, as we regaled each other with tales of our med-school lives, we discovered how alike we are. And how alike the healthcare is in our home countries, and how very different it is compared with the United States.

We all had stories of our Robin Hood days. Our hospitals couldn't supply things for free. There was no insurance. Patients needed to supply their own meds, IV lines, syringes. And since many could not, especially on an emergent basis, those who afford to do so got the "Wish List.” Families of women in labor were usually willing and able to go to the local pharmacy to buy things. So while she probably didn't need more than one pack of sutures for her episiotomy, they usually ended up buying two, plus two IV catheters, a vial of antibiotics, and various and sundry supplies. These we would keep for the trauma patients, who usually arrived alone or carried in by their drunken friends. Or for the man with bowel obstruction from a tumor that was probably unresectable.

We recalled those days of having to have patients' family members donate blood. It didn't matter if they were a match. But for every unit transfused, we needed a unit back. One woman remembered a patient in the burn unit who had been there for weeks. He needed so many transfusions, they ran out of family members. And during trauma surgery, who had literally run from OR to the blood bank and back to fetch blood? Oh, yeah, that was us.

We remembered the goiters the size of heads, the ulcerated breast cancer, and the death from stupid things like gastroenteritis. All from lack of preventive care. Because patients need to chose between feeding their family and paying for a check-up.

And we relived those fulfilling moments. The profuse thanks. The potful of food, in lieu of payment. The bucket of mussels or the basket of eggs as a token of gratitude. The half dozen children named after us because we assisted in their deliveries.

And we compared it to life here in the United States. Where patients complain that the hospital bed isn't comfortable or the hospital food doesn't taste good. Where the woman in her BMW carrying her Gucci purse asks "What did I pay a $50 copay for?!" when she doesn't want to hear it really isn't her thyroid making her fat. Where there is Medicaid and Charity Care and PADD. Where you can get antibiotics for free at the supermarket.

Anyone who complains about our healthcare system should spend a year or two in a third world country ER.
 

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