Free of Charge

“If all the rich men in the world divided up

their money among themselves, there

wouldn’t be enough to go around.”

-Christina Stead

She was one of my first patients.  She had a severe case of rheumatoid arthritis.  There was an older doctor, older than me anyway, who practiced down the hall from me.  He also specialized in arthritis.  Maybe because he had lost his passion for medicine; maybe because he was in failing health, maybe because he was not a pleasant person all along, he did not treat his patients well.  As long as he was the only game in town he had a large practice.  When the word got around that there was another choice to his demeanor, many of his patients made the short walk down the hall to set up an appointment with me. 

May was one of these people.  She came with Julia, her best friend, who also had RA.  My competitor had performed an abdominal exam on Julia, and after he was done he had scribbled the word “fatty” on her abdomen.  Yes, I know it’s hard to believe, but in those days doctors got away with a lot.  Julia was furious; she stormed out of the office and dragged May along with her, who was to be my rival’s next appointment.  I happened to have an empty slot at the time; May was seen promptly and courteously.  Julia set up a visit to come back when her medicine had to be refilled.

I took care of them for the next two years.  They always came together; a study in contrasts.  Julia was tall and mildly overweight; May was no more than five foot tall and slender.  Julia colored her hair a deep black; May allowed hers to be white.  Julia was loud and opinionated; May was quiet and reserved.  They lived in the neighborhood; they dressed modestly; there was nothing about their demeanor that made me think that they were anything but retired widows who had to scrimp and save in order to be able to make it.

The day came when May’s disease flared up.  In those days we used gold injections for the more severe cases.  I told May that the time had come to intensify her therapy.  She would need weekly injections for four months; she also had to have frequent urine and blood tests.  She showed me a look of concern.

“How much will these be?”

It would come to ten dollars a week; May’s Medicare should cover most of the lab studies.

“I can’t afford that.”
It’s your health.  Once we get you in remission the shots go to once a month.  Surely you can afford ten dollars a month to be pain-free.

“I’ll just have to get along without them.  I can’t come up with the money.”
At this point I got the impression that May was not done talking; that she was waiting for me to say something; that she really expected me to give her the shots for free.  Something in her expression…

I was about to say that I’d be glad to cover the cost of the injections when my nurse knocked on the door.  One of the hospital nurses needed to talk to me.

I excused myself and walked outside to answer the phone.  After I hung up I ran into Julia in the hallway; my nurse was escorting her into the next exam room.  I said hi, and was about to walk by her when she reached for my arm.
“Anything you want from Florida?”

Nothing I can think of.  Who’s going?

“I’m going with May.  We leave over the weekend.”
Who does the driving?

“We don’t drive; it’s too long a trip.  We fly.”

Staying for a few days?

“No; we stay for the whole month.”

Do you have friends that you stay with?

“We rent a hotel suite.”
How can May afford to fly to Florida and stay in a hotel for a month?  I couldn’t help but ask.

“May’s husband left her very well off.  He had sold his business, and there was a lot of insurance money.  She’s better off than I am.”

I felt my blood pressure rise a few points.  I wished Julia a nice trip, and I walked back into May’s exam room.  I produced the sternest look I could muster.

You’re starting your gold shots as soon as you come back from Florida.  And you’re going to pay for them. 

She smiled, much like a child who has been caught with her hands in the cookie jar smiles.

“OK.”  No more pleas or arguments.

May received her injections.  She improved.  She died a peaceful death in her early nineties.  We never discussed money again.

Time and again, over the years, I have run into similar situations.  Wealthy people who ask me for discounted rates.  A millionaire businessman who repeatedly begged for free samples of his diabetes medicine, even after I explained to him that I’d prefer to keep the samples for those who were struggling.  People who drive expensive cars and refuse needed treatments because they felt they could not afford them.

As old as I am, I still don’t get it.  I’ve given up trying to understand, and I certainly don’t have the resources to do an in-depth financial analysis of my whole practice.  Most of the time I end up giving in, and I skip a charge, because I could not live with myself if I ended up failing to help someone needy.  But I admit, I always wonder if I’m dealing with another May…


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This Post Has 5 Comments

  1. June Fleming

    I lived in a small town in Norhtern Ontario, Doctors are scarce, and there are no specialists to take care of various problelms people have, if you needed to see one you would have to go to Toronto, or maybe North bay, or Sudbury,

    I recall one day I had to take my daughter to our family doctor in New Liskeard, Ontario. One of my friends offered to take me because my husband was away. Dr. Labur’s office was full o people and there was hardly a place to sit. except on the floor. I was so worreid about my child that i just had to see my doctor. DR. Labur would come out and say” I am not taking anymor patients to day, so you all can leave now” but nobboy believed him and we all stayed.
    The nuse would come out and call another one in., and so it continued until he had seem everyone in the waiting room.

    I sat holding my child in my arms while she cried, and worrried about the kind man that was still sitting in his car to take us home. He was my dear friend’s husband. His wife Shirley and I worked at a mining office together years ago and her husband was a mining engineer, and a teaher at the minging school in Haileybury where we lived. Shiley and Al were the kindest caring friends I ever had. I will never forget them.

    Finally I got in to see my doctor, and he took care of my little one, and Al took us home. I thanked him for his kindness, and for waiting for us for so long.

    My next visit to Dr. Labur was for myself. I was cleaning my Kitchen window and rammed a sliver into my finger. I could not get it out myself. DR. Labur said you will have to go to the hopital to get it out. I said,I can’t do that. So he froze my finger in his office and took it out. I was so relived to get it out.

    A few months later my husband’s mohter was suffering from sever rheumtoid arthritis, and my husband’s sister Jean was home for a vist.. She didn’t know that we had called Dr.Labur for her mother..

    All of a sudden the door opens up and Dr. Labur comes in with his Dr case. Jean my husband’s sister looked up at the doctor, and said,” who are you,” as he was heading up the stairs to see mom Fleming he said,’ I am the undetaker,” and kept going. up the stairs.

    I laughed and told Jean he was mom’s Doctor. Those where the days the doctor came to your house to see you, if you were too ill to see him in his office.

    Jean and I went up stairas to see mom Fleming after the doctor left and asked her how she was doing. She said,” the doctor gave her an injection for pain.” Jean said, ” how much did the doctor charge you for his call. ” Mom repied, ” He just asked me for cigaretts, one for this call and one for the next one after this.. .

  2. Jorge González

    En muchas culturas del mundo se establece el regatear el costo de las cosas y buscar el mejor precio posible. En la Biblia Moisés le regatea a Dios que no destruya una ciudad si encuentra 50 personas con fe luego sigue reduciendo el número esperanzado en la misericordia de Dios. En la China se regatea todo precio como una costumbre común. En nuestra cultura al principio de siglo era muy común el estado paternalista, dándole ayuda a todo el necesitado. Hoy tenemos una parte de la población que vive de ayudas gubernamentales que se han hecho expertos en buscar todos los beneficios posibles del estado sin ellos aportar nada. Son conductas que recibimos de otras culturas. Jorge

  3. Vannessa Ramirez


  4. Cordell Webb

    Stories like this never cease to be amazing. It seems to me that the people who work the hardest to have what they have, work hard to keep it and because they had to work hard to get there and probably made sacrifices continue to be careful about spending. Of course this person was actually trying to take advantage of your kindness but that is wrong. Probably that had been her way of life and continued to be her way of life. Younger people who inherit wealth from family seem to enjoy spending to have all there wants in life. I am sure since you meet so many people, you meet all types.

    1. Betty Townsend

      I think we all have a set of priorities that we think are important. Thankfully I would go into debt to take care of my health. I like to pay my way, but there are things I will do without because I feel they are too expensive. to each his own.