A Tale of One City

A physician-mother has two children, both of whom sought medical care at a storied medical institution in the environs of Boston, Massachusetts, in December of 2022, as the city was in the grip of the “tripledemic” of COVID-19, respiratory syncytial virus, and influenza. Following is a summary of each case.

Patient One is tall and slender, in her mid-teens. She plays on her high school squash team and feels dizzy and weak. She is infected with influenza A and waits for hours in the lobby of a crowded suburban hospital with many other patients who are also coughing, wearing masks (some under their noses), and looking miserable. Patient One has the Cadillac of health insurance—a commercial PPO—and because she takes an immunosuppressive medication for a chronic health condition, she is at high risk for complications from influenza. After a four-hour wait in the hospital lobby, she is called into the emergency department and is evaluated by a doctor who hydrates her, checks her chest X-ray, and prescribes an antiviral. Due to a supply chain issue, the medication is not readily available in local pharmacies. However, the patient’s mother calls the “provider line” at a nearby pharmacy and, after repeatedly being put on hold, is able to secure the appropriate medication for her daughter.

Patient Two, also in her mid-teens, doggedly refuses to let her illness get the best of her. She is an intramural sprinter and generally feels well, though her right ear is itchy. She has a new instance of a recurrent bacterial ear infection. She used some topical eardrops at home, but the itching has persisted and she has developed some discharge from the ear. She has previously responded well to oral antibiotics and also has a comprehensive insurance plan. Her mother calls the doctor’s office (she can always get through on the telephone) and describes the patient’s symptoms. The doctor prescribes antibiotics without needing to see the patient. After a long day at work, the mother pulls up to the entrance of the clinic, having called the front desk to let them know she is coming. She picks up the medication, as there is a pharmacy right in the clinic.

What is the difference between these two patients, who are the same age and both have health insurance and live in Boston? Patient One is a human child; Patient Two is a silver miniature poodle. My dog receives better medical care than my daughter does. Thankfully, both are on the mend.

Karen E. Lasser
Chestnut Hill, Massachusetts