Month: October 2019

Speaking of Addiction…

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By Meaghan P. Ruddy

When we speak of addiction, there is a lot we can say. We can talk about stigmatization, how stigma is a mark, a signifier of something often associated with shame and disgrace, which in turn are responses to things deemed problematic by dominant cultural narratives. We could focus on historical usages of stigmatizing practices, how we come to know disgrace and feel shame by observing how others, particularly those who are in helper roles, respond to our marks, and how all of this negatively impacts healthcare. And we could, as we often do, speak about it from the safe, professional distance of the theoretical.

But there is a simpler truth here.

It is the truth expressed by the civil rights movement, the equity in marriage movement, and women’s suffrage. It is the truth that fuels both political correctness and the fight against it. It is the truth that language matters.

Think about it. If it didn’t matter, we would never take offense, never laugh at a joke, never tear up at a well-delivered line in a film or speech. No one would bristle at terms with historically racist or fascist overtones.

Yet, we do.

Healthcare has made some progress but our work is far from over. The person-first language movement has done a lot of good; even the CDC-recommended terms of use for people with disabilities. Even the word healthcare is a relatively new and welcome reframing away from the silos implied by medical care, rehabilitation, nursing care, etc. The harsh terminology that was once part and parcel of “clinical-speak,” handicapped, gomer, diabetic, depressive, has largely been abated or is at least on the way out. There has been wide-spread recognition that these are people first, conditions second.

Except. Except for one challenging, and unfortunately swiftly growing population.

Addict.

Drug-seeker.

Yeah, but c’mon, someone might say. They are seeking drugs. They’re a huge problem! They should know better.Read More »

“You will be alright” – A Doctor’s Reflection on the Power of Hope

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By Mahboobeh Mahdavinia

Alanna and Anthony are not yet ten years old, but they have been to the emergency room more times than most adults. Every few months since they were babies, their parents have raced them to the hospital for asthma attacks, superinfections of their severe eczema, or food allergy reactions. They each have been intubated twice in their precious few years of life.

But for the last year, Alanna and Anthony have not had to come to the ER in crisis. Instead, their parents have brought them to see me in my allergy clinic for scheduled medication shots and follow-up visits. I consider Alanna and Anthony a success story, or at least the start of one. But most hospitals would not – and neither would insurance companies.

The truth is, Alanna and Anthony have missed multiple appointments, and consequently missed almost half of their shots. Other patients I see have similar spotty records. Administrators who oversee my clinic have pointed out the large cost of no-show appointments. When inconsistent patients do come, their appointments often go overtime, creating conflicts with nursing and staff schedules. Some other hospitals and  clinic administrators would almost surely have come up with plans for dismissing Alanna and Anthony from the practice. However, we have all come to the agreement that we should do whatever it takes for them to stay as long as they choose. Read More »