Monday, March 9, 2009

The More Things Change

So I recently read the novel "Middlemarch" by George Eliot. (actually I listened to it, a free recording from which is a fantastic resource for audiobooks that are in the public domain). Among many other things, there was a doctor in Middlemarch, Tertius Lydgate, that came into town with lots of new ideas about how things should be done. He felt that if doctors directly dispensed medications and charged for them, they had a conflict of interest and would, perhaps, overtreat. He volunteered in the a new "fever" hospital, designed in case the cholera spread to middlemarch. He spent time knowing his patients, analysing thier conditions, and recommending approprate pharmaceutical and non pharmaceutical interventions. Some patients liked him, some didn't. Sometimes they got better, sometimes they didn't. But one thing was universally true. The stodgy old doctors in town hated Lydgate.
*small spoiler* In the end, Lydgates wife couldn't handle his dedication to his profession, he couldn't make enough money to pay his debts, he left town and went to the city, and he died young. His spoiled brat of a wife went on to marry a rich "more traditional" old doctor.

I guess I was fairly taken by the fact that even in 1870 the economics and politics of medicine were deeply enmeshed with the "medical" part of medicine. (and of course, there was no health insurance or government funding then, the hospital for the poor was financed by rich benifactors). The citizens of Middlemarch (perhaps spurred on by the old doctors) after seeing the financial and political trouble Lydgate had, began to question his medical judgement.

So I ponder the current climate. I wonder if I should make less waves. (This is purely hypothetical, because making waves is so a part of my nature that I doubt I could stop if I tried.)
I read the descriptions of the old docs in Middlemarch and had no choice but to envision the graying, balding, slightly overweight men I see at hospital and board meetings. (If you're someone I go to meetings with and reading this, I likely don't mean you). I feel as though I jump up and down and wave my arms and scream "THERE HAS TO BE ANOTHER WAY! LOOK!! TRY SOMETHING DIFFERENT!!!" (although I don't think I actually do jump up, I'm pretty sure I raise my voice.) And they look at me and shake their heads and mutter "poor misguided Tac. She had so much promise." If they see me at all. How long before they run me out of town, and I die young, penniless, and unloved.

Then I realize that I am none of those things. I am slowly chipping away at my debt. I have good community support, and home support like none could expect. And, alas, I am no longer young. So maybe we have learned something in 139 years. Or maybe things will always be in a constant state of change...

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