Once Upon A Time

ONCE UPON A TIME, in the not-so-distant past, medical care was priceless and those who practiced it were sought out, respected and appreciated. Money value was there for living purposes, but not a primary reason for work.

Perhaps the results — even miracles — became too common. Perhaps the practitioners became greedy. Perhaps outsiders saw opportunities for taking advantage.

Whatever — medical care became a commodity, to be bought and sold, to be investigated, to be awarded to the best promises, the lowest costs, the most for the money.

And why?

During that "once upon a time" a physician worked to better lives, even to save some. The physician was thanked, bills paid, and small gifts offered. There were platters of fruit, a box of apples, one of asparagus, plants for a garden, and on and on.

These gifts were never viewed with suspicion. They were happily given and gratefully received. They made the practice of medicine a satisfying, fun endeavor.

If a bad result occurred, there was discussion and explanation. Not every baby born could be expected to be perfect. The doctor did the best that could be done and limitations of skill were recognized. Those practitioners who were not qualified to practice good medicine faded away under patient dissatisfaction.

As in every profession and work endeavor, errors are inevitable and must be corrected. Unfortunately, a critical culture grew with the ideal of righting wrongs perfectly without question.

Was it to build a better world or to make money from unfortunate circumstances? Suddenly, it seemed, there was a loss of responsibility. Someone, or something somewhere must be at fault. Perfection was achievable, wasn't it, if a cause could be proposed?

Civilized life is within reach only by following the rule of law. Correct?

What better way, then, to judge responsibility than through the courts? With money. The necessary corrections could be settled once and for all.

So easy. Why not more? And more?

What followed was insurance, the means for protecting the defense, and doctors began to eye their patients with suspicion. Rapport was cautious and a reserve built up.

Mused the woman across the desk, "Hmm, I come to this doc for care, for a healthy baby. If I'm not satisfied, if anything goes wrong, I'll sue him."

And the doctor thought to himself, "What do I have here? Will she follow my orders? Will she trust me? Will we get along?"

Doctor and patient became adversaries, wary.

Pregnancies and deliveries are full of obscure puzzles, unexpected occurrences in growth, development, and labor, unforeseen incidents.

The charity that once was present between patient and doctor has almost disappeared and the experience that was at one time shared between the two has become an impersonal game.

There is no winner. In the end, a gift would be viewed with skepticism - but it would not be offered in the first place.

ebr8809@aol.com