Someone Has To Look After These People

It is older generations that leave behind valuable lessons. However, it is a society in general that fails to learn from those lessons until it is too late. My grandmother, if she were still alive, would be 101 in a few days. She worked as a psychiatric nurse for the now-closed Dorothea Dix Hospital in Raleigh, North Carolina for over 33 years. She loved her job because she had compassion and empathy for people. Many of her friends and relatives were concerned for her daily safety working closely with unpredictable seriously ill mental patients. However, she would eloquently put it, “someone has to look after these people.”

To me, that statement alone is paramount to many of the discussions surrounding criminal justice reform, mental illness, and compassion in society today. Decades ago politicians decided to close nearly all state-managed mental health facilities. Later it was insurance companies that began reducing policy coverages for underlying mental health assessments. Then that trickled down towards expensive medications that those with a mental illness cannot afford or ensure regiments are taken promptly to keep them off the streets. The bottom line is nobody is looking after the mentally ill. Well, at least not in a sense we were once accustomed to. Today, mental health is governed and managed by your local police or law enforcement department. Rather than adequately fund a psychiatric clinic, hospital, or increase our nursing shortages American culture feels that police can best manage the mental illness crisis.

When I read the newspaper and learn about another random school shooting, I quickly identify where such chaos and carnage could have been prevented not with gun control, safer schools, unique alert systems, or police presence. Instead the lack of mental health accessibility, counseling, facilities, and qualified individuals to identify these individuals are restricted by polished police cars, fancy badges, uniforms, guns, and police registries. A simple comparison of a mental health clinic versus a police station looks like night and day in America. Perhaps it is time to spread out that police funding to other departments to help citizens go back towards helping people and those with mental illnesses. Jails and solitary confinement facilities are not a proper way to treat mental illnesses.

Additionally, society must stop second-guessing individuals trying to use mental illness claims as a way to skirt criminal justice. It is time to allow qualified and licensed doctors to make that assessment. If someone is a danger to society, then let a someone with a medical license, doctorate, and a hospital residency instead of an individual with a two-week jailer course and basic first aid/CPR.

Lastly, psychiatric facilities are not institutions where we lock individuals up and throw away the key. They are treatment facilities that utilize plans of action to assimilate people back into society. After all, these are people and human beings too. The stigma of mental illness is typically identified negatively within society. That is because we fail to see or witness first hand the overall successes and rely on poor data or circumstances of particular individuals that enter and exit habitually. Our overall vision of mental health encompasses those where psychological effectiveness is not working rather than the whole. This is where we must halt rhetoric such as throwing away a key because doing so doesn’t provide a treatment plan or an ability to remedy mental health issues. Instead, it is a recipe to pass on the problems to future generations because there was nobody to look after them.

When Did the Billing Agent become a Nurse?

Emergency room visits are typically not a pleasant experience. I think those that design emergency waiting areas want to extend in some form that very unpleasant experience. Today I had an embarrassing visit. My hemorrhoids flared causing me three days of anguish. So I made my journey to the emergency room. Let me interject by saying that emergency room furniture is designed by someone clearly depressed and uninspired. The artwork is replaced with bright health related meticulously placed framed posters. There are plenty of AARP and random golf magazines lying about. Nurse staff calls out names similar to a basic training induction. There are little humanity and comfort in a place where it seems to be needed the most.

Once you are finally called to the triage area you are not greeted by a nurse or doctor. Your first visit is someone from the billing department. Seems very insensitive in my opinion.  Somewhat providing an argument that billing is more important than overall health. Again, a missed opportunity of compassion, comfort and putting patients first.


After about an hour of waiting and lots of forms, I was cleared to be seen. I thought it was easier to buy a new car than go to the hospital. I signed HIPAA documents, and I asked an important question. “By signing this form does the mean my insurance company and doctors will be speaking to one another?”  I was told that doesn’t happen. So basically we are the only advocate for our insurance program policies to continually fight for what insurance won’t pay but physicians order. Again compassion, comfort and putting people first are not what health insurance and doctors seem to advocate for. Instead, they argue against one another putting patients in the middle. No wonder people won’t see a doctor or seek preventive medicine in America.

Not only do we design our hospitals sterile but we also develop healthcare in the same fashion. I am not demanding plush exuberant conditions. Rather I am asking that health care and its agents become a bit more aware of how it represents its industry. The first people to greet patients should be medical staff, not billing personnel. I am concerned that we are turning an institution that was once filled with compassion, dedication, and ethical standards into another sterile facility where bedside manners and caring for our neighbor must regulate itself past a billing agent.


I am mindful that there are plenty of doctors, nurses and other practitioners that take immense pride in what they do. However, the overall hospital experience from my observation didn’t seem very courteous, inviting or reflective of the hospitals I once knew from decades past.  Ironic how a regular doctor’s visit would have only cost about $125 with insurance, medication and a referral update in an office that was warm, inviting, and seemed to care about my medical needs. That same emergency room visit with all its sterility and no tests or medical procedures cost over $7000. We wonder what is wrong with our medical institutions in the United States? I think I just found one of the answers why.

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