Health Care

Health Care Monologue

Ever since I opened this B&B, I’ve seen it all. There’s the tourists who want to touch the Bell. I warn them — it’s coated with wax so it won’t decay from the nitrates in the fertilizers in the grass nearby. They can’t really touch it -- their fingers can only touch the wax coating. But there’s an energy there and they can feel that. They go — some feel it and some don’t. They all love Ben Franklin’s sunrise chair in Independence Hall. And the silly symmetrical doors that don’t open in the old court room. The savvy ones go to see the Maxfield Parrish mosaic in the old Curtis publishing building and marvel at the glowing water lilies.

Some of them go to see Eastern State Penitentiary. That’s the first penitentiary in the world — penitentiary — not prison. Silly Quakers. To them, isolation, fresh hot meals, a skylight and a Bible — that’s heaven. But people don’t become criminals because they like solitude and meditation. That penitentiary got indoor plumbing before city hall, so the criminals wouldn’t have to leave their cells for anything. Think of all that time saved for meditation. But the criminals didn’t care. They got that place closed down for cruel and unusual punishment. You can’t help folks who don’t want to be helped. Somebody asked Willy Sutton, the bank robber, "Why do you rob banks?" He answered, "Because that’s where the money is." How could a guy like that enjoy meditating on the Bible?

But lately, I’ve been getting more visitors from the HMO’s than from the tourist agencies. It’s cheaper for an HMO to contract with me than with the hotels, and I’ll even throw in meals and transportation to the hospitals — Philly has lots of hospitals. I drive them to surgeries by top doctors. I drive them to get radiation and chemotherapies. Those hospitals are swank places. I usually get a cup of coffee free while I wait for them. And they’re so brave. Especially the children. But maybe they just don’t know better. Maybe when you’re young, death doesn’t scare you as much.

I’ve been seeing the HMO’s cheap out more and more. Those cups of coffee grow smaller and smaller. The type on the forms gets smaller and smaller, too. I’ve had guests who came away with dime-store glasses instead of prescription just because it’s cheaper, and I’ve heard the docs say, "It’s just as good" in a tone of voice that shows they know better.

I thought I’d seen it all. Then I got a call from an HMO asking me to take my next guest to 5^th and Girard. "That’s a bad neighborhood," I told them. "What kind of doctor works in a neighborhood like that?"

Oh, I know. People in bad neighborhoods get sick too. Probably even more than people in good ones for that matter, with all the drug addiction and malnutrition and such like. But if you’ve got the money to join an HMO, you deserve to go to doctors in nice neighborhoods — if you ask me... "Is this guy a charity case?" I asked. I was going to give them what for if he was — about how charity cases deserve just as good care as anyone else. They said, "No, he’s a regular member — paid up through his job." So, I couldn’t give them my righteous lecture. After I hung up, I wanted to lecture them anyway "No member, charity or regular, should have to go to a doctor in a bad neighborhood." I wasn’t even sure I wanted to drive my car into that neighborhood. My car is only 6 years old.

What kind of specialist (the HMO only brings folks into Philly to see specialists) would work in that neighborhood? I picked Baldwin up at the train station. He was in his 40's but looked older. He was bald from the chemo, scarred from surgery on his skull, and he looked nearly dead. He had a brain tumor. They got about half of it with the surgery. But the rest of it kept growing back. You could tell from his face — he was in terrible pain and he walked like he was dizzy from spinning in circles.

"What kind of specialist are you seeing tomorrow?" I asked. He didn’t know. "I just hope it’s a good one," he said. "I woke up this morning and the pain was worse. None of the pain pills could stop it, so I called. And they got me this appointment tomorrow. I didn’t even ask who it’s with. They just said to be there at 9:30 sharp."

I could tell he was scared. Pain will do that. Pain and fear of dying. And he’d been through so much. Surgery. Chemo. Radiation. And none of it had worked. But he wasn’t ready to quit trying. You can tell when they’ve given up. I wonder why they go through the pain of treatment when they don’t intend to get well...

I took Baldwin home. All the way from the train station he complained. The HMO hadn’t diagnosed his cancer soon enough. They’d used cheap drugs on him. The doses had been too low. They wouldn’t prescribe enough pain pills. They couldn’t seem to do anything right in his opinion. That was part of how I knew he wanted to live. People who have decided to die don’t complain like that. And usually they bring a relative along — the relative who wants them to live — to do the talking for them. They don’t want the procedure. The relative does. And they’re just going through with it to prove to the relative that nothing will save them — not even the best medicine. And it’s true — once they’ve decided to die, they are in charge — not the doctors.

Okay, I read about one teenaged boy who had AIDS and he was ready to go. The doctors told him there was nothing they could do for him except the pain pills. His mom looked him right in the eye and said, "I’m ordering you. Get well. Live a long life. And keep me company. I want you there at my funeral." And he got well. Now there’s an obedient son if I ever saw one. He tested negative for AIDS the next time he came to town for his checkup. The docs don’t know what to make of it, so they call it remission. I call it a miracle -- if it happened -- you never know when you don’t see it for yourself -- just read about it.

Anyway, if Balwin had a mother, she wasn’t the bossy type, or he wasn’t the obedient type. He was the complainer type.

The next morning, I drove him to 5^th and Girard. Right in the middle of that bad neighborhood is a gorgeous church. The sign says Shrine of Saint John Neumann. I’d never heard of him. He’s not famous like Saint Peter at the pearly gates. ... You drive by all these houses that need painting and have trash on their walks and there’s this sparkling building with a glorious steeple. But no doctors offices. I told Baldwin, "I’ve heard of churches going broke and selling their buildings. Maybe your doctors are in there."

We parked and went in. It was still a functioning church, with smoky incense and everything. It made me cough when I took a deep breath. On center stage was a dead guy in a glass case. He was wearing some kind of mask — I don’t care how long a man’s been dead, his face never looks all grainy like that. I’ve seen the incorrupt body of St. Bernadette on the Internet. She’s the stiff at Lourdes who gets credit for all the healing miracles there. She’s still pink and fresh looking after being dead over 100 years. I read that a doctor examined her and her liver is still fresh and soft and wet — suitable for transplant — but the church won’t let anybody have it. Not that I’ve had any guests who need liver transplants.

Everything was all quiet — it was a church. But Baldwin continued complaining, his voice only slightly hushed. "Where’s the doctor? Where’s the receptionist? Are you sure this is the right place? I knew that HMO was doing everything to save money, but faith healing? Who do they think they’re kidding?"

A nicely dressed woman about the same age as Baldwin came up to us. I was sure she was going to shush him. She tapped him on the shoulder. He turned toward her and said loudly, "Who’s in charge here?" The woman answered him sweetly, "You are."

That shut him up. The woman led us to a museum where we saw pictures of the dead guy being dug out of his crypt after being declared a saint. The woman said that’s standard procedure with saints — you dig them up and put their remains on display. Gross if you ask me, but it’s not my religion. The corpse still had hair and skin, but he’s no beauty like Bernadette. You could see why he needed that mask. The woman explained that the dead guy, John Neumann used to be Bishop of Philadelphia, but after three of his healings were documented by the Catholic Church, he’s a canonized saint.

The woman offered us coffee. She brought us big Styrofoam cups like the hospitals used to give.

She admitted Neumann’s body isn’t perfect like Bernadette’s. That’s why he’s got the wax mask, but you can still feel the energy coming from him. Bernadette, after all, saw Mary 18 times. Compared to that Neumann had an ordinary life. He was born in Bohemia, spoke 14 languages, got interested in the church because him mother gave him a penny every time he went. He worked long hours — like a Wall Street tycoon. He started the US system of Catholic schools. He learned Irish so he could hear confessions from Irish immigrants who hadn’t learned English. He was one busy fellow. But when a priest does it, you don’t call him a workaholic. You call him dedicated and selfless.

We know it’s the same thing — they’re both doing what they think is right and destroying their health in the process. Neumann died at 48. But now, after he’s dead, he’s a healer. The woman said they get calls almost daily about healings thanks to St. John Neumann. She thinks Philadelphia is on the verge of becoming the next Lourdes. I gave her my card. Maybe she’ll send me some B&B guests — folks who come to Philly to see the saint. Lourdes is sure popular for tourists — why not Philly?

Baldwin interrupted the spiel. "I’m not religious. What’s in it for me?"

The woman continued — that calm voice of hers was starting to irritate me. "St. John Neumann has brought many back to the church. I think that’s a greater miracle than healing the body. That’s healing the soul."

Baldwin grabbed his head like it really throbbed. The woman and I helped him lie down on an old marble stoop that lay in a corner of the museum. The woman said, "John Neumann died on this step. When they tore down the building, we got the step for the museum."

Suddenly, Baldwin sat up. His eyes were clear. His voice clear and no longer complaining. "I come here to be healed and you put me on a doorstep to die? Well it didn’t work. I’m not dying. Tell that to the HMO!" Then he grabbed my hand and led me out. His gait was steady. On the way, he put some bills in the donation box.

My car was still there. I drove Baldwin back to my home. He didn’t say a word the whole ride. When he got in the door, he went straight to the phone, and dialed the HMO. He pushed a few buttons, but he didn’t talk. Then he called for a cab to take him to the train station, like he couldn’t get out of Philadelphia fast enough.

Now I’ll never know if he was cured. But maybe surgery, radiation and chemo have died with the 20^th century. Maybe HMO’s will make shrines their first choice of treatment. And it won’t cost them a penny. Philadelphia — the next Lourdes — I like the sound of that.