Heart of a Lion, Hands of a Woman: What Women Neurosurgeons Do
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Monday, April 18, 2011

Fingernails and Insurance

She came into my office with the usual complaints-neck and arm pain, back and leg pain.  All started after the car accident more than 10 years ago.  As the story unfolded I took my notes but my attention was drawn to her fingernails.  What struck me was how perfect they looked-luciously long, groomed, and painted.  These were obviously well tended nails-the kind that take an hour to create-with the latest technology for fillers/lengtheners and the like.  I have sat next to women in various nail salons who were receiving such nails and was struck by both the time and cost associated with this-not to mention the frequency of required treatments to maintain.  For some reason, on this patient, these perfect nails struck me in an unpleasant way.
This was a woman who otherwise seemed to care little for herself.  She was sloppily dressed and not only overweight but clearly out of shape and unhealthy.  When she removed her shoes during the examination, her socks were more gray than their original white.  In addition, her history as she related included numerous times when she opted not to have insurance because she didn't want to pay her "portion" or when she opted out of recommended care because she couldn't afford the required co-payments.
Fast forward, and before me sat a woman now with a chronic pain syndrome-out of work for more than 6  years as a result and thus statistically unlikely to EVER return to gainful employment.
And yet her fingernails were perfect...
Hard as I try, I can't put myself in this woman's shoes.  I can't say for sure that she made poor choices about her limited funds.  It may be that the only thing she does for a "treat" just for herself is her nails.  Perhaps even this was a first-a special occasion and not something done regularly.  Undoubtedly there are many possibilities that perhaps I can't even imagine.
I just know I was struck by the dichotomy-the willingness to devote significant amounts of resources to her hands while neglecting a whole spectrum of healthy living activities, some of which require little or no money at all.  It did raise the question in my mind about the balance between societal and personal responsibility, especially when it comes to health and utilization of those precious resources.  In the coming years, perhaps these questions will be an increasing component of the discussions about health care insurance, Medicare, and reform.

Saturday, April 16, 2011

Black and White and Yellow

It is like they took a black and white photo
And someone had just one paintbrush
And began to touch it all up with
The color yellow.

As I drive along the road
My eye is invariably drawn
To these audacious highlights
Signaling spring.

The wind still howls on many days
The rain can lash cold against the face
But nights draw longer inexorably
Seasons change.

Why yellow in all that is touched?
Whether sun-stroked bush
Or multitudinous erupting bulbs
April's color.

Yellow, breathing life back into
The slumbering world of black and white
Assaults the eyes and senses
Brings a smile.

Thursday, April 7, 2011

Just Two

Brilliant purple they stand alone
Two welcome beacons of
Warmth, light and color
That will soon infuse the day

Saffron threads peek out
From beneath regal robes
Huddled close to ground
Beneath still barren trunk

Oh, how just two
Can raise my smile
Cause heart to swell
Lift shackles of winter.