This is my nonsensical or almost-sensical use of some of the recurring terms used last week at the Rabinowitz Symposium “Telling Stories, Revealing Narratives: Perspectives on Illness and Care” by the Program on Values in Society at the University of Washington. I learned that it is not a good idea to tell an academic philosophy professor that academia is not the real world. But really—how many people do you hear every day dropping words like “trope” and “emplotment” (which, by the way, is a made-up word by an academic historiographer)?
As Robertson Davies so aptly wrote in his book Rebel Angels: “But what you are missing! A great monument of scholarship and seventeenth-century English! And what rich neologisms! Slabberdegullion druggels, lubbardly louts, blockish grutnols, doddipol joltheads, lobditterels, codshead loobies, ninny-hammer flycatchers, and other such defamatory epithets!” This is part of his Cornish Trilogy, a sad-sweet satire of academic endeavors.
Less entertaining to me at the symposium was the recurring statement that ‘frequent flyers’ to the emergency departments (EDs) were what was “taking down the US health care system.” This statement and belief came not only from ED physicians, but also from many other community-based and academic physicians in the audience. At some level I can forgive the ED physicians for their incorrect beliefs, since they have a necessarily myopic view of the health care system. But this was repeated by more than a few people throughout the day and no one challenged it. Well, OK—of course, I challenged it, because it’s not true from a health systems perspective. It is beginning of life care (hospital care for premature babies) and end of life care (mainly heroic hospital care for the elderly)—and the high cost, including administrative/insurance ‘overhead,’ that is taking our health care system down. And then there’s the issue of ED misuse being symptomatic of a broken health care system and lack of accessible primary health care—as well as a lack of basic social services for low-income people. It was an interesting example of how anecdotes can be misused and perpetuate incorrect health policy information.