Saturday, May 21, 2011

Alone in the Bay

I went out for the first time ALONE to row. No one else was there, save a few people across the way fishing...I proved to be excellent entertainment.

I got the shell and me together, in the water with the oars on the correct side and disembarked without much difficulty. The wind was still up, so I just rowed in circles in the bay, working on steering, turning and generally how to get the oars, shell and me to get along and agree on what the hell we were doing. It actually went really well.

Then, came the return to the dock, or The Landing. Remember, rowing is a sport one faces backward to the direction of motion. It took three tries and some crafty oar-pulling-me-closer-to-dock action for me to finally get it done. I could not help but notice the very entertained fisherman across the bay...he just kept laughing! I supposed I could have sold tickets....

The rowing is going very well and the only down side to it is Kate ("Fuzzy Pants") can't go with me.

Wherever You Go, There You Are

Why is it so impossible for most people to be happy 'where they are?' How is it that no matter how well an individual is doing, often times, there is this constant, I need more, I want more, this is not enough.

Is it the constant deluge of advertising? The ever-present magazine covers showing all the stuff you need in order to fit in or be accepted? That sense of lacking and incompleteness seems to seep into our everyday existence with the stealth of the latest military stealth bomber.

I have to wonder this because I am generally one of the happiest people I know an I don't have all that stuff. I don't even have cable. I have a few other friends who also believe, "You make your own happiness." This is true.

Is happiness a choice? Do you craft it out of an appreciation of much needed rain, the fact your car is paid for AND still runs well, or just that you have a roof over your head that does not leak regardless of the size of that roof?

It seems that our lives have become so fast paced we have no time but for looking forward so as not to trip over the next obstacle, but yet no time to reflect, turn around and look behind us - to be grateful for how far we have come, how much we have accomplished.

You can wish this, wish that, wish, wish, wish, but really, in the end, wherever you go, there you are.
You have to learn to be at peace with that.

Right or Privilege?

I have been talking with people regarding whether they think medical care is a right or a privilege. I have talked with MDs I work with as well as fellow RNs, friends and family.

The general consensus of medical staff is health care is a privilege. Some friends say privilege and some say right. I found this conversation necessitates defining these terms:

Right - something a civilized, developed nation should guarantee at a basal level to its citizens. Basically the same thing as you should be able to be safe in your home, pursue whatever career choice you want and the choice of worshiping, or not, whatever deity you chose.

Privilege - something earned, bestowed upon or above and beyond those basal "Rights" spoke of earlier. Like a driver's license. You have to behave within parameters to obtain and keep you privilege to drive.

Once those definitions were hashed over, I came to think the following: I think every person should have a right of some basal level of medical care. Vaccinations, annual physicals, screenings, nutritional education; all basal levels of care that should be available to all. To me, these equate to the betterment of society and thus provide for a more productive society. An investment that benefits society as a whole, much like our public school system does now. I pay taxes and don't have kids, but I see the need for public schools.

However, there are levels to health care that are most certainly a privilege. Keeping people alive when the most honest, humane thing to do is to "let nature take its course," is not a right. As harsh as it sounds, I think if you want that for a family member, or even if you yourself wrote this out in a living will, your estate or your family needs to cough up the cash to pay for it.

There are many other instances where a much higher level of care or intervention is a privilege and should often times be denied to an individual so that greater resources are available for the society at large.

As a health care professional, the real question is this: Will these interventions (treatment) improve or return the person back to his or her previous level of function and comprehension? Will we really make something better? Or are we just prolonging death?

Once those questions are posed, one still has to ask, who is going to pay for it? The reality is someone is going to.
Our society has become removed from the fact health care is not a product, it is not something one purchases that will have perfect function and is completely full-proof in its application. If it does not do what the person receiving it expects, you cannot return it for a refund! This attitude of "It did not work the way I wanted, so now give me my money back plus pain and suffering..." well, that is the attitude of privilege.

Another recent attitude of privilege is people expect hospitals to be 5-star hotels. Hospitals used to be wards...with curtains. But our "I'm so entitled" society now thinks they need to be at the Westin while having surgery, or even just food poisoning....

So what do you think?
Privilege or Right?