Why is one of my loved ones from the streets of Kensington having to go back to a crisis center for the third consecutive day so as to MAYBE be admitted to a detox unit that accepts Medicaid patients?

 Answer:

The Hippocratic Oath as sworn by the Nursing and Medical personnel who work in these crisis centers is NOT Being honored.

Discussion:

A patient of any other medical condition (out of control diabetes as one among many examples) would NEVER be required to go to their local emergency room three consecutive days so as to be treated and bring their Diabetes back in control.  Why are patients of Substance Use Disorder treated in such a substandard way?

During these intervals of leaving and then returning to the crisis center, if they can bring themselves to return, patients of Substance Use Disorder will continue to take their medicine and some will die. 

Is this the intent of the nursing and medical personnel in these crisis centers?

As I write this, one of my Medicaid reliant loved ones from the streets sits in a crisis center awaiting a bed for detox.

Will this person be treated with the dignity and respect offered to a patient in any of our Philadelphia area emergency rooms with (for one among many examples) out of control diabetes? ...their symptoms managed and comfort care provided while awaiting in-patient services or will they be treated as described by another of my Medicaid reliant loved ones:

**********

I have personally been to several crisis centers in Philadelphia. A few months ago, I went to one and sat for about 13 hours in a waiting room so very sick shaking and sweating and vomiting everywhere and all for them to come out and tell me that there were no beds and said to come back the next day to try again.

Mind you I was very very sick and when they told me that, I asked them what should I do as I was laying on their bathroom floor vomiting everywhere and it looked like someone had sprayed a hose on me because I was dripping wet. My clothes were soaked and I was flopping on the floor like a fish out of water.

The doctor said to me "I don't know what to do." She said she cannot give me anything because I am not admitted and there are no beds. So they asked me where would I like to go to because they will call a cab for me. As I was waiting for the cab, security and a nurse came outside to me and asked me what I was doing and I said "You told me you are calling a cab." The nurse said, "We did not call one and you have to get off of the property!"

Mind you I had no money and I was so sick so I ended up walking to the EL. The SEPTA personnel told me I cannot go through without money and I told them that I just came from the hospital. I showed them paperwork and they still said "No" so I ended up jumping the train and the SEPTA personnel hit the alarm!

So thank God the train came before any cops got there so I was fine. As I was on the train I dropped to the floor and had a seizure. When I woke up people were standing around me and they were waiting for the ambulance but I jumped up and said no and got back on the next train and got off at Somerset station and had to find a way to get well...

My experience that day with the crisis center made me so sick to my stomach thinking that I really wanted to get clean and I really wanted help and nobody helped.

**********

It is high time that Medicaid Reliant patients of Substance Use Disorder who are wanting detox be given the same dignified and prompt care that is automatically given to patients of any other medical condition.

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As I write this blog, an inspirational human being who is made in the image of God and who is worthy of dignity, honor, respect, and love lies in an Intensive Care Unit bed with a chest tube and multiple IVs

...so as to bring her back from the edge of a very thin hiking trail on a cliff that separates life from death that he's walked on as she[1] has tried to traverse over Medicaid Mountain.  

Too many medical and nursing professionals who have dedicated their careers to the ideals of Hypocrites have failed in their sworn privileges when this human being sought care in their required visit to a local crisis center.[2]  

• They failed to treat him with the dignity and respect that he deserves.  
• They failed to provide basic comfort care as she waited double digit hours for full[3] treatment as an inpatient.  
• They failed with their built-in procedure that any human being must wait double-digit hours for care that is (currently) only provided as an inpatient.

 

Here's how one person explained their experience when they tried to traverse Medicaid Mountain… 

I have personally been to several crisis centers in Philadelphia.  A few months ago, I went to one and sat for about 13 hours in a waiting room so very sick shaking and sweating and vomiting everywhere and all for them to come out and tell me that there were no beds and said to come back the next day to try again.   

Mind you I was very very sick and when they told me that, I asked them what should I do as I was laying on their bathroom floor vomiting everywhere and it looked like someone had sprayed a hose on me because I was dripping wet.  My clothes were soaked and I was flopping on the floor like a fish out of water.   

The doctor said to me "I don't know what to do."  She said she cannot give me anything because I am not admitted and there are no beds.  So they asked me where would I like to go to because they will call a cab for me.  As I was waiting for the cab, security and a nurse came outside to me and asked me what I was doing and I said "You told me you are calling a cab."  The nurse said, "We did not call one and you have to get off of the property!"  

Mind you I had no money and I was so sick so I ended up walking to the EL.  The SEPTA personnel told me I cannot go through without money and I told them that I just came from the hospital.  I showed them paperwork and they still said "No" so I ended up jumping the train and the SEPTA personnel hit the alarm!  

So thank God the train came before any cops got there so I was fine.  As I was on the train I dropped to the floor and had a seizure.  When I woke up people were standing around me and they were waiting for the ambulance but I jumped up and said no and got back on the next train and got off at Somerset station and had to find a way to get well... 

My experience that day with the crisis center made me so sick to my stomach thinking that I really wanted to get clean and I really wanted help and nobody helped. 

It is time to plow down Medicaid Mountain!

---

[1] (Note the deliberate mixing of the pronoun he/she.  This story is playing itself out multiple times and in multiple places as I write and as you read.)

[2] Medicaid reliant patients of Substance Use Disorder are required to go to a crisis center - a place where mental disorders are diagnosed - for clearance and as the first step in finding a bed for further treatment somewhere within the city.

[3] And proper treatment as outlined in their sworn Hippocratic Oath

Symptoms of Sickness

The symptoms of the medically recognized condition known as 'Substance Use Disorder' can be found here.

The symptoms of withdraw, commonly referred to on the street as 'dope sickness,' can be found here.

It is time for us to look at the symptoms of sickness that make health care provision to patients of Substance Use Disorder and who are reliant on Medicaid so incredibly week and unable to support its patients who are in desperate need and desire for care. 

There are no articles that I can find to share with you so here are two blogs from within my own series:

It would be far better to initiate treatment of the Medicaid reliant patient of Substance Use Disorder in the Crisis Center rather than make them wait for full admission to the detox facility.

A Tale of Addiction, One Set of Fraternal Twins And Two Sets of Simulated Hardwood Floors

In these links, you will find firsthand accounts of the symptoms of Medicaid healthcare provision sickness that is causing overdose death at a higher rate than the actual use of the drugs would cause in and of themselves.

It all boils down to money.  In round numbers, private insurance pays $1,000 per day to provide Substance Use Disorder detox and rehabilitation services in an inpatient facility.  Medicaid pays $200 for the same services.  

Close that gap.  

Find ways for Medicaid to properly fund and we will save lives.

My First ever Redundant and Repetitive Blog that Says the Same Thing In Different Ways... :)

This is the first time that I can recall when I used my occasional ministry email as my blog.  I'm repeating themes and topics in hopes that some readers will decide that this topic needs to be addressed.  

And so, without further delay,  Here's a link to my recent email that expands on recent blog posts.

If for any reason that link does not work, here it is in its raw detail:

https://myemail.constantcontact.com/-Your-Helpful-Neighbor--An-Update-on-Ministry-in-Kensington---where-life-is-real-and-love-and-care-for-each-individual-is-thorou.html?soid=1102708875927&aid=hhUcgSbB5O8

It would be far better to initiate treatment of the Medicaid reliant patient of Substance Use Disorder in the Crisis Center rather than make them wait for full admission to the detox facility.

The following is a firsthand account of a person I've known for a few years now as he tried to seek detox services while being reliant on Medicaid.

 

I have personally been to several crisis[1] centers in Philadelphia.  A few months ago, I went to one and sat for about 13 hours in a waiting room so very sick shaking and sweating and vomiting everywhere and all for them to come out and tell me that there were no beds and said to come back the next day to try again.  

 

Mind you I was very very sick and when they told me that, I asked them what should I do as I was laying on their bathroom floor vomiting everywhere and it looked like someone had sprayed a hose on me because I was dripping wet.  My clothes were soaked and I was flopping on the floor like a fish out of water.  

 

The doctor said to me "I don't know what to do."  She said she cannot give me anything because I am not admitted and there are no beds.[2]  So they asked me where would I like to go to because they will call a cab for me.  As I was waiting for the cab, security and a nurse came outside to me and asked me what I was doing and I said "You told me you are calling a cab."  The nurse said, "We did not call one and you have to get off of the property!" 

 

Mind you I had no money and I was so sick so I ended up walking to the EL.  The SEPTA personnel told me I cannot go through without money and I told them that I just came from the hospital.  I showed them paperwork and they still said "No" so I ended up jumping the train and the SEPTA personnel hit the alarm! 

 

So thank God the train came before any cops got there so I was fine.  As I was on the train I dropped to the floor and had a seizure.  When I woke up people were standing around me and they were waiting for the ambulance but I jumped up and said no and got back on the next train and got off at Somerset station and had to find a way to get well...[3] 

 

My experience that day with the crisis center made me so sick to my stomach thinking that I really wanted to get clean and I really wanted help and nobody helped.

 

---

[1] Medicaid reliant patients of Substance Use Disorder are required to go to a crisis center - a place where mental disorders are diagnosed - for clearance and as the first step in finding a bed for further treatment somewhere within the city.

 

[2] She said she cannot give me anything because I am not admitted and there are no beds…  The crisis center is the equivalent of an emergency room in a medical hospital.  Would the nurses or doctors of an emergency room tell a patient with severe life-threatening injury or illness that "We cannot treat you because you're not yet admitted to the hospital."?  No. Of course not!  That patient with the medical injury or illness is a patient of that medical emergency room and would be provided whatever medical intervention is needed until being transferred to an inpatient setting.  Why do we treat patients of Substance Use Disorder differently and in such a substandard way - a way that dishonors the sworn intentions of the Hippocratic Oath?

 

[3] … find a way to get well… Well…  From what?:  What does that really mean?  Here's an outline as provided in this linked article:

 

The Symptoms of Withdrawal

Symptoms of dope sickness – and their intensity – can vary by person, drug of choice, and the amount of drugs used on a regular basis. However, common signs of dope sickness include:

Nausea, vomiting, diarrhea and/or constipation

Loss of appetite/huge return of appetite

Hot and cold flashes

Muscle aches and spasms

Sensation of bugs crawling on or under skin

Hyper-awareness

Dry mouth

Headaches

Insomnia

Sweating

These physical effects are often accompanied by mental and emotional symptoms. Those who are dope sick may also experience:

Agitation

Anxiety

Paranoia

Frustration

Depression

Despondency

What does "Find a way…" really mean?  Imagine, not that you can actually fully understand but do your best to try…  Imagine being a woman in this situation.  You have no money for that five-dollar little blue paper-wrapped "cure" to your dope sickness.  You have no option but stand on a street corner doing all you can to hide the above symptoms when some random man pulls up next to you…

 

"One was an important lawyer who picked me up in his Cadillac, took me to a center city hotel, tied me to the bed, had his way with me, got dressed, untied me and left the room.  I had to use some of the money he gave me for public transit just to get back here to buy my medicine." 

 

It would be far better to initiate treatment of the Medicaid reliant patient of Substance Use Disorder 

in the Crisis Center 

rather than make them wait for full admission to the detox facility?

My experience that day with the crisis center made me so sick to my stomach thinking that I really wanted to get clean and I really wanted help and nobody helped.

Compare and contrast the Hippocratic Oath with the reality faced by men and women who are dealing with Substance Use Disorder, addicted, and reliant on Medicaid… 

Hippocratic Oath: Modern Version 

I swear to fulfill, to the best of my ability and judgment, this covenant: 

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. 

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism. 

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. 

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery. 

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God. 

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems if I am to care adequately for the sick. 

I will prevent disease whenever I can, for prevention is preferable to cure. 

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm. 

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help. 

—Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.

**********

And now read this, an all too common account of what a patient of Substance Use Disorder in the active grips of addition faces when that human being decides it's time to seek treatment… 

I have personally been to several crisis centers in Philadelphia.  A few months ago, I went to one and sat for about 13 hours in a waiting room so so sick shaking and sweating and vomiting everywhere and all for them to come out and tell me that there were no beds and said to come back the next day to try again.  

Mind you I was very very sick and when they told me that, I asked them what should I do as I was laying on their bathroom floor vomiting everywhere and it looked like someone had sprayed a hose on me because I was dripping wet.  My clothes were soaked and I was flopping on the floor like a fish out of water.  

The doctor said to me "I don't know what to do."  She said she cannot give me anything because I am not admitted and there are no beds.  So they asked me where would I like to go to because they will call a cab for me.  As I was waiting for the cab, security and a nurse came outside to me and asked me what I was doing and I said "You told me you are calling a cab."  The nurse said, "We did not call one and you have to get off of the property!" 

Mind you I had no money and I was so sick so I ended up walking to the EL.  The SEPTA personnel told me I cannot go through without money and I told them that I just came from the hospital.  I showed them paperwork and they still said "No" so I ended up jumping the train and the SEPTA personnel hit the alarm! 

So thank God the train came before any cops got there so I was fine.  As I was on the train I dropped to the floor and had a seizure.  When I woke up people were standing around me and they were waiting for the ambulance but I jumped up and said no and got back on the next train and got off at Somerset station and had to find a way to get well... 

My experience that day with the crisis center made me so sick to my stomach thinking that I really wanted to get clean and I really wanted help and nobody helped.

 **********

How was the Hippocratic Oath upheld and honored that day?…  

That day repeats itself multiple times each and every day and is doing so as you read this…

Too many people have died recently in this apartment building.

 "Too many people have died recently in this apartment building.  One was in the building for three days before they found their body."[1] 

Subsidized housing for people who are suffering homelessness can be a powerful first step in regaining orientation to life and strength and developing a clear focus on what steps to take next in life.  

If that person's reason for homelessness is rooted in Substance Use Disorder and that person is still using, is housing in a setting of solitude an acceptable answer?  Is it a safe answer?  Is it an answer that the medical community, the members of which have dedicated their careers to the ideals of Hippocrates, would approve? 

People who are still using must continue to use until medical intervention is realized within their personal journey.  Until then, I simply ask this question in this short blog: 

Is private housing in the absence of a definite plan for ending potentially deadly drug use an acceptable answer to this current crisis?

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[1] This quote has been generalized so as to preserve the anonymity of those who have died and the one who made this statement.