I had tabled this particular blogpost because I felt it wasn't quite complete enough to tackle the controversy that I'm trying to expose. But as this blogs is merely a platform for an exercise in writing, I thought I'd post it in hopes for a lively discussion or searing critiques.
I’ve always loved a good story, particularly when the
subject matter revolves around my favorite celebrity—me. To start with, I realize my fortune; I don’t
have any serious medical conditions and I have health insurance. But sometimes,
I want sympathy, I want shock value, and saying you’ve got a sore back when you
just finished 5 rounds of disco-bowl doesn’t usually make friends and family
come running with a heating pad, foot rubs, and chicken noodle soup. So imagine
my incredulity when I tested positive for TB.
This Christmas, when I was in town, I visited my
pediatrician, whom I still visit occasionally for inexplicable reasons (mostly
because he wears a teddy bear bow-tie) due to a persistent cough and cold. My
mother strongly suggested that I get a TB skin test as well, in the same way
that she strongly suggested my sophomore year that I wear a helmet and hockey
pads while riding in the car with my girlfriends. That being said, I brushed
her off initially, but then, on a whim, decided to request it anyways.
Three days later, I came back in with an angry, red lump
underneath the skin of my forearm. It was clear. I was positive for the TB
bacteria. He called the public health department and ordered a blood test and a
chest X-ray, looking wide-eyed. As one of the only positive results in his
three decades of practice, I’m pretty sure my case was an exciting break from
his routine of baby hernias and snotty noses. After all, most pediatric
patients don’t run in high risk circles. Despite my questionable choices in
friends, migrant laborers and Russian prison inmates have unfortunately
heretofore not been a part of my immediate social network.
But I have sat on a bus so crowded that people clung to the
sides, and children laid over rows of seats like plywood. I suppose in that
circumstance, an uncovered cough could be problematic. As my skin reaction
continued to swell, I thought about all the famous noteworthies who succumbed
to TB. Emily Bronte, King Tut, Nicole Kidman’s character from Moulin Rouge, and
Doc Holliday, the famous gunslinger from OK Corral. A sanitarium would be the
perfect setting for a Gothic romance novel, I fantasized! They called it
consumption at the time, which sounds a lot… wetter.
My X-ray, sputum test, and blood work all came back
negative. I have the TB bacteria inside of me, but no active infection. I AM
NOT CONTAGIOUS.
But, as the reality and scope of the disease sank home, my nonchalance
over a potential 9 month round of antibiotics sickened me. I was ashamed. I
was treating a potential TB infection as a joke, a ploy for attention and some well-placed
references to Florence Nightingale.
But it’s not. It’s not a joke. It was only a joke to me
because I’m a lucky one. Put simply, I’m healthy, I’m young, I’m well-fed, I am
part of one of the most developed biomedical systems in the world. I’m rich,
comparatively. I have health insurance. I’m the neatly pieced and presented Exhibit
A of Market-based Medicine’s display at the science fair. I have no reason to
be scared.
It’s a matter of access, haves and have nots. Consumption,
as it was known in the olden days, did not discriminate back then. Egyptian
mummies are buried with ancient curses and some bling, but their skeletons
spell TB. Emily Bronte, a high-born
Victorian (although perhaps constitutionally delicate, as she would, no doubt
want us to imagine her) died of it.
So where are the posh patients now? All I see are poor
patients. Because in 1,323 B.C. or in 1848 A.D. water was dirty, travel was
hard, and black, graveyard themed 40th birthday parties were swiftly
followed by an actual funeral. Doctors were quacks and antibiotics a thing of
the future. Modern medicine hadn’t made its grand debut, with scrub-clad high kicks
and latex-gloved jazz hands, a show performed only for those who can pay the
price of admission.
But now, the 1.3 million people who die each year are
concentrated in the poorest countries in the world, where all those hardships
of the past are present realities—Nepal, Haiti, Malawi house the
burden of disease. Treatable diseases, such as TB, HIV, and malaria, doggedly
follow the poor, and if they don’t run fast enough, will snatch them by the
ankle and bear them to the ground. For
many, TB is a death-sentence, or at least, another giant setback for those
already fighting the long defeat of poverty and malnutrition.
So tell me, in a world where Twitter can start a revolution,
a man can play putt-putt on the moon, you can take a satellite photo of your
own garage, and medicine can reattach limbs, why can’t we prevent poor people
from diseases we’ve had cures for since before
that inaugural lunar golf game? Does this showcase the progress of humankind? I
think not.
What it shows, in stark, dark relief, is that we haven’t
gotten our priorities straight. It can’t be scientifically impossible to ensure
that neither rich nor poor die from these diseases, we just… can’t be bothered
with it. The rich aren't dying from it, so why are the poor? We must ask ourselves this question, and not be afraid to stare at the ugliness of the answer.
But I’m lucky. I can take the possibility of a disease that
kills 1.3 million people each year as a God-given gag gift. A trivial anecdote
to pull out at during that summer camp ice-breaker.
There, my friends, penned into every syllable of this text,
is packaged privilege.
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