Finding the Humanity in Healthcare
A grave failure and a tremendous opportunity
Healthcare in America feels like a pot that has been simmering for the last five years (probably longer) and has finally reached a boil— so much pain, so much suffering, and so much frustration.
So little humanity.
I was on vacation last week with my family, and after five days of soaking up the sun and basking in our kid’s enjoyment of the beach, we all got hit by a brutal stomach bug. I got so dehydrated that I couldn’t stand, and my body started cramping. As I lay there with the room spinning and muscle spasms cycling around my body, I gave in to my wife’s pleas to let her call the EMTs.
Despite a language barrier, it was clear to them and us that I needed fluids. The problem was that they could only give me the IV they had with them if I agreed to go to the hospital. So off we went. Given the dizziness, I was desperate for anti-nauseous medicine, yet again, there was red tape. They needed to call and ask some distant person for permission. Worst of all, their “standard of care” was to take me 40 minutes to the regional hospital, which was only avoided because my wife intervened and convinced them to take me 10 minutes to the local emergency room (ER). The bureaucracy and rigidity added friction to each step, dragging me along while the world spun and my body cried out for water. In the grip of these “protocols,” I felt a growing anger and gnawing helplessness.
Yet when we arrived, I was brought right into a back room where two wonderful humans immediately and lovingly nursed me back to health. It felt like being transported back 50 years. There were no computers anywhere but paper charts and paper scripts. The young doctor showed up in jeans and a sweatshirt with a casual and warm: “What’s going on? How can I help?”. He then proceeded to listen to my story, treat my symptoms, and check back in until I was ready to go. Simple, yet so refreshing.1
Now that we’re home and on the mend, I can’t stop thinking about the differences within this experience.
The EMTs were friendly and kind. They playfully joked with my wife in Spanish that I was likely another victim of the local fish and teased me for working too hard in the gym. Yet the system wouldn’t let them bring this same humanity to my actual care. The ER was somehow an oasis from this bureaucracy where the doctor had the freedom and confidence to treat me like a human. In his presence, I felt myself relax, and I knew I was safe.
This is a minor example, but it’s fresh, and I’m sure you can relate. Unfortunately, everyone I know has had or knows people who have experienced something similar.
This lack of humanity is present in so much of our modern healthcare.
I don’t have an easy solution to share today, but I want to discuss why I think it matters. I want to poke at the problem to highlight what is lost.
I’ve had my share of run-ins with healthcare throughout my life— A stomach surgery at 14, a type 1 diabetes diagnosis at 15, a Thanksgiving morning trip to the ER for stitches, and now this latest island ambulance adventure.
The simplest way I can describe how I felt in each of these is deeply vulnerable.
In many ways, these moments are when we feel most human, most raw, most alive, and most aware of our mortality. All the bullshit fades to the background, and we’re left face-to-face with what matters most to us.
To take a full breath, to swallow and digest our food, to stand and smile without the room spinning, to hold our kids, to kiss our loved ones, to be with our people, to do our work, to move our bodies, and to savor every moment.
Yet, in these moments when we are most human and most vulnerable, we are met with a system so lacking in compassion, empathy, support, and connection.
It breaks my heart to think about all the different ways I’ve seen this play out. The person whose life is thrown upside down by a cancer diagnosis and then spends their precious energy navigating insurance roadblocks and scheduling headaches. Or the person who returns home from the hospital after suffering a heart attack, alone, with no one but themselves to adjust to their new world of rehab, medication, and lifestyle change. Or the person who suffers from chronic pain or treatment-resistant depression who bounces from provider to provider and treatment to treatment in desperate hope for something and someone to finally help.
Often, a family member or a friend jumps in to help navigate the mess. Or, if you’re lucky like we are, you have a rolodex of friends who are doctors that you can call. My wife and I joke that we’ve collected someone in every specialty to backdoor the system. We can talk human to human and get personal guidance and ongoing support.
But even with this immense privilege and access, there’s only so much they can do. At the end of the day, when you’re in the system, you’re in the system. There’s an ICD-10 code to diagnose you. A CPT code to submit a bill for you. A prior-authorization or a claim review to hassle over the reimbursement of you. The insider lingo doesn’t matter, the point is we’re just numbers— unique identifiers with associated dollar signs.
There are amazing people in healthcare. There are doctors, nurses, and armies of support staff that show up each day to care for the vulnerable and heal the sick. Even most of the administrative people throughout the system are well-intentioned. I know because I’ve worked with them. The humans working in healthcare go to extremes to work through and around the system.
But everything in the system pushes us away from being treated as people and toward being treated as numbers. They are fighting against the tide, and we’re just along for the ride.
So, what happens in this mismatch? In the discrepancy between our humanity and vulnerability and the system’s callous indifference and detached bureaucracy?
People give up.
They stop trying. They shut down. They lose hope. They stop taking their medication. They bail on the lifestyle changes. They skip the next appointment. They opt out of the system. Sometimes, they even pay with their lives.
Some will read this and think: “But where’s the personal responsibility?”
That exists. It’s real and needed. However, we should ask how our healthcare system can encourage and empower this responsibility instead of tearing it down. We should push for a system that nurtures the human spirit instead of extinguishing it.
If this sounds idealistic or naive, then we’ve lost the plot.
There are so many patients who respond to life-threatening diagnoses and near-death events by transforming their lives for the better. There are people like Dr. Paul Farmer who create beautifully human community-based care models. There are organizations like Boston Healthcare for the Homeless that support some of the most complex and challenging patients with the deepest levels of compassion and connection.
These examples point toward what is often missed about the failings of our current system. The moments when people need the system, when they are in their darkest and most vulnerable hours, are moments ripe with everything that makes us human. These moments open us to love, death, beauty, connection, gratitude, renewal, aliveness, and so much more. Yet so often, and for so many, the door slams shut before they can step through. Our current system snuffs out the flame.
To me, this is both a grave failure and a tremendous opportunity.
So, while I don’t have answers, I plan to share more stories and ideas that bring me hope. I plan to connect with people and contribute to projects striving to bring more humanity to our healthcare.2 My guess is this will require the people inside and the people outside the system to come together to tackle the problem. Human to Human.
In the next post, I’ll share a deep dive into one area of healthcare that I think is way ahead of the game on this.
Thank you for reading. As always, I’d love to hear from you with any reflections, questions, or ideas in the comments or by replying directly to this email.
This experience happened in Puerto Rico, which feels fitting given it’s both a part of America and yet not fully “A State of the Union”. I’m not suggesting care was better 50 years ago or that computers and technology are the problem. I'm just sharing how nice and human my experience in this ER felt.
If you’re working on bringing more humanity to healthcare or know of exciting things in this space, I’d love to hear from you.