An MD Speaks Out on Health Care, Her Article Quoted

I have permission from Dr. Katherine Ottaway to reproduce her contribution to the blog of the Mad-as-Hell-Doctors’ Blog and web site.


What I learned from my first Mad as Hell Doctor week

{ September 28, 2009 @ 3:12 am } • { Mad as Hell Doctors, financing healthcare, rural doctor }

{ Tags: Health Care, Mad as Hell Doctors, medicine, Single Payer }

I spent a week with the Mad as Hell Doctors, as a Mad as Hell Doctor, doing town halls about health care and about single payer, HR676. We went from Seattle to Denver, with 1-3 town halls a day, and then I flew home.

They are still on the road and I rejoin them tomorrow, for the last week. We will end in Washington DC, with a caravan and a white ribbon protest at Lafayette Park on September 30, 2009 and October 1, 2009.

I have been home for just under two weeks and am STILL trying to sort out what I learned and feel. I suspect it will take months.

1. I am not alone.

2. I am not used to applause.

3. People are brave and noble.

First, I learned that there are other doctors who truly put patients first and will go on the road for 3.5 weeks to prove it.

Dr. Mike Huntington, a radiation oncologist. He says that in the last 10 years of practice, the treatment for prostate cancer tripled from $17,000 to $54,000 because of fancier technology and computers. The result? Minimal to no better results for the patient. It horrified him. He quit. He is on the road.

Dr. Joeseph Eusterman, an internist. He did internal medicine, that is, adult primary care, for 25 years. He was in the military. He then switched to Workman’s Comp. He was horrified to find how deeply frightened Americans are of their supervisors, of being injured, of speaking up when they are injured and how dysfunctional the system is. He is retired, over 80 years old, and is driving Winnie, the Winnebago, across the country. I pray that I am that strong and determined to do right in my 80s.

Dr. Paul Hochfeld, an emergency room doctor. About four years ago, he got furious at the system and started reading and searching for the reasons our health care cost so much. He started with that question. The writing that made sense led him to call the experts and he asked for interviews. He made a movie, titled Health, Money and Fear. He is furious that our political system is run by money, corporations and that Congress seems to have forgotten the people, with all the corporate money that is thrown at them. He is fighting for reform.

Dr. Robert Seward, an internist. He is horrified that 60% of bankruptcies in this nation are because of health care bills. Think of all the press on people losing their houses: the fact is, they are losing their houses in large part because of health insurance companies and the failure of health care in our nation. He spoke with a Canadian man on the trip, who said, “Why don’t you Americans take care of your people?” That is still echoing among us. Dr. Seward says, “I was ashamed. We don’t. We Americans don’t take care of our people and we could and I am ashamed.”

Dr. Margaret Flowers, a pediatrician. She is working for Physicians for a National Health Program (PNHP) as a Congressional Fellow. She wants single payer on the table in the Congressional discussion. She was arrested for refusing to leave Senator Max Baucus’s office in May 2009. She is fighting for single payer.

I had never met these people before I joined them in Seattle. I was nervous about it: a road trip with strangers and talk into a microphone? But it was like coming home and it felt right.

Second, I learned that I am armored against criticism: it’s praise that I don’t know how to handle. The day before the trip, I spoke to one of the doctors on the phone and he said that I wouldn’t be on the panel of Mad as Hell Doctors in Seattle. I would watch the first town hall and then be on the panel at the next, in Spokane.

At the last moment, they said, oh, no, you are on the panel. I hopped up and left my purse at my seat. I remembered it 45 minutes later and thankfully was able to retrieve it. It would have been difficult to fly home from Denver otherwise.

Each doctor had 1-3 minutes to say why they were Mad as Hell. I winged it, and that was not a problem, because I AM Mad as Hell at our present medical system, the drug companies, the insurance companies and could go on for hours. Other doctors at my hospital would no doubt roll their eyes and say that I DO go on for hours.

I am used to being ignored, marginalized, told “we’re concerned about you”, told “we want you to succeed,” pressured and fired. There were secret meetings about the call schedule that I was not told about because they didn’t want me there. I’m stubborn, used to it, speak up anyhow and armored.

But in Seattle, I said a 2-3 minute piece of what I’ve been arguing about for 20 years.

People clapped. Applause.

I sat down. I wanted to crawl under the table and hide behind the white sheet covering the front. I was dumbfounded. I didn’t know how I felt. I concentrated on what the other doctors were saying, one after another, instead.

The other doctors thanked me, glad to have a woman doctor, glad to have a family practitioner and a rural one to boot. At each town hall, we talked to anyone who came, before and afterwards. The program itself was about 90 minutes but with the time talking to people before and afterwards, it was more like three hours. We did one to three programs a day and drove in between. It was physically and mentally tough. Residency trains us to put away emotions until later, so that’s what I did. The doctors are all tough and no one wanted to complain too much with our 80 plus year old gung ho and tough as a boot.

After I got home, the strongest feeling was wanting to weep. My Death Panel writeup had been in the local paper and four people thanked me in three days. I didn’t know what to do with that either. Under all the armor is someone who wants to be appreciated and loved. I’m used to criticism but praise went through the armor straight to my heart and to a part of me that I didn’t know was there. That person appears to be rather young and undeveloped. She is going to take some bringing up. Meanwhile, I asked for help in the form of my improvisation teacher. How, I asked, do I handle applause? He gave me clear specific instructions. I can do what he said, even if the emotional stuff inside is hiding under the table. Doctor training kicks in easily.

Third, I learned how people from Seattle to Denver, across the country, will stand up if given the opportunity. Part of the program was the Mad as Hell Minute. ANYONE, whether they agreed with us or not, could come forward, say their name and be on camera. They said why they were Mad as Hell about health care. They did not have to agree with us, with single payer, they could argue the opposition. But everyone was supposed to listen. Adam Klugman, our creative director, spoke of how it was an exercise in speaking up to our friends and community members and an exercise in listening to each person. And anyone who spoke, might show up on Youtube.

At some programs, one person would get up to speak. People were shy. Then a second would get up, then two more and then we would have a line. Not everyone spoke, but most of the people at the indoor town halls spoke. They told heartbreaking stories of family members, friends, their own loss of a job with a loss of insurance and people who weren’t being treated, or died because they could not afford treatment.

They were brave and honest and that made me want to weep too. And it was inspiring, to see people speak up. I hope that Congress is watching the Mad as Hell Minutes. These are the people they should be listening to and responding to, not the 1-2 million dollars in lobbying paid for by the insurance companies DAILY.

I have been cursing up a storm in my diary. I’m going back on the road, leave tonight for Seattle, take my daughter to her grandmother, and rejoin the Mad as Hell Doctors for the last 6 days. I feel blessed. The cursing is to balance me out; there’s no room for the grumpy, irritable, argumentative part of me on the trip so it is having a field day before I go. Back to hear people’s stories and applaud. And I have faith that change is in the air.



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5 CommentsLeave a comment

  1. We can all do with scanning this, your a real author and you have helped me about this. Do you have a tweets account? read, can not get ample desire there are more like this certain. will like this certain post on facebook….
    [JFD: Nothing but this.]

  2. Bravo, Elizabeth! I hope Dr. Ottaway checks back to read your astute response to her essay, to read a sensitive analysis of one of the most significant series of events on the whole debate of the issue. Your analogy of political action as theatre is apt. The actors in theatre have an aesthetic distance, seeing themselves both as the characters and the audience member’s critical view; but, Elizabeth, don’t the actors ultimately know who they are and what they are doing, where the bad politicians do not have that self-critical view, have lost their sense of a role in the larger view as the people’s representatives in their vaunted self-importance?

  3. First of all, John, deep and fulsome thanks for giving us this compelling blog from this extraordinary woman. Although, come to think of it, most of the real people I know in the medical profession are much like her. Would they were in the majority, hence ordinary.

    And second, I couldn’t help noticing how her description of her experience in becoming a speaker, and the process of weaving the audience response into the whole experience — how much this is the heart and soul of my entire life’s experience of theatre. Theatre as I know it, that is, theatre that is for real people in the present moment, meant to stir consciousness, not promote after-dinner detachment. Entertainment, yes, certainly, but not a commodity.

    Dr. Ottaway spoke from her center, for once, and was heard, for once, and was momentarily blown away by the experience of strong response and appreciation. I will never forget seeing an actor have a momentary epiphany and accidentally connect directly with an audience (Thurber’s Carnival, a direct storytelling piece). He was so unnerved by feeling the energy circuit completed that he went entirely up on his lines, and stood there like a deer in the headlights.

    Dr. Ottaway asked for help from her improvisation teacher. Well, brava. And how astonishing that there would actually be an improvisation teacher. The result? Community, in fits and starts. A public license to care, to be moved, to offer additional personal stories, most of them probably painful, some of them probably embarassing, and a few undoubtedly humiliating. And all these stories brought people together.

    Compare this to the Tea Parties. Not communication, but the brute application of heckling. I surmise that the only feeling of fellowship to come out of those meetings was the self-congratulation of the hecklers. What about all the people who came to ask questions, and possibly to offer their own experiences? Not a lot different from the sour experience of seeing a comedian devastated by a hostile audience in a night-club.

    Mayhap if we think of regressive political action as bad theatre, complete with the full panoply of deception and manipulation, and then think of positive progressive action as the equivalent of really good theatre, replete with insight, stimulation, energy, and above all, communication, we might begin to get somewhere in reversing this gluey tsunami that’s currently threatening to envelop us.

  4. Both are CO-Primary, two sides of the same coin. Add in the millions who do not have health care, and also subtract out the billions in profits and administrative costs that go to the health insurance companies.
    HEALTH CARE FOR ALL! Everybody IN! Separate the nation’s physical well-being from capitalistic drives.

  5. I am confused. What is the primary objective? Reduce medical costs, or insure 100% of the population?

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