Entitlement and the Poor

March 15, 2007 at 10:59 am (Michael's Posts)

I was shadowing one of the very senior attendings in the department of medicine at Cook County Hosptial a week ago. His reputation is well-established as a thorn in the side of those who would rather turn a blind eye to the bureaucratic waste and BS that the poor who utilize the Big Public Hospital have to put up with. He fights for them in every way he can every day. Because of his fierce advocacy, he has been passed over for promotions that he absolutely deserves. He’s not popular with the higher-ups. But the work he’s been doing for the last 30 years is indispensable. Truly an inspiration.

As we were coming out of one patient’s room, Dr Schiff commented that he was a “Classic County patient. Never worked a day in his life. Just sitting around waiting for a handout.” Now listen for a minute to this guy’s story. And imagine that everyone we talked to had a similar one.

When Dr Schiff asked this man what he had done for work in his life (he was 81 and built like a horse except his heart was fluttering like a drunk butterfly), the man looked at him with a weary smile and said, “Everything.” He worked construction during the week, bartended at night, drove a cab on the weekends, did upkeep work for various churches, etc, etc. He put FIVE of his eight kids through college. In short, he lived a busy, stressful, and very productive life.

Dr Schiff was obviously kidding when he said what he did. And with a lot of bitterness in his voice. He made me realize consciously what I knew about the people I saw in the outpatient clinic: all of these people worked hard and they’re still poor.

This idea we Americans have about “Bootstraps” and the ability to pull oneself up by them is maybe partially true but is way more conditional than we’d like to think. It depends on what you have to fight against to get upward motion. It depends on if you even have bootstraps to pull on. Think about our 80 year old friend who, with the most dignity I can imagine, submits to the whims of an inefficient bureaucracy whose higher-ups could care less about him for his medical care. Think of his grandchildren whose lives he made better. How can we treat him the way we do?



  1. Eli said,

    Thanks for this compassionate post. I also see that we tend to disregard the hard work of immigrants, both legal and illegal, making it hard for them to get health care, for example. The bootstrap idea is a terrible myth because it implies that the poor are lazy and/or stupid and even deserve to be poor. Oddly enough, the social mobility of some poor people into richer neighborhoods seems to undermine our compassion for others. Just like how saying that such-and-such a person “triumphed over her illness” because she had “an insurmountable will to live” casts scorn on those who just don’t make it through.

    In the back of my mind, I’ve known about this blog for some time, and I’m glad to finally see it!

  2. msoule said,

    Thanks for reading! I appreciate your comment and look forward to seeing more of you around here đŸ™‚

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: