My Uncle Bobby is one of the nicest people you will ever meet. He is mostly deaf. He was, remarkably, not checked for deafness until he was exiting high school. By that point everyone had taken for granted that he was simply unintelligent, considering he always did so poorly in school and frequently couldn't follow instructions. Turns ou…
My Uncle Bobby is one of the nicest people you will ever meet. He is mostly deaf. He was, remarkably, not checked for deafness until he was exiting high school. By that point everyone had taken for granted that he was simply unintelligent, considering he always did so poorly in school and frequently couldn't follow instructions. Turns out he never could hear what anyone was saying if their back was turned. By that point it was clear he was not on track to go to college. He worked for decades making an honest living at a pizza parlor, and was liked by absolutely everyone.
Oh, he is also diabetic. That should be unimportant, considering how many people are. Unfortunately, the opposite is true. All it took was for him to hurt his leg, get a cast, and have that cast not fit just right. There goes the infection. There goes the leg. There goes the job at the pizza parlor. There goes that meager salary. There goes the social life, too. Here comes living in a tiny room, with nothing to fill the day, and no way of getting around. Here comes the slide into barely concealed alcoholism. Here comes the after-effects of all that beer and immobility on a 60 year old diabetic body. There goes the other leg. Here comes the nursing home.
Funny thing about the nursing home, now that he is a ward of the state he actually gets the excellent care that could have prevented him from landing in the nursing home.
Oh, and this was right before the pandemic. So there goes being able to see your family for a few years. And here comes getting Covid. Twice. And fighting it off. Twice. And another infection. In your skull. And fighting that off too. And managing somehow to get out of your chair. And putting on your leg braces. And walking down the whole long hallway, just leaning on a walker, pure upper body strength and determination, captured on a shaky phone camera, probably by one of the nurses you are currently in love with, because you fall in love with all your nurses, because you've never had a real girlfriend, not once, and because they are kind and bring you coffee and take care of you, and you've never had anyone to take care of you, other than your sister Dianne, who even though she is only 11 months older still was assigned to walk you to school because she was so mature and you were so simple, and that is who you are sending this to right now, because she'll be proud of you and send back a message of nothing but heart emojis and candy canes, even though Cristmas is over, because you both love Christmas THAT MUCH.
This is a strong person I just described. Also a dependent person. Don't get it twisted, they can be both. This person would have been dead many times over, year after year, if it wasn't for a very easily manufactured medicine.
Eli Lilly can afford to cut their costs by 70% and still make money. What were they making before? Too much. And now, still, too much. The correct amount would be zero dollars. No one should make so much money on something so many others cannot afford to be without.
Will, in my career, I worked in the lab of a major medical center in Chicago. As I ran hundreds of blood tests each day, I'd look at the diagnoses that the ER entered in the computer. They sometimes put a direct quote of what the patient told them. A number of times I saw, "ran out of" or "can't afford" insulin. Who knows if these people had insurance, but I would see the astronomical glucose levels and figure that they weren't going home that day. The lack of affordable medicine lead to EXACTLY the type of situations you talked about! Which in the long run, increased costs for ALL of us.
I might also mention that diabetes often leads to renal failure. Renal failure leads to dialysis---I believe (someone help me here?) that is one of the biggest expenses to Medicare/Medicaid. Also, big business, as John Oliver had a segment a few years back about the dialysis industry which was eye opening.
A former co-worker of mine was borderline diabetic for most of his career. He retired from the SO and went to work for one of the casinos managing their security team. He ended up having to retire from that when he (due to diabetic neuropathy) could no longer walk. His ultimate "last walk" went from digital amputation on one foot, followed in short order by amputation below, then above the knee, then a double amputation above the knee, and a very difficult recovery due to both renal and heart issues and ultimately resulted in his death from a heart attack at age 60. He could never afford the treatments he was offered as the more "preventative" ones were not covered by insurance.
And generally dialysis, yes, for renal failure, is poorly tolerated by diabetic individuals, which makes prevention by proper early treatment true life extension, and it's far less expensive than the treatments needed for all the complications detailed in your and Wil's notes. But if companies only see their bottom line and ignore everything else, and if half crazed lunatics in our House of Representatives only see political advantage, things would never change. We must stay woke. For woke means awakened to injustice.
Not only does long-standing, poorly controlled diabetes cause renal failure, it puts you at high risk for infection, metabolic syndrome (heart disease/stroke/diabetes), heart failure (CV disease), retinopathy (vision damage), puts you at higher risk for developing Alzheimer's disease, foot complications due to neuropathy as stated below and depression! I am a nurse practitioner who works on a critical care unit and see the devastating effects of on a daily basis. We need physicians, physician assistants and nurse practitioners, who work in primary care to be trained in 'lifestyle medicine' to educate these sick folks about the 6 domains (see below) to healthier living in order to reverse or at least tame this disease, to use health coaches
(make sure insurance companies cover coaching) and YES, provide insulin at little to no cost! We must address this problem holistically (whole food plant-based diet, physical activity, restorative sleep, avoiding risky substances and promoting positive social connections.
Don't know where you are but your nursing philosophy is spot on. It's why I spoke to a large conference of NP's about 25 years ago and told them that I believed, as a primary care internist, that eventually there would be few primary care docs and most primary care would be done by nurse practitioners. Of course, I had special education as I was and still am married to a now retired ARNP.
Thank you for dedicating your career to primary care, we need more of you! My dear friend is also a primary care internist in rural PA (my home state) and he would agree with you. I became a member of the American College of Lifestyle Medicine (ACLM) and got certified in Lifestyle Medicine as a Health Coach during the pandemic. I have lectured about Lifestyle Medicine and the Blue Zones and it's positive affect on health and well being. The ACLM is an ever-growing society of health professionals on a mission to reverse chronic disease. I am currently working as an ICU NP in San Francisco but will be launching a LM course that specifically focuses on women's health (perimenopause and menopause). Lifestyle Medicine is evidence-based and research shows this is the future of healthcare! I highly recommend checking their website out, lots of good resources to point friends and family to that need help getting healthier!
More power to you. Your experiences doing that would be of interest to a journal like Menopause, I bet, in which Ellen Mitchell and Nancy Woods, U of Washington, published many things about the menopausal transition which they studied for about 25 years. Stuff that women really want to know about how long the transition to FMP will last and what symptoms tend to be exaggerated or changed by the transition. Somehow, we have all made the transition to retirement together, but it was a great fun ride!
Once upon a time there were nutrition courses, obligatory in public schools. Does anyone remember “the basic seven”? Nutrition studies have advanced since then, but the rash of diabetes is a tribute to corporate America’s pushing sugar: colas, sweet snacks. At a recent check-up I was twice asked if I have diabetes. It’s expected of people of “a certain age.” It’s time for really thorough “health” courses in public schools, particularly before Florida can take over truth.
We are a nation of drugs over exercise. It may well be our undoing. Once public schools had vigorous sports programs for everyone (how well I remember being the last chosen for a side playing softball - astigmatic, I couldn’t catch or hit a ball), not just the “athletes.” What happened?
There has been a suggestion(out "there") that a moratorium on law suits be provided for dieticians and the medical community in regard to current protocols for the treatment of T2d, type 2 diabetes. There is a huge online community of motivated diabetics. Over the years, the medical community has agreed to a pharmaceutical answer to all of T2d. There is evidence the SAD(Standard American Diet) promotes metabolic syndrome. There are alternatives. Capitalism shows us it is not the economic vehicle to provide community health and wellness. ...plenty of stuff, yes. Be safe. Be well.
Agreed. It is expensive to eat healthy. In the long term though it is cheaper if you can avoid the health problems that co m e from the SAD.
Think of the food deserts and people buying good at dollar stores. I sometimes watch a YouTube channel where they do "southern" cooking. She has done a few shows where she buys all the ingredients at one of them. I was horrified at the fat/sodium laden canned junk she threw together, but I realized that is all many of her viewers can afford. Very sad.
Will, thank you for such a clear and concise explanation of what happens when we put profit over people. I will never understand how anyone can accept that medical care should be profit based. It’s just so wrong!
Now there is an idea. I wonder what form it would take - a substack? A prime time TV half hour? The wingers would loooove that. And demand equal time to rebut.
The translation is something like “Who do you think you are, expecting us to respect facts? People believe us more than anything you can ‘prove’ with facts.”
You describe a series of situations that collide to cause a mans life to collapse. Yet, he endured.
I am so moved by this story of Uncle Bobby and by your writing skill.
Some of those events were avoidable, preventable situations. Some were just the luck of the draw. I suspect most of us have family members who were victims of ignorance and neglect. Or just plain suffered the assault of illness after illness.
You write with such compassion and literacy. You honor the unfortunate. You are a talent to be reckoned with. You have a powerful gift. More please, as you please.
I've not yet read the comments here yet (I'm imagining there's one or two). Your story of your Uncle is one similar to what I saw a number of times in my career where, for want of adequate medical attention, people die (keeping in mind that my introduction to them comes from having to do a death investigation when they die while "not under the care and treatment of a physician."
I am watching a childhood friend enter Hospice care this week at the age of 60 due to lung cancer that was undiagnosed (because no insurance, and made too much money as a pizza delivery driver/gas pump jockey to qualify for the Oregon Health Plan) until his lungs were full of tumors.
Health care is not something you earn, or deserve to have. Everyone should have access.
Will~this is one of the most beautiful, illuminating, and poetic pieces of writing I have ever seen that bring the systemic failings of our cruel profit-over-people-at-all-costs society. You brought Uncle Bobby to life in a powerful way that everyone can see, feel, hear, mourn, and celebrate. You have a real gift. I'm not sure what you should do with it, but these kind of takes on any number of lives that have been sacrificed in the name of extreme greed are just what we need to turn the tide by open more eyes among those who vote against their interests, because I am sure they have experienced limitations and suffering in their own lives at the hands of the super rich + powerful.
OMG Will 😳 I hope that you publish your writing. You have an amazing ability in seeing and then communicating what you see. As a healthcare provider I am too familiar with your Uncle Bobby. How heartbreaking to endure an entire childhood of being deaf and not having that recognized by another being. Thank you for writing and sharing. ❤️🤗🙏
Will, your story of Bobby should be published widely and read widely. Then people could grasp how in America so many end up not being able to be the productive citizens they wish they could be. Instead they end up homeless, addicted or, as with Bobby, needing nursing home care when that all could have been avoided with better healthcare and a better educational system (that would have detected Bobby’s hearing problem). Thank you.
Thank you Will for your wonderfully well-written witness to the struggle some folks had before dyslexia, learning disabilities, auditory processing disabilities and so many, many other bars to learning and education were recognized. Your Uncle is a true hero.
My Uncle Bobby is one of the nicest people you will ever meet. He is mostly deaf. He was, remarkably, not checked for deafness until he was exiting high school. By that point everyone had taken for granted that he was simply unintelligent, considering he always did so poorly in school and frequently couldn't follow instructions. Turns out he never could hear what anyone was saying if their back was turned. By that point it was clear he was not on track to go to college. He worked for decades making an honest living at a pizza parlor, and was liked by absolutely everyone.
Oh, he is also diabetic. That should be unimportant, considering how many people are. Unfortunately, the opposite is true. All it took was for him to hurt his leg, get a cast, and have that cast not fit just right. There goes the infection. There goes the leg. There goes the job at the pizza parlor. There goes that meager salary. There goes the social life, too. Here comes living in a tiny room, with nothing to fill the day, and no way of getting around. Here comes the slide into barely concealed alcoholism. Here comes the after-effects of all that beer and immobility on a 60 year old diabetic body. There goes the other leg. Here comes the nursing home.
Funny thing about the nursing home, now that he is a ward of the state he actually gets the excellent care that could have prevented him from landing in the nursing home.
Oh, and this was right before the pandemic. So there goes being able to see your family for a few years. And here comes getting Covid. Twice. And fighting it off. Twice. And another infection. In your skull. And fighting that off too. And managing somehow to get out of your chair. And putting on your leg braces. And walking down the whole long hallway, just leaning on a walker, pure upper body strength and determination, captured on a shaky phone camera, probably by one of the nurses you are currently in love with, because you fall in love with all your nurses, because you've never had a real girlfriend, not once, and because they are kind and bring you coffee and take care of you, and you've never had anyone to take care of you, other than your sister Dianne, who even though she is only 11 months older still was assigned to walk you to school because she was so mature and you were so simple, and that is who you are sending this to right now, because she'll be proud of you and send back a message of nothing but heart emojis and candy canes, even though Cristmas is over, because you both love Christmas THAT MUCH.
This is a strong person I just described. Also a dependent person. Don't get it twisted, they can be both. This person would have been dead many times over, year after year, if it wasn't for a very easily manufactured medicine.
Eli Lilly can afford to cut their costs by 70% and still make money. What were they making before? Too much. And now, still, too much. The correct amount would be zero dollars. No one should make so much money on something so many others cannot afford to be without.
Will, thank you for standing up here to represent Bobby so well. It hits one in the heart.
Will,
I hereby title your short story:
"Untold Stories of the Real America".
I look forward to more of these.
Will, in my career, I worked in the lab of a major medical center in Chicago. As I ran hundreds of blood tests each day, I'd look at the diagnoses that the ER entered in the computer. They sometimes put a direct quote of what the patient told them. A number of times I saw, "ran out of" or "can't afford" insulin. Who knows if these people had insurance, but I would see the astronomical glucose levels and figure that they weren't going home that day. The lack of affordable medicine lead to EXACTLY the type of situations you talked about! Which in the long run, increased costs for ALL of us.
I might also mention that diabetes often leads to renal failure. Renal failure leads to dialysis---I believe (someone help me here?) that is one of the biggest expenses to Medicare/Medicaid. Also, big business, as John Oliver had a segment a few years back about the dialysis industry which was eye opening.
A former co-worker of mine was borderline diabetic for most of his career. He retired from the SO and went to work for one of the casinos managing their security team. He ended up having to retire from that when he (due to diabetic neuropathy) could no longer walk. His ultimate "last walk" went from digital amputation on one foot, followed in short order by amputation below, then above the knee, then a double amputation above the knee, and a very difficult recovery due to both renal and heart issues and ultimately resulted in his death from a heart attack at age 60. He could never afford the treatments he was offered as the more "preventative" ones were not covered by insurance.
And generally dialysis, yes, for renal failure, is poorly tolerated by diabetic individuals, which makes prevention by proper early treatment true life extension, and it's far less expensive than the treatments needed for all the complications detailed in your and Wil's notes. But if companies only see their bottom line and ignore everything else, and if half crazed lunatics in our House of Representatives only see political advantage, things would never change. We must stay woke. For woke means awakened to injustice.
Not only does long-standing, poorly controlled diabetes cause renal failure, it puts you at high risk for infection, metabolic syndrome (heart disease/stroke/diabetes), heart failure (CV disease), retinopathy (vision damage), puts you at higher risk for developing Alzheimer's disease, foot complications due to neuropathy as stated below and depression! I am a nurse practitioner who works on a critical care unit and see the devastating effects of on a daily basis. We need physicians, physician assistants and nurse practitioners, who work in primary care to be trained in 'lifestyle medicine' to educate these sick folks about the 6 domains (see below) to healthier living in order to reverse or at least tame this disease, to use health coaches
(make sure insurance companies cover coaching) and YES, provide insulin at little to no cost! We must address this problem holistically (whole food plant-based diet, physical activity, restorative sleep, avoiding risky substances and promoting positive social connections.
Don't know where you are but your nursing philosophy is spot on. It's why I spoke to a large conference of NP's about 25 years ago and told them that I believed, as a primary care internist, that eventually there would be few primary care docs and most primary care would be done by nurse practitioners. Of course, I had special education as I was and still am married to a now retired ARNP.
Thank you for dedicating your career to primary care, we need more of you! My dear friend is also a primary care internist in rural PA (my home state) and he would agree with you. I became a member of the American College of Lifestyle Medicine (ACLM) and got certified in Lifestyle Medicine as a Health Coach during the pandemic. I have lectured about Lifestyle Medicine and the Blue Zones and it's positive affect on health and well being. The ACLM is an ever-growing society of health professionals on a mission to reverse chronic disease. I am currently working as an ICU NP in San Francisco but will be launching a LM course that specifically focuses on women's health (perimenopause and menopause). Lifestyle Medicine is evidence-based and research shows this is the future of healthcare! I highly recommend checking their website out, lots of good resources to point friends and family to that need help getting healthier!
More power to you. Your experiences doing that would be of interest to a journal like Menopause, I bet, in which Ellen Mitchell and Nancy Woods, U of Washington, published many things about the menopausal transition which they studied for about 25 years. Stuff that women really want to know about how long the transition to FMP will last and what symptoms tend to be exaggerated or changed by the transition. Somehow, we have all made the transition to retirement together, but it was a great fun ride!
Thank you for the reference to the Menopause journal, I will definitely look into that! Enjoy your retirement, I am getting close!
Please add education in every school on Adverse Childhood Events.
https://www.cdc.gov/violenceprevention/aces/fastfact.html
Once upon a time there were nutrition courses, obligatory in public schools. Does anyone remember “the basic seven”? Nutrition studies have advanced since then, but the rash of diabetes is a tribute to corporate America’s pushing sugar: colas, sweet snacks. At a recent check-up I was twice asked if I have diabetes. It’s expected of people of “a certain age.” It’s time for really thorough “health” courses in public schools, particularly before Florida can take over truth.
We are a nation of drugs over exercise. It may well be our undoing. Once public schools had vigorous sports programs for everyone (how well I remember being the last chosen for a side playing softball - astigmatic, I couldn’t catch or hit a ball), not just the “athletes.” What happened?
There has been a suggestion(out "there") that a moratorium on law suits be provided for dieticians and the medical community in regard to current protocols for the treatment of T2d, type 2 diabetes. There is a huge online community of motivated diabetics. Over the years, the medical community has agreed to a pharmaceutical answer to all of T2d. There is evidence the SAD(Standard American Diet) promotes metabolic syndrome. There are alternatives. Capitalism shows us it is not the economic vehicle to provide community health and wellness. ...plenty of stuff, yes. Be safe. Be well.
Agreed. It is expensive to eat healthy. In the long term though it is cheaper if you can avoid the health problems that co m e from the SAD.
Think of the food deserts and people buying good at dollar stores. I sometimes watch a YouTube channel where they do "southern" cooking. She has done a few shows where she buys all the ingredients at one of them. I was horrified at the fat/sodium laden canned junk she threw together, but I realized that is all many of her viewers can afford. Very sad.
Will, thank you for such a clear and concise explanation of what happens when we put profit over people. I will never understand how anyone can accept that medical care should be profit based. It’s just so wrong!
I think President Biden should bring back the weekly fireside chat. The first thing he should do is read Will’s post to the nation.
He'd never get through it without crying. And that's ok too,
Now there is an idea. I wonder what form it would take - a substack? A prime time TV half hour? The wingers would loooove that. And demand equal time to rebut.
Hmmm...well, in answer to those 'wingers' I might suggest a variation of Empty's staffer's vulgarly rude answer to media questions, "Fk off!"...
Somehow I doubt they'd enjoy hearing it nearly as much they seem to enjoy saying it to others.
The translation is something like “Who do you think you are, expecting us to respect facts? People believe us more than anything you can ‘prove’ with facts.”
They are Believing !! UNTO DEATH !!
Will, wow.
You describe a series of situations that collide to cause a mans life to collapse. Yet, he endured.
I am so moved by this story of Uncle Bobby and by your writing skill.
Some of those events were avoidable, preventable situations. Some were just the luck of the draw. I suspect most of us have family members who were victims of ignorance and neglect. Or just plain suffered the assault of illness after illness.
You write with such compassion and literacy. You honor the unfortunate. You are a talent to be reckoned with. You have a powerful gift. More please, as you please.
I second that!
💯💯💯
I've not yet read the comments here yet (I'm imagining there's one or two). Your story of your Uncle is one similar to what I saw a number of times in my career where, for want of adequate medical attention, people die (keeping in mind that my introduction to them comes from having to do a death investigation when they die while "not under the care and treatment of a physician."
I am watching a childhood friend enter Hospice care this week at the age of 60 due to lung cancer that was undiagnosed (because no insurance, and made too much money as a pizza delivery driver/gas pump jockey to qualify for the Oregon Health Plan) until his lungs were full of tumors.
Health care is not something you earn, or deserve to have. Everyone should have access.
Will~this is one of the most beautiful, illuminating, and poetic pieces of writing I have ever seen that bring the systemic failings of our cruel profit-over-people-at-all-costs society. You brought Uncle Bobby to life in a powerful way that everyone can see, feel, hear, mourn, and celebrate. You have a real gift. I'm not sure what you should do with it, but these kind of takes on any number of lives that have been sacrificed in the name of extreme greed are just what we need to turn the tide by open more eyes among those who vote against their interests, because I am sure they have experienced limitations and suffering in their own lives at the hands of the super rich + powerful.
👍🏼👍🏼👍🏼👍🏼👏🏼👏🏼👏🏼
Thanks again Will. I lost both my brother and sister-in-law to diabetes. Your story should be before Congress.
My sister lost her husband to diabetes.
Thank you Will. What informs you informs us and breaks our hearts.
OMG Will 😳 I hope that you publish your writing. You have an amazing ability in seeing and then communicating what you see. As a healthcare provider I am too familiar with your Uncle Bobby. How heartbreaking to endure an entire childhood of being deaf and not having that recognized by another being. Thank you for writing and sharing. ❤️🤗🙏
Will, your story of Bobby should be published widely and read widely. Then people could grasp how in America so many end up not being able to be the productive citizens they wish they could be. Instead they end up homeless, addicted or, as with Bobby, needing nursing home care when that all could have been avoided with better healthcare and a better educational system (that would have detected Bobby’s hearing problem). Thank you.
Your message made me cry. Tell Uncle Bobby that he has another girlfriend.
Such a moving story!!!!
Thank you Will for your wonderfully well-written witness to the struggle some folks had before dyslexia, learning disabilities, auditory processing disabilities and so many, many other bars to learning and education were recognized. Your Uncle is a true hero.
Wow! Thank you. One of the most powerful comments I have ever read.