There are two types of physicians who practice medicine: those who choose medicine as a career and those who medicine chooses to serve. When you are called to serve, your relationship with patients extends beyond a 15 minute boundary. Such was the case of my relationship with my patient, Adriana Echeverri Tucker.
Adriana was 38 years old when she first entered my office both happy and anxious about her first pregnancy. If she had medical insurance, I might not have met her. She was married to a U.S. citizen but had to wait the prescriptive time period for her green card so she was not eligible for state-funded insurance and her husband was self-employed.
Adriana was a dog trainer by trade and originally from Colombia, South America. Her ambition and entrepreneurial spirit was contagious and admirable. She was an older woman who had conceived without the benefit of In Vitro Fertilization and I, who was childless at that time, knew her pregnancy was a precious gift. She ultimately delivered a beautiful baby boy, who she named Martin. When she brought Martin to Colombia to see her family, she brought me back a gift that remained on my desk for years.
I eventually lost contact with Adriana until recently when I flipped through my local newspaper and saw her name in the obituary section. At first I wasn’t sure if it was the same person until I read the part about her being a dog trainer. A memorial service is scheduled for the next day.
Three months before her death, Adriana complained of having severe back pain. It was not known how long she had this complaint. She reluctantly went to the emergency department and was subsequently admitted. Days later, she was given a diagnosis of late-stage cancer with an unknown primary. Adriana refused chemotherapy opting to go to Mexico where the cost of healthcare was less prohibitive because she was uninsured. Unfortunately, there was a waiting list for beds in Mexico and Adriana could not be treated immediately. When the pain became unbearable, she decided to return to the country of her birth, Colombia for further medical attention. Regretfully, Adriana expired one day after her arrival.
According to the Census Bureau, there were 50.7 million uninsured Americans in 2011 – an all time high. Although 48 million Americans are receiving Medicaid, Adriana would probably not qualify because she was a small business owner. In 2002, the Institute of Medicine reported a 25% increase in mortality that is associated with the uninsured for working age adults. Therefore being uninsured can actually be a death sentence. Presently, small businesses pay an average of 18% more in premiums than large businesses. In 2014, this practice will stop. Companies with 100 employers or less will be able to pool their resources and buy health insurance for their companies through an exchange.
The next time you hear someone complain about the new health care law, aka The Affordable Care Act, please think about Adriana. Not only was she my patient – she was also my friend.