A Doctor Writes About Caring For Poor Patients, And What She Has Learned About The Healthcare System

In her memoir, “No Apparent Distress,” native Texan, Dr. Rachel Pearson ponders the difference between the big-hearted Texans she knows, and the system that deprives some people of the care they need.

By Joy DiazMay 26, 2017 7:23 am,

It’s likely you’ve heard people say things like, “our healthcare system is broken,” or perhaps you heard President Donald Trump famously say, “nobody knew health care could be so complicated.” You also may know that Texas continues to lead the nation in the number of uninsured patients.

There’s a new book about healthcare that, although it’s a tough read, may leave readers hopeful.

No Apparent Distress” is the debut memoir of Rachel Pearson, a physician and researcher who is a medical resident at Seattle Children’s Hospital. During her practice years she served patients in Galveston through the University of Texas Medical Branch and St. Vincent’s, a free student-run clinic.

Pearson spoke to Texas Standard about her work with uninsured patients in Texas and how this shaped her practice and perspective on the nation’s medical system.

On medical students practicing on poor people:

One of the reasons I had to write about [Mr. Rose] was because I made a mistake early in my care for him and that mistake was part of what caused his diagnosis to be delayed. Mr. Rose wasn’t unique in having a mistake made on him. That mistake happened because he was poor, African-American, didn’t have insurance, living in Southeast Texas at a time where we didn’t have a county health program and the state hadn’t expanded Medicaid.

You learn pretty early on as a medical student that you will be able to do procedures on your poor patients, your uninsured or publicly-insured patients, that you would never be allowed to do in a private clinic.

On why Texas is a mystery – big-hearted, and at the same time a healthcare desert:

I am a fifth-generation Texan and I love this place. Folks are so generous with their smiles and their conversation and their time. It’s always struck me as strange that we are a community of kind-hearted folks who politically support measures that deny access to medical care to children [and] a state that actively restricts women’s access to basic medical care. The kinds of measures we support politically hurt people.

On how the conversation around health care needs to change:

I think that this conversation about health needs to be centered around morality. I don’t think we’re a country that can stomach just letting people die of treatable diseases… The groups most likely to be denied access to medical care are the groups who have contributed the most to it – I’m talking about poor communities and communities of color who have served as research subjects and the subjects of medical training like the patients I saw as a medical student. Those communities have contributed absolutely the most to medical knowledge, and the fact that those communities are denied the full benefits of medical knowledge and medical care is just unconscionable.

On the distress she sees and feels as a doctor:

Hundreds of times I’ve walked into rooms and seen patients who are in No Apparent Distress (N.A.D), but when I got to know their stories better, I realized that there was a lot of suffering, a lot of distress that was not immediately apparent. I feel like that in a way about our medical system. It’s big and fancy and has great machines and smart people, but underneath the surface of the system there’s a lot of injustice…There’s so much pain involved for me as well. Not being able to get your patients what they need and seeing them suffer, that’s really painful.