<\/p>\n
\nThere\u2019s a popular myth that the uninsured\u2014in Texas, that\u2019s 25 percent of us\u2014can always get medical care through emergency rooms. Ted Cruz has argued that it is \u201cmuch cheaper to provide emergency care than it is to expand Medicaid,\u201d and Rick Perry has claimed that Texans prefer the ER system. The myth is based on a 1986 federal law called the Emergency Medical Treatment and Labor Act (EMTALA), which states that hospitals with emergency rooms have to accept and stabilize patients who are in labor or who have an acute medical condition that threatens life or limb. That word \u201cstabilize\u201d is key: Hospital ERs don\u2019t have to treat you. They just have to patch you up to the point where you\u2019re not actively dying. Also, hospitals charge for ER care, and usually send patients to collections when they cannot pay.<\/p>\n
My patient went to the ER, but didn\u2019t get treatment. Although he was obviously sick, it wasn\u2019t an emergency that threatened life or limb. He came back to St. Vincent\u2019s, where I went through my routine: conversation, vital signs, physical exam. We laughed a lot, even though we both knew it was a bad situation.<\/p>\n
One night, a friend called to say that my patient was in the hospital. He\u2019d finally gotten so anemic that he couldn\u2019t catch his breath, and the University of Texas Medical Branch (UTMB), where I am a student, took him in. My friend emailed me the results of his CT scans: There was cancer in his kidney, his liver and his lungs. It must have been spreading over the weeks that he\u2019d been coming into St. Vincent\u2019s.<\/p>\n
I went to visit him that night. \u201cThere\u2019s my doctor!\u201d he called out when he saw me. I sat next to him, and he explained that he was waiting to call his sister until they told him whether or not the cancer was \u201cbad.\u201d<\/p>\n
\u201cIt might be one of those real treatable kinds of cancers,\u201d he said. I nodded uncomfortably. We talked for a while, and when I left he said, \u201cWell now you know where I am, so you can come visit me.\u201d<\/p>\n
I never came back. I was too ashamed, and too early in my training to even recognize why I felt that way. After all, I had done everything I could\u2014what did I have to feel ashamed of?<\/p>\n
UTMB sent him to hospice, and he died at home a few months later. I read his obituary in the Galveston County Daily News<\/em>.<\/p>\n<\/blockquote>\n