NOTE: My statements are not necessarily my opinions. I often post point-counterpoint essays in which I strongly take one side of an issue and later counter that with antithetical views. This intellectual exercise helps me see the merit in opposing opinions and augments my creativity.

Giffords receiving special treatment

“Some animals are more equal than others.”
— George Orwell in Animal Farm

Marian Wang reported that Rep. Gabrielle “Gabby” Giffords may receive special treatment that is denied to U.S. troops injured in combat. According to one of my Facebook friends, Giffords already has received special treatment.

This friend did not want me to name her (I'll call her Jan) or her friend (I'll call him Ted) who works for a medical device company that produces a special scanner put in Gifford's room for her exclusive use. This angered Jan because giving Giffords sole use of that device meant that it was taken away from other patients who could have benefited from it—thus being yet another glaring example of preferential treatment for the elite.

Jan feared that Ted would be fired if I named him or the device. I assume he is the sole rep to that hospital for that scanner, so it would be easy to put 2 and 2 together to figure out who was spilling the beans about the special treatment given to Giffords.

I responded to Jan's private Facebook message by asking her if I could quote her eloquent statement of why special treatment is wrong. She replied by asking me what I would say. I pondered that, questioning whether I wanted to release the information. While special treatment cannot be justified, it obviously wasn't Giffords asking for it; it was the hospital (or people working there) taking from others to give more to her. I didn't want people to blame Gabby for that. My heart goes out to her and others injured and killed by the madman Jared Loughner.

As I mulled over whether I wanted to write about this topic, I logged on to Facebook and found that I had been permanently banned with no way to appeal that decision. A coincidence? Probably, but deleting my account to keep me from getting more info about this special treatment is one of the few plausible explanations of why they booted me off that site. In another article, I discussed my account deletion, which left me and my friends mystified about why they axed me.

As an ER doctor, I can tell you that special treatment began long before Obama came to power. Jan told me about Gifford's special treatment and asked if that seemed right. I replied:

That is definitely NOT right, but it is all too typical. When I treated various big shots in the ER, a hospital administrator would often arrive even BEFORE the patient did and then hover around that person's chart. If anything needed to be done, the head nurse or whomever would do it: run the blood/urine to the lab, put the results in my hands seconds after they were available, fetch x-rays, kick other patients out of their rooms to make room for the big shot, etc. As someone who believes in treating all people equally, this special treatment made me sick. When a big shot did something illegal, it was hilariously maddening to see how the hospital administrator went overboard trying to keep that a secret.

The VIP syndrome

As I mentioned in one of my books and websites, special treatment is not always better treatment. In a brilliant article, Dr. Tim explained why the VIP Syndrome is usually a prescription for poor health.

The VIP syndrome exists when doctors don't treat special patients the same as everyone else. Those special patients may be politicians, Hollywood or TV stars, celebrities, professional athletes, dignitaries, software tycoons or other CEOs, miscellaneous bigwigs and big shots, models, drop-dead gorgeous women, or a member of the hospital Board of Directors.

One of the most notorious cases of the VIP syndrome gone awry is that of Jackie Gleason, the famous comedian. Because Gleason was a celebrity, his physician neglected to perform a rectal exam on him, thus missing a rectal tumor that might otherwise have been detected early enough to be cured. Instead, the cancer was discovered at an advanced stage and Gleason died.

Elvis Presley's penchant for drugs was fueled by a doctor who gave The King what he wanted. And then there is Michael Jackson, whose plastic surgeons evidently didn't know when to say no, and ultimately died because he was treated by a doctor willing to do more for The King of Pop than he would for an ordinary patient.

Thus, while Giffords will likely benefit from her special treatment, other VIPs pay a big price for not being treated equally.

Making the case for Giffords receiving special treatment

As a member of Congress, Giffords supported Obamacare: thousands of pages that dictate to patients and doctors what they can and cannot do, because government knows best, or it thinks it does.

What was given to Giffords wasn't Obamacare or any one-size-fits-all thing close to it, but Ruling Class medicine considerably better than anything you'd receive, unless you happen to be Bill Gates or similarly suffused with cash.

However, preferential treatment is sometimes a fact of life. In my years as an ER doctor, most of which was spent in Detroit and Flint, we would sometimes have so many patients and so little staff that it was necessary to choose who we'd work on. Who made that decision? A government or insurance company bureaucrat? No, it was me, with a license to practice medicine, and hence a license to decide who lives and who dies.

Citizens and state legislatures think they have better things to do with their money than to spend more of it on police and emergency services, all of which often leads to urban ERs being stacked to the rafters with patients. With ambulances sometimes depositing critically ill or injured patients every few seconds, and with no way to clone the nurses or myself, usually the only ER doctor on duty, I'd sometimes need to decide who we would treat first. Since prompt treatment is often crucial for survival, deciding who is treated first is tantamount to deciding who has a shot at more life, and who will soon have a toe tag and be resting on a cold slab in a morgue.

These snap decisions are usually based on medical estimations of the probability of saving life, with preference obviously being given to folks who seem to have a better chance of survival. However, all cases aren't clear-cut; doctors do not have crystal balls. In that case, who lives? Who dies?

Doctors aren't given ethical guidelines; we do what we think is best. Imagine I had three middle-aged patients with gunshot wounds, but one was a police officer. Who do you think I would work on first?

The officer, not because I was friends with some, but because the officer was (in every case I had) shot in the line of duty. We're all obviously people, but officers are also a symbolic embodiment of the good in society. As a member of society, I don't want scumbags desecrating officers and what they stand for, so I'd give preference to saving the lives of officers.

How does all of this pertain to the special treatment given to Giffords? While I generally oppose preferential treatment, justifying it is easier in cases in which the patient was shot because of what he or she represents, as opposed to average shootings. As a civilized society, I think most people would agree that Presidents, members of Congress, or police officers shot in the line of duty deserve the best care, because we all want to thwart the savages who use violence to get their way.

In a perfect world, emergency departments would never be so swamped that it was necessary to select who is treated first and hence who is more likely to survive, but voters elect politicians who have different ideas than I do about how our money is spent. You might wish they spent more on police and emergency services the minute you need them, but by then it is too late. In the years since I first expressed that sentiment, we've seen almost nothing but cutbacks.

“You get what you pay for” applies not just to the stuff you buy, but the services we support with our tax dollars.

The views expressed on this page may or may not reflect my current opinions, nor do they necessarily represent my past ones. After reading a slice of what I wrote in my various websites and books, you may conclude that I am a liberal Democrat or a conservative Republican. Wrong; there is a better alternative. Just as the primary benefit from debate classes results when students present and defend opinions contrary to their own, I use a similar strategy as a creative writing tool to expand my brainpower—and yours. Mystified? Stay tuned for an explanation. PS: The wheels in your head are already turning a bit faster, aren't they?

“The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function.”
F. Scott Fitzgerald

Reference: Imagining dialogue can boost critical thinking: Excerpt: “Examining an issue as a debate or dialogue between two sides helps people apply deeper, more sophisticated reasoning …”

Comments (2)

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Comment #200 by Anonymous
Contact the commenter via MySpamSponge: verywisewoman Contact this person via MySpamSponge
January 25 2012 11:01:41 AM

Another view

In response to the professor's comments, I agree with what was said. Another alternative outcome to consider for the audience: Consider if Congresswoman Giffords were instead named Terri Schiavo, and received the same treatment that Mrs. Schiavo received: A court order for death by withholding nourishment. Terri was brain damaged like the congresswoman was, but perhaps her injuries were more extensive and the medical treatment was less than what Gabby Giffords received. Gabby Giffords, immediately after her injury, was also in a coma-state, and could not tell people what she wanted. The outcome was quite different for each of these women. Could anybody see anyone wanting Congresswoman Giffords to get a similar treatment that Mrs. Schiavo received? No, people would be horrified if she did. But that's how people are. What's good for the goose is not also good for the gander.

Comment #197 by Anonymous
Contact the commenter via MySpamSponge: the_professor Contact this person via MySpamSponge
January 25 2012 10:31:05 AM

Giffords resignation

I watched with great interest the video that Congresswoman Giffords presented. She stated, "I will return and we will work together for Arizona and this great country..." Later I saw one of her fellow Congressmen stating how she would come back to serve later. After having seen many brain injured patients after their injury took place, and likewise seeing her speak, it made me wonder in what capacity that she could serve realistically? She was considered the state's congressional representative after she was injured, but was in a coma state for a length of time, and had and continues to have to re-learn basic skills. And don't forget that she received the best of care that most Americans even with health insurance would never receive--only because she was who she was. If you or I were in a similar situation, we would be out in the cold, jobless, living on a rehab unit--if we had insurance paying for it, and then perhaps homeless, due to not being able to pay our bills. We would not be having other people pay for us, nor would we be allowed to still be considered in our job--like she was until now, and get paid for doing nothing. Does any of this seem fair? Is it as in Orwell's Animal Farm in which some animals are more equal than others? If only the rest of us could get such treatment just for being who we are! In the real world, it is not like that, nor will it ever be, fair or not. It is just something to think about.

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