Only Anecdotal

Being invited into a person’s home is an enormous privilege. Most people I see have recently been quite ill, or more often have chronic ailments that have put them into the situation of wanting to find out how they can stay in their homes, so a good number of them also spend some time apologizing in advance for the mess.

With all the technology that is available now, I can see that it would be far easier and faster for me to teleconference. It would save my driving time–and mileage costs–and the consumer would never have to worry about the mess in the house. We could talk, and I could look things up immediately in my office, much more easily than is often the case when I go out. And I could see more people. I could teleconference with hospital staff, and even meet with patients if portable devices were available there.

But the problem, you see, is that you cannot drink tea by teleconference.

You cannot shake hands, or smell the lemon–or gosh, the kitty litter. You cannot sit beside a person in a hospital for a few minutes, and you cannot run into a colleague in the hall.

I see a tremendous solution in this technology to the difficulty so many people have just in securing transportation to medical appointments–or at least some of them. It could open so many doors, decrease the number of times a visiting nurse has to go out to a home…

But I think of the woman I saw two weeks ago. She had just made coffee when I arrived, in spite of the infection that was developing right then, post-surgery, in spite of the fact that a day later she would be in the hospital once more. She told me about her pets, her life before moving to this country, the flowers she had long ago planted in the backyard–and I could see the hostas from the kitchen table.

She was alone in the house, and spent many days without seeing another person, she told me.

Another couple showed me the schedule of their appointments to a variety of doctors and clinics, the pharmacist. It seemed to be the only time they left their house, and their lives revolved around it.

“Being young isn’t for sissies,” a consumer once told me. He confessed later that he had stolen the line from Bette Davis. But he said it was true–I was trying to figure out how he could get some help while his wife recovered from flu. He had just come home from the hospital after a bout of it himself, and they went round and round with that, then pneumonia from hospital to home, or short-term rehab, then home.. and the insurance?

I see people all the time whose lives are focused on their healthcare. It is hard to imagine them not going out to see their doctors this way, not to depend on the daily visits from a nurse. It would be so nice if the visits were not focused on this sort of monitoring, but if the people were healthy–even with disabilities–these visits would stop. It is a huge shock to lose a friendly face who comes every so often, or even just once in a while. It is hard to give up leaving home for a few hours, even to go through another blood test, or lecture. There is always the stop for lunch, the chat with the woman with the baby in the waiting room.

People with chronic illnesses and disabilities are often so isolated, and so easily defined not by their unique qualities as human beings, but by what is perceived by most of us as abnormal: their illness, their disability. I wonder, if we remove the barriers to easy treatment with telemonitoring, with other technologies… can we also devote so much time and expense into removing the barriers to bringing people back to the community? Can we devote the savings to better transportation for non-medical needs? Can we build better communities in general, more accessible housing, more available housing? Can we figure out a way to make it more possible for people to use their time in ways that they choose?

Can we fill the gap that we will create by removing so many in-home visits for providers, so many office visits for consumers?