The author, an emergency doctor, shares her experience contracting encephalitis and seeking treatment at both a public and private hospital. She contrasts the care she received at each facility, highlighting the disparities in access, resources, and patient experience based on insurance status.
I recently suffered from what doctors believe was encephalitis, a brain infection, likely contracted while traveling internationally. For the first time outside of pregnancy, I — an emergency doctor — experienced what it feels like to be a patient.
I sought treatment when I was plagued by recurrent bouts of diarrhea and vomiting, while simultaneously becoming convinced that my husband of nine years was plotting to kill me for my insurance policy . My heart was racing, my skin was hot and I was spouting off ramblings that were, thanks to my medical training, just coherent enough to fool some into thinking I was OK. But my family knew something was terribly wrong.hospital, a health care facility that primarily serves patients who are uninsured or covered by Medicaid. In my altered state, I thought this would be the best place to uncover why I was acting so strangely. As a child of Medicaid raised well below the poverty line, I grew up in a family that largely depended on the public hospital system to receive care. Due to Medicaid’s low reimbursement rate, most general physicians did not accept our insurance, and those who did were already swamped. If something was “wrong” — whether a constellation of worrying symptoms or a broken limb — we would go directly to the emergency room for evaluation. There, the doctors, who I at a young age envisioned as superheroes, made sure that no stone was left unturned and that my family would be provided equal care as those society considered “better.” Today, I am an attending physician and no longer in need of Medicaid’s support. Yet in my ill state, my mind resurrected my family’s pervasive concerns over finances and worried about my ability to pay. So I turned to a public hospital expecting the care of my past. Instead, the experience was a blur of overwhelming confusion and fear. The public hospital system I once knew no longer existed. In its place was a system that was overburdened, chronically underfunded, and neglected. I left understanding why patients often distrust the medical system or leave hospitals against medical advice.When I arrived at the hospital, I was evaluated by an emergency medicine physician. Even though labs were drawn, I was sent for a psychiatric evaluationcompleting a medical workup. Only once I was cleared by psychiatry did they send me for brain imaging and an ultrasound. Everything felt slow — not just because of my temporarily shattered mind, but also due to a palpable lack of urgency among the health care workers. The overworked physicians and staff were stretched thin, theirEven now, I’m confused: Why was psychiatry the starting point? Was my altered mental state dismissed as a psychiatric problem because it was easier to label me a “crazy” person? I don’t believe the clinicians consciously thought this way, but exhaustion and systemic pressures breed shortcuts. It’s a slippery slope toTwo young, healthy Black women were both misdiagnosed as psychiatric. One died of bacterial meningitis, the other of a severe stroke. Both were avoidable deaths. During my own ordeal, I wondered what would have happened if my husband, also a physician, hadn’t advocated for me — pushing for tests, demanding imaging and ultimately forcing me to leave against medical advice. Would I have suffered a similar fate? At the private hospital where I sought further care, diagnostics were faster and more thorough. I was evaluated for diseases I had not even considered since medical school. I underwent a lumbar puncture, MRI scan and specialized labs in record time. This hospital seemed to run more like a well-oiled machine, and as I looked around the emergency room, I could see why. In comparison to its public counterpart, the doctors had an ample supply of support from nurses, physician assistants, emergency department technicians and transporters. This allowed them to center the patient and expedite their care. I also couldn’t help but notice that at the private hospital, the patients around me seemed different. Many appeared to be white-collar professionals, likely with adequate health insurance. They appeared to worry less about an inability to pay and were just focused on getting better, a luxury that is not possible for a. As I rested in my room waiting for an EEG, I felt a lump in my throat as I realized that I was one of “them” now — someone with good insurance.I wondered how many of my Medicaid and Medicare counterparts, how many of my family and friends, would be able to receive such an extensive workup without facing a hefty, perhaps life-altering medical bill. How many would have been seen by neurology and had a lumbar puncture, MRI, and extensive viral testing prior to being “cleared for psych”? For how many would the workup I received have meant that they would have to take a second mortgage or work months of overtime just to cover the interest payments? Twenty-five years ago,Today, I’m recovering. My brain fog is improving, though I still struggle to find words at times. But what lingers most isn’t fear for myself; it’s fear for patients. We know that issues such as a lack of equity in care, lack of access, barriers to insurance coverage and implicit bias among providers — issues that perpetuate the systemic oppression felt by marginalized Americans — go a long way towards explaining whyexperience stark differences in health care outcomes. As a health system and as health providers, we must do better. We need to advocate for programs, both within and beyond health care, that improve the lives and health of patients.The privatization of medicine and the simultaneous defunding of the public health system are growing problems that disproportionately affect marginalized populations.Continued health care privatization risks further marginalizing these groups by creating barriers to access, including higher costs and less comprehensive care. Limiting public funding for health care also leads to lowered staffing, higher patient ratios, and more overworked physicians relying on their instincts rather than information. This leads to more missed diagnoses among a group whose life expectancy is already severely impacted bymust increase in order to combat many of the issues faced by the most vulnerable. The state governments must prioritize maintaining public health and public hospitals even if it means providing subsidies where necessary, especially in. Finally, the experiences of dozens of other developed countries — as well as a thorough analysis from a 2021 study — show thatTo my future patients: I finally know what it is like to feel like your doctor is not taking you seriously, to feel pushed aside, ignored, and doubted about your own body. I needed to go through the patient experience to truly realize how we have been failing you. I am sorry.set strong financial incentives for many and can affect final pay. Medicine has become corporate and deeply flawed, but we cannot let a broken and battered system cause us to push aside our oath. Together, we can rebuild trust with our patients.— to first do no harm — not just in individual patient care but in the systems we build to serve them. Systemic changes won’t happen overnight, but they are necessary steps toward a more just and compassionate system.The next four years will change America forever. But HuffPost won't back down when it comes to providing free and impartial journalism.You've supported HuffPost before, and we'll be honest — we could use your help again. We won't back down from our mission of providing free, fair news during this critical moment. But we can't do it without you.You've supported HuffPost before, and we'll be honest — we could use your help again. We won't back down from our mission of providing free, fair news during this critical moment. But we can't do it without you.Dr. Shacelles Bonner is an emergency medicine physician in NYC and Public Voices Fellow through Yale University and The OpEd Project. She is a first-generation college graduate and global health advocate. She writes on social inequity, systemic reform and patient-centered care. You can follow her Do you have a compelling personal story you’d like to see published on HuffPost? Find out what we’re looking forMy Dad Has A Serious Illness. 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HEALTHCARE PUBLIC HOSPITAL PRIVATE HOSPITAL INSURANCE DISPARITIES ENCEPHALITIS
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