The Team

On the psych ward there is a very even ratio of health-care professional to patient. On the geriatric floor I'm working there are 12 patients. Many of them are "train-wrecks," and require a lot of back effort and forward planning. Their stay on the floor averages out to anywhere between two weeks and a month.

To coordinate the effort to care for these 12, Team A - of which I'm a part- (mostly silent part) gathers every Monday, Wednesday and Friday morning at 9:15. Around the table are pharmacists, nurses, social workers, case managers, physicians, insurance agents, and students. Friday I counted 12 at the meeting. One health care worker for each patient.

Now let me take you back to Kum-Kundi-Yilli. Just north of this village, down a long, red dirt road sits a hospital. Green weeds and trees border the building and pools of water reflect all over the grounds. The entrance to the hospital is enclosed by a metal gate, like the kind you see around elementary schools. Outside are vans with people sitting. They are either bleeding or waiting for someone that is bleeding. Leading up to the hospital is a line of villagers doing the same thing. Inside the gate is a giant courtyard with concrete seats lining the walls. Each seat supports a patient. And off in the northeast corner of the courtyard is a little office. Inside the office is a well-groomed gentleman with glasses. He wears a tie and wields a pen. He's the physician. All his supplies lay scattered on the desk. He is also nurse, surgeon, primary care physician, pharmacist, and hospital administrator. The nurses are on strike, so today his job, theoretically, is to treat all the patients outside his office.

That's Kum-Kundi-Yilli, in northern Ghana, at least how it was when I visited for a month a few years ago. Our health care system is broken, I hear. But on the battle front I still see something good. I see American brothers and sisters working for the idea that life, any life, is worth saving. I don't know if it gets any more complicated that treating a majorly depressed man who comes in after his 8th suicide attempt. Yet the team works as if he were their own flesh and blood Grandpa.

I know comparing the Ghanaian health care system to ours is apples and oranges, but it's worth reflection that as Americans we budget ourselves into the red because we believe in the cure. Call it hubris. All I see, so far, is courage. But I'm biased, I work on Team A.

My challenge the next five weeks is to formulate my own opinion on the best way to reform health care. I'm a naive knave...