By R.D.

This blog is part of our series and opinion on quality of life, awareness, wellness, public safety and accountability. It’s an analysis along with other areas where we have experts to help address a number of issues.

The Eternal Struggle of Inefficiency, Politics, Complication, Implicit Bias, and Bureaucracy!

While the medical profession strives to treat all patients equally, healthcare inequalities and disparities persist. Colonial rule along these Caribbean shores has left a legacy of disparities and social disadvantages.

According to the expert, a significant portion of the global population, approximately 2.4 billion people, currently lack access to basic healthcare facilities.

Whose responsibility is it to ensure the well-being of individuals: elected officials or the private sectors that dominate this industry, particularly in impoverished and developing countries?

The sad reality is there are two healthcare systems, not only in the poor and developing nations but also in the wealthy ones. Are refugees in private wards getting the right diagnosis, care, and treatment? However, the issue is not about the rich but about those we often overlook or forget who need the same care

Witnessing the medical tragedy firsthand. Our long X-ray of the system!

Being a doctor or a leader in the medical field comes with significant authority, trust, responsibility, and accountability. They are highly respected, even more so than armed police officers, local judges, pastors, or politicians.

Even if some patients struggle to read their medical notes, healthcare professionals always respect their prescriptions and recommendations.

Even with all their knowledge, achievements, and immense power, understanding the complex workings of the nation’s healthcare system can still be a challenging task, especially for those who are less fortunate or lack connections.

The situation does not indict the entire system, but it does highlight some serious problems that require attention.

Bidding farewell to Johnny, his story, and the medical failure

You may encounter them while walking down the streets, under a bridge, an abandoned home, or within these communities.

They are often overlooked, forgotten, and left to fend for themselves. But they are someone’s dad, brother, cousin, or uncle.

Despite his mental health issues, he was able to care for himself, function properly, and pose no threat to the community.

It was heartwarming to see the love and affection they had for him during his funeral, knowing how deeply they loved him while he was alive. As everyone gathered at the repast, the moment had come for my final farewell.

I came back to bid farewell to his 81-year-old mother while the hired vehicle patiently waited.

Deep down, I was aware that no matter what I said, the chances of me making the journey to this part of town to support her and provide her with extra strength in person after her son’s funeral were slim.

There was a profound sadness in her eyes as she gazed at me, and her hands clung to mine with a firm grasp, as if she had a final message to share or a reason for me to stay.

I waited an extra minute before entering a small back room, approaching another family member, and questioning as to what caused Johnny’s horrible demise.

I returned and sat in a little hallway, watching folks pass in and out with many unanswered questions. Should this be another funeral, and we go on? I wondered.

During our summer and winter breaks, I couldn’t help but admire how he looked after us. He had a way of showing love, care, and instilling important values in everyone he met.

Unfortunately, his mental health struggles eventually overshadowed who he was.

How could someone just toss aside those valuable life lessons? “What on earth would he have done?” I asked.

I have been trained in a field that emphasizes the importance of providing an explanation or seeking closure before burying a civil servant or a family member.

My brief trip unexpectedly transformed into a five-day journey, but it was undeniably worthwhile as I learned more about the medical system and sought the truth or evidence.

Now, what happened to Johnny?

At first, what were the documented concerns?

“Did he vomit before arriving?” Question asked.

How did he arrive at the facility, and can we have a breakdown of the thousands of dollars spent?

May I inquire if there were any records or follow-up care provided when he was admitted for the first time and subsequently discharged?

Were there any follow-up visits or calls to verify if the most recent medication was effective?

The prescription and issuance of medication at the medical center should ideally be accompanied by a receipt indicating the amount paid and type of medication.

Who attended to him? Could his mental illness have contributed to the lack of notification or follow-up regarding the correct administration of the medication?

How can you obtain a copy of the prescription medication? This became like a strange language.

Johnny was familiar with the doctor and the local medical center, despite not being known by them.

The initial interaction with an intake or evaluation staff at these community medical health centers is of utmost importance.

The decision made by these intake units could have life-saving consequences.

Classism, poverty, and inequality greatly affect many patients’ lives, reducing their value to mere monetary worth.

Unfortunately, like many other places, it seems a person’s social or economic status dictates their value in today’s society.

Despite perhaps an unclean appearance and potential need for hygiene, it is important to consider the urgency of someone seeking help before dismissing them based on surface-level judgments.

The uncertainty, outrage, and silence that persist within this system.

Decision fatigue cannot adequately address the thousands of dollars spent on recommended tests, medications, and additional tests that are required to evaluate the outcomes of previous tests, all of which are funded by hard-working family members abroad, some of whom are on a fixed income.

Unfortunately, not many are still alive to look at any potential results or have the resources. This situation is one of the reasons why many families have fallen into financial catastrophe and yet have no solution and are still waiting on the results

Although our society cannot blame all losses on poor care, this “inexplicable death” embodies a familiar model of suspicion that has caused financial, emotional, and psychological anguish for many families.

Where is his doctor when he asks follow-up questions and verifies his medical records? Who takes his or her place at this medical facility if he or she is out of the country on vacation?

The exact cause of Johnny’s death remains a mystery; however, the family must either embrace or reconcile the information provided in the official death certificate.

It is truly appalling that the family was contacted after his passing to inquire about symptoms, possibly in an attempt to justify the information that should be recorded on the death certificate.

The Office of the Medical Examiner is responsible for identifying the cause and manner of death.

How could they have come to this decision if he hadn’t been treated for cancer and had no prior diagnosis, despite years of evaluation by medical professionals?

What were the reasons he was admitted for several days, given fluids, paid for testing, and thanked you for his care?

Do you happen to have a copy of the cancer medication that your team has kept? Additionally, were any recommendations given regarding a treatment plan?

We are still waiting for a response.

If they released him alone on the street, where are the documents of his treatment plan, or what caused his discharge if he returned to the center in a few days for the same medical issue?

Was he prescribed appropriate pain relievers, or is it based on his ability to pay, or did they confiscate the money we sent him and give him whatever was available that day?

“Speak up, ask questions, and demand an answer if you become ill.”

Despite the lack of documentation, our relentless quest for the truth left us with even more questions after each visit to different medical facilities he visited.

I am not a doctor and do not play one on television. I continue to respect and admire their work, but I am aware that preventive medicine and the medical system, particularly in low-income rural counties, could benefit from an update, improved accountability, and increased access for the poor.

It was quite frustrating to discover that no one was willing to provide any information regarding the date and specific type of prescription given.

An effectively qualified employee, such as a caring intake staff member at a local hospital or a knowledgeable pharmacist distributing prescription drugs, can help save lives.

Research indicates that administering controlled substances to patients without adequate counseling can significantly increase the risk of overdose and mortality.

Based on my professional experience, I have observed the harmful effects that can result from the overuse and misuse of medication when there is a lack of support or awareness.

As I investigate the circumstances surrounding his death, I question the absence of monitoring for prescribed medications.

This raises concerns about whether pharmaceutical companies exert influence over the use of their products through financial incentives and whether adequate safeguards exist to prevent misuse.

In discussions with several patients, I’ve found that providing a sick patient with a personal letter from a doctor often leads to additional financial burdens without effectively meeting the patient’s needs.

Now, let’s refocus on the investigation into Johnny’s death.

Given the limited number of pathologists available to serve multiple parishes in a country with a population of approximately three and a half million, the bureaucratic backlog remains a persistent issue.

It appears that the delay in burial may be related to this backlog, as the family had to wait a considerable amount of time before receiving notification to arrange the burial.

Given that many families cannot afford even the most basic medicines or burial costs, how can one seek an answer when a loved one dies and there are issues about the death or how the reports or cause of death are being handled?

Discussing the treatment plan and potential medical outcomes with the patient and family can foster trust, comfort, and fairness in the system, even if the desired results are not achieved.

It is crucial for local doctors, medical examiners, and the coroner’s local offices to reach a consensus on the exact cause of death.

They should prioritize providing families with independent answers instead of worrying about fees.

An autopsy is crucial, as it may reveal vital clinical findings that can help safeguard the family’s future well-being.

If there is uncertainty surrounding the cause of death, it is considered acceptable to use terms such as “unknown,” “undetermined,” awaiting further examination,” or “probable.” It does not affect one’s professional reputation.

Although it may not offer solace to loved ones, it does shed light on the moral expectations placed upon individuals in disadvantaged circumstances.

This premature death reflects a gap in access to better health care between the haves and have-nots, as well as a lack of critical accountability in some sectors where patients should come first.

The systemic implicit bias toward poor patients and lack of empathy.

Another Example: Donating blood is crucial. I fully grasped the importance of maintaining a balanced reserve for the benefit of others.

While the argument is sound, it promotes a tit-for-tat mentality, leaving those without a support system at a disadvantage when it comes to their social welfare.

Nevertheless, it is crucial to establish certain regulations in the medical field to ensure resources are available for others, especially the poor.

What would Johnny’s file have revealed if they had access to his medical records?

Did they only see his mental illness, which was frequently labeled [insane or mad man], and use that to determine the level of attention?

Did anyone know he used to be a public servant, a dedicated police officer?

Individuals, regardless of location, community, or status, must be able to obtain the information and support they need for their medical care.

Absolutely no one should be greeted with silence when they seek assistance.

Given his status, it appeared that one had to die for a bed to become accessible; or perhaps because he arrived alone when the pain was unbearable without bedding supplies, as many argued, it is more useful to have your own and keep it under close supervision.

What happened to the bedding and additional items he brought to the facility when he was admitted?

They had previously turned him away several times, and it appeared as if the medical center had already admitted patients who had arrived earlier and had reached bed space capacity, so please wait on God.

I imagine he must have felt like a veteran who left to serve his country in a war and returned alone to find himself homeless on a city street.

Without a family member or an advocate, you are on your own.

Is there such a thing as a “Patient’s Bill of Rights” or even a “Nurse’s Bill of Rights?”

The community expects local medical practitioners to adhere to high standards and hold one another accountable, as many medical experts advocate, regardless of socioeconomic status.

These centers vary greatly, and they face additional challenges due to a depressing lack of essential resources and inadequately qualified personnel.

Sadly, for those who cannot afford to pay in advance, death may be the only option to alleviate their suffering.

It is a harsh reality that lives are lost every minute around the world due to various causes, including medical conditions, accidents, violence, and other unforeseen circumstances, but poverty remains one of the major causes.

What happens to even the most basic expectation that there is someone there to guide a sick person, especially those who may have some mental health issues, to effectively and compassionately connect them to aftercare when they are receiving medical care there?”

It is indeed astonishing to observe how certain local emergency rooms and medical centers appear to have transformed into facilities where individuals face dire outcomes.

Clearly resources are scarce, and the downtrodden must take what limited care is available even in emergencies. It is as if their lives are of absolutely no value!!

The reality on these medical systems:

Johnny’s situation is not unique to these communities, nor is it an isolated incident. The more questions people asked about his treatment, the fewer answers they received.

The absence of ethical standards in medicine is causing the loss of lives, while the silence surrounding the issue allows thousands of dollars in medical debt to serve as the only evidence of care.

Imagine accompanying a loved one on a long journey, traveling through the hillsides and lovely plains for hours with anxiety, or returning at dawn, terrified that a loved one may endure severe pain overnight, only to discover yourself in a morgue with no answers.

The added misery of the hospital clock buzzing to signal the end of visiting hours forces families to bid farewell, unable to offer any overnight support.

With limited resources, who can say what kind of care will be provided during the night?

Nobody knows if an overworked staff, may under paid nurse on duty during the midnight shift has had the time to provide oxygen, clear vomit offer a small meal or to help a patient breathing, or administer pain medication.

Heartbreaking news has emerged of individuals tragically dying while awaiting critical surgery, a reality that is all too familiar, and it seems people have become immune to the pain.

Striking a balance between healthcare, humanity, and medical costs is essential.

Doctors, just like anyone else, have their fair share of financial obligations. It’s no surprise that in any medical system, both public hospitals and private networks have to invest in purchasing MRI equipment and ensuring it stays up to date.

Magnetic resonance imaging (MRI) is a test that uses powerful magnets, radio waves, and a computer to make detailed pictures of the inside of your body.

The imaging system is a crucial element in modern medicine with critical important to aid the treatment for many patients.

Yes, the advantages of modern technology have generally been positive, but considering the number of patients referred for MRIs, even when it has been determined that little can be done to save their lives, raises concerns. 

An MRI seems to be a status symbol, but it can be costly. They ordered one for Johnny, that results maybe still pending.

Imagine other families , who may still be paying for medical expenses, while their loved ones are no longer here and real cause of death unknown. 

Getting an MRI, especially without medical insurance, have to pay upfront and it is expensive. 

Yes, many of these local doctors are vital to their communities and have done exceptional work, but there is still a significant imbalance between life and profit—many individuals, like Johnny, are still walking the streets in need of medical care.

When does honesty and integrity ensure that additional requests for tests are not driven solely by financial motives but rather by the genuine hope of saving lives?

Johnny’s test results, like those of many others, remain inconclusive despite undergoing multiple tests; even retesting previous results does not provide clear explanations or recommendations.

Is it liver, stomach, or kidney cancer? Is it water on the brain, wheezing, shortness of breath, excess mucus, chest tightness, diabetes, or past health issues that have often led to recommended surgeries—and in many cases, fatal outcomes?

Moreover, if no one is held accountable for negligence, medical professionals warn that their influence in these communities, coupled with minimal post-procedure monitoring, will foster further errors and erode trust in the overall system.

This approach harms other competent doctors and nurses who strive to do the right thing despite facing inadequate resources, and little or no oversight, or job protection if they come forward!

Even today, it remains uncertain what medical standards effectively protect families seeking accountability for their healthcare.

Many patients, like Johnny, have died after surgery and others left bedridden while their finances were drained.

If the healthcare system is to address its deficiencies, doctors and support staff must clearly communicate these issues to patients, including potential outcomes and reasons for long waiting periods. 

Jonny called back once after reaching out to his family about additional symptoms from the medication, and no one followed up.

The files of administrative bureaucracy

A few days later we were on the road again, working backwards. On this stop, it is clear that Johnny’s prior medical local centre was struggling to keep up with the increasing and ageing population.

Many patients have remained in a crowded area for an extended period of time, which points to the urgent need for substantial resources to revamp the medical system.

Although there are few official certificates displayed on the back wall, they do not represent personal achievements. One has to wonder where the “Board Certification” document is located.

When hiring a police officer from another state or county, even country, it’s crucial to understand their departure reasons and obtain their files, training records, and necessary certifications for transfer.

Who is verifying some medical fees? And are there any updated training sessions to meet today’s demands and use cutting-edge technology?

These certificate is frequently used to demonstrate that a physician has passed periodic exams to confirm proficiency in the field.

I have a few questions after exploring this place. (Answers are still pending)

The local people are not the only ones to grade or test the qualifications of medical doctors in these communities.

Referrals often come from word of mouth, but the individual medical issue may vary.

And as the experts have said, if they are not qualified, then they are just crossing the line in terms of human rights, patient care, and social responsibility.

Johnny and many others may have left some of these offices on their own to avoid becoming another case where patients died before Emergency Management Services [EMS] arrived.

Building trust to reduce barriers in the local system.

These early detection has the potential to prevent diseases, lower medical risks, and extend life expectancy, but who gets access, and are they free to the poor?

Barriers often give rise to doubt, and even medications funded by the government or important contributions from international health organizations are considered experimental drugs by some people.

Medical education, such as affordable access, saves lives, and it begins in schools by changing some cultural ideas and stigma, which remain a social concern for some.

For example, erectile dysfunction, chronic chest discomfort, or a peculiar mass on one’s body might necessitate the care of a trained doctor, not a homemade drink or alternative medication.

Who do you blame for some people’s way of thinking, especially in a system where no one seems to question authority or leaders and where there is constant minimization to deflect?

What comes next and how to proceed.

A number of these medical students have undergone training both domestically and internationally.

This situation will lead to a significant decline in essential services for the nation and place a burden on the overall economy to address these pressing needs.

One nurse I spoke with mentioned the lackluster management and the less-than-ideal pay of the job.

The solution begins with implementing logical economic strategies to tackle medical school debts, attract highly skilled doctors, and potentially enhance compensation, while also addressing necessary upgrades, accountability, and patients’ bills of rights.

Ensuring equal access to medical care for all, regardless of background or health, is just as crucial as it is for local social or sporting events.

Even though certain upgrades have been implemented, the idea of a highly efficient medical system can differ significantly from the real situation, posing substantial challenges in an era of rising economic disparity.

It will be better, or has it? The same political medicine

On the outside looking in, as we unpack Johnny’s journey through the system, it appears that political leaders are often handing out prescriptions without diagnosing the problem.

Some people will run with anything promised and when there is an actual emergency there is no blueprint of care.

Many individuals heard promises to enhance their health care during election campaigns, but nothing has changed since, especially for the underprivileged.

What if some of those leaders invested in more local family practitioners, internists, and pediatricians or established a path to becoming a physician?

These specialized treatments and preventive screenings save lives and reduce the need for expensive emergency room visits and hospitalizations.

Why would individuals seek specialized treatment abroad in countries such as the United States, Canada, or England for surgery when they have local health problems, especially considering that some wealthy individuals have died after trusting their local medical system?

Many wealthy countries, including the United States, Canada, Germany, and the United Kingdom, experience high wait times for care, similar to these less efficient and well-funded medical systems.

However, the chances of someone dying on a bench for over 8 hours while waiting for a local doctor are slim.

Another family member of ours died of cancer after seeing the same doctor for 40 years and having excellent medical insurance.

While we do not question the cause of death, each family member will wonder what else they could have done; however, the lack of knowledge about the cause of death, along with potential neglect, is concerning.ng.

Accept it, eat, drink, get and dance because the alternative is unknown.

It seems like these communities have developed a certain resilience to these sensitive issues, likely because they lack the necessary resources, accountability, hope, advocates, resources to get to answers, or support, and perhaps a need for updated laws.

Unfortunately, this pattern has become all too familiar. We still have hope, but it will take the next generation of younger students and leaders who are demanding better to diagnose and cure this medical cancer.

This beautiful land is always bound by heritage, culture, or genuine love, but no one would jeopardize it all because of the poor medical infrastructure, which has outpaced its effectiveness in the face of an aging population.

The Bittersweet Goodbye: It was tough, but we had to keep pushing ahead.

I’m hopeful that Johnny’s unexpected mission will act as a voice for those who lack one, as well as for those who choose to remain silent to protect their image.

While we may never fully understand the cause of your death, I have investigated the circumstances surrounding it and, as part of our duty, have identified a plausible case of negligence to pursue.

However, the extended stay and additional expenses were driven by a quest for knowledge, accountability, and closure, rather than an intention to file a claim based on the information collected.

Your influence, motivation, compassion, and affection for humanity continue to resonate.

You took us to the beach during our summer vacations, winter holidays, and memorable block parties and street vendor meals, but most importantly, your strong principles and commitment to the law made a lasting impression.

We did not come seeking a terrible story or to express an opinion. This situation analysis seeks to address a significant flaw that often lurks beneath the surface, masked by a pleasant smile, within this medical system.

We will continue to speak up for the voiceless so that this does not happen again to anyone, regardless of race, gender, color, or socioeconomic background.