Take, for example, the requirement for our three-person transplant center to form a support team. No one can survive the physical and emotional consequences of the transplant without help, especially the first year. But not everyone is fortunate to have people who can commit to helping with medications and appointments. Will we choose not to list someone whose family members live in a different state? How about a patient who would be an ideal candidate but who simply lives an isolated existence?
And even if a patient is approved for a transplant, the process – like any extended hospital stay – can result in unforeseen expenses. Although the procedure itself and the necessary medications are usually covered by private insurance or Medicaid, patients who live far from a transplant center and have to travel back and forth for appointments may have to bear the cost of paying. ‘one night just to be seen by their doctor. . Even the simple act of parking in a hospital can cost hundreds of dollars each month, a loss largely invisible to patients and families who are already struggling to simply exist.
Even as we prepare for this next wave, my 61 year old patient and his family continue to wait. Standing at his bedside, I am struck by the reality that if his son had not pressured him to be transferred to a hospital he would consider him a potential candidate for the transplant, if we did not have access to the transplant. machine that could achieve this goal, he would surely be dead.
Maybe he will again, his family’s grief only prolongs. It’s right at the start, and we can’t yet know if it will even happen to transplant, or what will happen if it does. But he has a chance.
When Dr Nirmal Sharma, the medical director of transplantation at my hospital, first speaks to patients and families like this, he asks them to imagine themselves at the foot of a mountain.
“If we look at the mountain, we get overwhelmed and feel like we’re going to fail,” he told them. “So we don’t worry about the peak. We focus on the individual steps. There is still no guarantee. But we will try. That’s all we can do.
Daniela J. Lamas, opinion author, is a pulmonary and intensive care physician at Brigham and Women’s Hospital in Boston.
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