BAINBRIDGE ISLAND, Wash. — I OPENED the curtain and found my patient stretched out flat on the recliner, one arm thrown across his eyes. Worried, I reached for his pulse, but then I heard a soft snore. He was sound asleep, before I’d given him any anesthesia. I felt far less relaxed than he seemed to about his upcoming surgery.
Thanks to the Affordable Care Act, this man had health insurance for the first time in over a decade, and his diabetes, hypertension, clogged blood vessels and early emphysema — the death threats silently stalking him for years — had finally been identified and treatment had been started. Already an ophthalmologist had discovered that he would most likely go blind without surgery, and every day he delayed put his vision at risk.
But you don’t undo 10 years of neglected health in six months. I needed time to untangle his newly accumulated tests and labs, talk to him about his symptoms, and make my best guess about whether he was stable enough for surgery. When I finished examining him, we were 20 minutes behind schedule, with a long row of waiting patients.
I recently treated a man with a painful hernia who had passed out two weeks earlier because his blood sugar was seven times the normal level, and an elderly man whose untreated thyroid disease made his eyes bulge and skew — a problem I last saw when I volunteered at a charity clinic in rural Thailand. Every month, more of my patients are new to the medical system because, at last, they have health insurance and can see a doctor about long-neglected symptoms.
[For more of this story, written by Carol W. Cassella, go to http://www.nytimes.com/2015/04...nd-doctors-sane.html]
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