Day 3 Dispatch (6/29) – Valparaiso, IN to Hamlet, IN

While at breakfast (again, waffles, hard-boiled eggs, bagels, and OJ) I talked with some guests. Erin, visiting the Dunes from Indianapolis, told me a story.

Erin: Her mother has multiple sclerosis by doesn’t qualify for SSI (Social Security disability) or Medicare. Her medication costs are so high that there’s no money left for anything else. Her symptoms involve significant diplopia (double vision) and she can’t work but nevertheless has not been able to be on disability.

I checked out and thanked the wonderful staff at the Fairfield Marriott in Valparaiso (kudos to Jackie!) who provided a complimentary night’s stay. Here’s me heading out in the brightly sunny morning.

The day was hot (though not as bad as Saturday) and fortunately there was a stiff breeze which diluted the truck fumes from the US-30 / Lincoln Highway. My route called for me to walk along the new US-30 (which while not an Interstate, is a pretty heavily travelled truck route). Later on in the Walk, I take the old US-30, which is a more traditional two-lane road—more scenic and … safer. Here are some scenes along the highway. Endless cornfields (some soybean fields), dotted with farmhouses, and every so often flowers by the roadside. It was long and straight and the only thing to do was simply to keep going.

About ten miles out from Valparaiso, I had lunch at the Subway in Wanatah. These are small towns so it makes sense to use the direct article ‘the’ rather than the indirect ‘a.’ There is only one Subway in Wanatah. A group of people traveling back to South Bend, recognized me from the Chicago news. “I thought I recognized you,” one of them said. “You’re that doctor walking to Washington, DC.” And so, after foot-long turkey and a change of shoes & socks, I spoke with Michael, one of the sandwich artists.

Michael: He told me he had no insurance. “Do you get sick?” I asked. “Well, I try not to,” he answered. “If I must, I go to these clinics, but the appointments are way off, there are long waits, and sometimes it’s impossible. I mean I can’t miss much work, either. And dental’s really expensive. I could have gotten a job that provided insurance but I’d actually end up making much less.” I then headed out for the six mile walk to the town of Hanna.

Upon reaching Hanna, marked by a railroad crossing, I took a rest on the grass by the roadside. I tweeted the following post:

Rest in Hanna by the railroad crossing. Listening 2 Rodrigo Concierto de Aranjuez. He was blind but all-seeing. Is Washgton seeing but blind?

And then back again for the ten mile walk to Hamlet. At this point my feet are really killing me and it is getting dark. I arrange for a cab to pick me up by the roadside a little less than five miles from Hamlet. No: this is not necessarily ‘cheating’ as the motel is often not exactly on my route and I usually arrange some transport to take me back and forth. Also, I live out of a large suitcase for the month and this is shuttled separately each day from one lodging to the next. In any case, discretion is the better part of valor and to miss a few miles is better than walking on a major highway at night or getting gangrenous blisters. So Keith (of All-American Taxi in Plymouth) picked me up and he told me his story.

Keith: A few years back he lost his job at the yoghurt factory in town. This provided health insurance but now as an owner of a three taxi cab small business, he doesn’t have health insurance. He has significant heart disease and has had six heart attacks, the first one at age 32. For this he’s gotten seven stents (a device placed in the coronary arteries that keeps them open). The first two were covered by insurance but since then he’s racked up $56,000 in bills which he has paid down to $12,000.

[Interpretative note: I know a bit about stents and I was surprised to hear he had so many. But he did tell me that they continually get blocked up and he takes Plavix—a form of ‘blood thinner’—to prevent further blockage. I didn’t ask him but perhaps he has the less-expensive, bare-metal stents as compared to the much more expensive drug-eluting stents which are designed to reduce the possibility of blockage, or restenosis. While only speculative, I would not be surprised if bare metal stents were to be preferentially used for patients without insurance. Unfortunately that might mean less cost per operation but it typically results in more operations, ending up in even greater cost.]

And so I arrived at the hotel, the Days Inn in Plymouth. Many thanks to Jay Patel, the manager, for making possible a complimentary room. He also paid for the cab ride! And Jay has a story to tell but more on that in my Day 4 dispatch …

© 2009, Ogan Gurel, MD

ogan@walk4healthcare.org

P.S. If you want to see the aftermath of over 70 miles of walking in three days, click here.

Erin in Valparaiso, Indiana

Erin in Valparaiso, Indiana
Originally uploaded by walk4healthcare

Erin’s mother (Dianne) has multiple sclerosis but doesn’t qualify for SSI (Social Security disability) or Medicare. Her medication costs are so high that there’s no money left for anything else. Her symptoms involve significant diplopia (double vision) and she can’t work. Erin shook her head, “It’s a difficult situation and I don't really know what to do.”

Michael in Wanatah, Indiana

Michael in Wanatah, Indiana
Originally uploaded by walk4healthcare

Michael told me he had no insurance. “Do you get sick?” I asked. “Well, I try not to,” he answered. “If I must, I go to these clinics, but the appointments are way off, there are long waits, and sometimes it’s impossible. I mean I can’t miss much work, either … And dental’s really expensive. I could have gotten a job that provided insurance but I’d actually end up making much less.”

Keith in Hanna, Indiana (Picking me up to take me to the hotel in Plymouth)

Keith in Hanna, Indiana (Picking me up to take me to the hotel in Plymouth)
Originally uploaded by walk4healthcare

A few years back he lost his job at the yoghurt factory in town. This provided health insurance but now as an owner of a three taxi cab small business, he doesn’t have health insurance. He has significant heart disease and has had six heart attacks, the first one at age 32. For this he’s gotten seven stents (a device placed in the coronary arteries that keeps them open). The first two were covered by insurance but since then he’s racked up $56,000 in bills which he has paid down to $12,000.

[Interpretative note: I know a bit about stents and I was surprised to hear he had so many. But he did tell me that they continually get blocked up and he takes Plavix—a form of ‘blood thinner’—to prevent further blockage. I didn’t ask him but perhaps he has the less-expensive, bare-metal stents as compared to the much more expensive drug-eluting stents which are designed to reduce the possibility of blockage, or restenosis. While only speculative, I would not be surprised if bare metal stents were to be preferentially used for patients without insurance. Unfortunately that might mean less cost per operation but it typically results in more operations, ending up in even greater cost.]

6/29/09 Day 3, Valparaiso, IN to Hamlet, IN

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Day 2 Dispatch (6/28) – Hammond, Indiana to Valparaiso, Indiana

Back on the road. Once again, many thanks to the Fairfield Inn & Suites in Hammond for providing a reduced rate room. The staff was friendly and professional and the continental breakfast was more than continental. That is to say, I made sure I ate lots of sausage biscuits and waffles for the long road ahead.

Roderick: Roderick from the hotel told me, “Everyone should have healthcare and it should be provided by the government, not by for-profit companies.” I asked him if he thinks the current reform proposals are enough. He shook his head, “No.”

And so I headed out on the road. I usually walk on the westbound lane (against traffic) and as I was walking along 25^th Avenue on the way to Gary somebody honked going eastbound. They stopped. I looked over. “Hey, Doc—weren’t you on TV last night?” And so I headed over to say hello and get the next story of the day.

Chris: We didn’t have too much time to talk as traffic zoomed on by. But he told me, “We need help, it’s rough out here for everybody—not just the elderly. There’s drugs and alcohol problems, no treatment and the price of medications is too much.” I asked if he had a specific example. “Sure. My mother’s got Alzheimer’s and her medications are five to six-hundred dollars a month.” His friend in the passenger seat shook his head in amazement that they had bumped into someone they had just seen on the news. I contemplated the incredulity of it too. Maybe we’re onto something …

A couple miles down the road I stopped into the Black Oak Baptist Church (they were fifteen minutes away from starting the service) and spoke with the Pastor, Rev. Bob Parnell of Black Oak Baptist Church. He told me that they will pray for me and for healthcare and good health for all on this bright Sun morning. From there I made it to the Indiana University campus and stopped into the police department for some water. There I met one of the officers:

John: “It’s a critical situation,” he told me. “Especially now that people are losing jobs. But keeping prices down is important. Even with the insured, prices are inflated, they’re sky-high.” I nodded in reply. “So, it’s hard to stay healthy if you can’t afford health care.”

Six miles later, when N. Hobart becomes E State Road 130 (IN-130), I stopped into United States Security (a private security service) for some water and talked with Ed Paralta, the Director.

Ed: “Definitely things need to change,” he said. “But it’s more like tweaking. I’m 100% against something like the Canadian system.” I asked what he thought of the health care reform debate in Washington. “Well, I don’t like the idea of the upper brass fat-cats reaping rewards. They need to be dissolved or at least held accountable … and take another bottle for the road,” he added.

Later, heading down the long stretch of IN-130 (7.7 miles) I stopped into the 2^nd Street Bar & Grille for some water & juice. There I met three individuals, two of whom were so supportive of the Walk that they not only shared their stories but also gave me $30 as a donation, $5 of which I gave to the bartender as a tip for the free water and OJ. I spoke with Eric and John, sitting together to the right of me, and later with John on my left.

Eric: Eric’s got a brother who had an eye accident, lost his job on account of that and being without health insurance had to file for bankruptcy.

Jack: Jack has good insurance. But his story starts with unexplained pain in both of his feet. He went to dozens of doctors, podiatrists, and other specialists but nothing seemed to help except painkillers and these were prescribed only sparingly. It was a terrible problem and he could barely walk and was at risk of losing his job. “Then there was this neurologist who gave me two injections in the back—L4, L5, I think it was—and that worked!” I nodded, realizing that his foot pain was clearly related to the back (perhaps spinal stenosis or a herniated disc) rather than the feet. “But, guess what, the insurance company wouldn’t pay for the one thing that worked and now I owe $6,000!” I grimaced at the story. “Oh yes,” he added, “before, several years ago, I didn’t have insurance and I had to declare bankruptcy.” Eric glanced over with a knowing look.

John: John actually had two stories. First, his wife has diabetes, lupus, and fibromyalgia and he feels that the drug companies are just pushing drugs … through the doctors. The drugs don’t work; she doesn’t seem to get better and the only effect seems to be that she gains weight. His second story was after his first son was born. The $11,000 dollar bill forced his family into bankruptcy, again, soon after his wife gave birth. John felt the bill was ‘padded’ but there was nothing he could do about it.

Continuing on along IN-130 (another driver, recognizing me from the Chicago news, stopped to talk and provide encouragement), I finally reached Valparaiso but had to cross to the other side of town to get to the hotel. (Many thanks to the Fairfield Inn & Suites in Valparaiso for a complimentary room.) It was getting late and I finally reached my destination (slowing down because of the growing blisters) at 10:30 PM. I don’t think I could take another step. But the front desk clerk, a young man named Kyle, had a very interesting story to tell.

Kyle: It’s a bit complicated so bear with me. Kyle’s a senior in college (at Purdue in Hammond) but he started college a couple years after graduating from high school. Because of this unusual transition, it ended up that he had missed the deadline for getting insurance through his mother’s policy. He was working to put himself through college with various part-time jobs though none of them provided insurance. Then he got sick, very sick. He was bedridden for several days with fatigue and fever. He finally went to his family doctor who took a blood test. Two days later, his mother received an urgent call from the doctor saying that Kyle would need to go to the emergency room immediately. It was the highest white blood cell count he had ever seen and he was concerned Kyle had leukemia. So, at the behest of the doctor, and actually feeling better by this time, they went the emergency room. It turned out, thankfully, not to be leukemia, but Kyle ended up with a $9,000 emergency room bill (he was never even admitted to the hospital). They spent months fighting and negotiating and finally the Church organization affiliated with St. Mary’s helped to take care of the bill. Shaking his head in disbelief at the Kafkaesque ordeal, Kyle concluded, “It was something—and I’m not talking about the illness—I never, ever want to go through again.”

And so I checked in, went to my room, lathered the Neosporin on my feet and called it a night.

© 2009, Ogan Gurel, MD

ogan@walk4healthcare.org

Roderick in Hammond, Indiana

Roderick in Hammond, Indiana
Originally uploaded by walk4healthcare

Roderick from the hotel told me, “Everyone should have healthcare and it should be provided by the government, not by for-profit companies.” I asked him if he thinks the current reform proposals are enough. He shook his head, “No.”