Dad coughed up a few small specks of blood one morning in late November. His niece took him to the hospital an hour away in a neighboring state. They diagnosed him with lung cancer, which is terrifying at the best of times.
But dad doesn’t live in the best of times. He lives in America today, as an elderly widower who resides alone in Appalachian Virginia. Like most of the region, the area where he lives is populated by poorer, older, sicker and less-educated communities that lack access to services. Plus, we’re in the second year of a politically divisive pandemic that’s led millions of Americans, including many of dad’s neighbors, to resist basic medical science and public health advice and mandates.
Dad’s illness made breathing difficult for him. Watching him struggle has been traumatic for the people who love him as they help navigate an uneven healthcare system that’s more burdensome than it should be, especially in a country with as many resources as this one. The fact that so many Americans can likely relate to his — and my — struggle is no comfort, because it is needless.
Consider dad’s situation. There is no public transportation in dad’s hamlet, which is similar to most of rural America that lacks public transit links to small towns and larger metropolitan districts. No public transportation is one of the key reasons that elderly Americans cannot age in their home place. Dad couldn’t be treated for cancer and stay at home for this reason.
But that wasn’t the only reason. The volunteer emergency medical services that operate in dad’s area were hollowed out by the county board of supervisors, who eliminated funding two years ago and shifted the monies to a town 15 miles away. Rural residents trying to survive without EMS or with underfunded and understaffed services is increasingly the norm in America, a report by the Kaiser Family Foundations says.
The corporate, non-profit hospital system that is the closest to dad, Ballad Health, operates a B rated facility, according to a state-wide survey. It’s located 25 miles from his house.
Dad refused to go to the Ballad operated hospital for his initial assessment because of a lack of trust, and because of the stories shared by friends who had negative experiences with the hospital. Over the past few years, hospitals in his area have closed, merged and lost trust because of a decline in care.
Throw COVID-19 into the mix and dad’s care situation gets even scarier. Ideological extremists on social media have politicized basic public health, medical care and science in conservative America. Appalachian Virginia is solidly conservative and Republican with about 7 out of 10 voters going for the incumbent President Trump in the 2020 general election.
What this means is that relatively few people wear masks in public, which becomes obvious with a quick trip to the grocery store. Unsurprisingly, the COVID-19 infection rate in dad’s area is double the state’s average.
Shortly after Dad’s cancer diagnosis in late November, Ballad’s vaccine mandate crumbled. I wasn’t surprised. The hospital announced that the vaccine mandate would create staffing shortages, which was the common reason given by healthcare systems across the country that opted out of basic public health procedures.
The same myopic Supreme Court decision that stopped the Biden administration’s federal vaccine mandate for large businesses thankfully had a brighter side. It affirmed vaccine requirements for healthcare providers that serve Medicare and Medicaid patients, which means that Ballad was compelled by law to require employees to get vaccinated.
By that time, however, dad’s radiation therapy was over.
Dad temporarily moved to Chicago with us. We transported him to the top notch Rush Cancer Center for five radiation therapy treatments, and provided a warm place to convalesce for some weeks. Rush took the pandemic seriously and required vaccines early.
Atrium Health Wake Forest Baptist hospital in North Carolina also took the pandemic seriously, which is where dad was initially diagnosed when he spat blood that terrible morning in November. He’ll go there for his quarterly, routine cancer screenings.
Dad’s glad to be home in southwest Virginia.
But the ordeal he faced was sobering. His tumor is dead, we hope. But it seems the twin tumors of inequality and ideological extremism are alive and well in America today with little chance of abatement.
