View from Washington: Regaining Our Sight

How one patient’s medical journey back to the United States is a reminder of what’s most important about our healthcare system

His name is Paul. Soon he will be a patient in the U.S. healthcare system. While in Australia, Paul was involved in a tragic climbing accident. Prior to the accident, Paul was a 27-year-old athlete and accomplished mountain climber from Philadelphia, Pa. He went to down-under late last year for a climbing challenge on some of Australia’s most rugged peaks. What happened to this young man, and what will happen, says a lot about what is best about healthcare – some things policymakers seem to be losing sight of in health reform.

Fears realized
I was touring the Royal Victorian Eye and Ear Hospital in Melbourne, Australia when I was approached by the CEO. She asked if I would be willing to meet with an American couple whose son was severely injured in a climbing accident. He had numerous traumatic injuries. Ultimately, his parents told me that his emergency care had been first rate. The Australian healthcare providers saved Paul’s young life. However, one of the results of the severe head trauma he suffered was that Paul was now completely blind. The Royal Victorian Eye and Ear Hospital did everything it could to help Paul. However, his parents had questions about what might be best for their son if they decided to bring him back to the States. They were grappling with whether Paul should remain in Melbourne or be brought back to the United States when he was medically able to travel.

They had come to Australia as soon as the accident happened, five months ago. English is the language in Australia, but it is still a foreign country all the same, with an unfamiliar medical system. As soon as Paul was out of intensive care and stabilized, he was admitted to a long-term rehabilitation hospital. His parents did not know how they were going to pay the medical bills that Paul’s care had run-up since being initially brought in by helicopter rescue. There were hints that their life savings had been gone through, jobs, incomes, and lives put on hold, while his parents did everything they could for their son.

In a café in Australia, I listened to Paul’s parents. Words just simply fail me in trying to describe their courage and faith. After months of anguish at their son’s side, these parents simply would not give up hope. They also told me of doctors and nurses that would not leave Paul’s bedside after their shifts were over.

Nurses volunteered to do private duty to help out. His parents told me of a chief medical officer at a hospital who said he had a guest house behind his home that he needed someone to look after. He inquired if they would be interested in helping him out. Staying in this guest house permitted them to both stay in Australia to be near their son during this difficult time. There was the chief of medicine at the Royal Victorian Eye and Ear Hospital who examined Paul and provided his parents with the news that despite the severe head trauma that his eyes were indeed still healthy – hope for returned sight remained. There was the Royal Victorian Eye and Ear Hospital CEO who likely ate the charges for Paul’s examination, medical tests, MRI, etc. The list goes on.

Bringing Paul home
At our café meeting, I recommended that when Paul’s doctors thought he was able to travel safely, that coming back to their home in Philadelphia was a good course of action. The parents said they would dig in and wait for that word. Last night an e-mail from Paul’s parents came through telling me the doctors thought Paul could make the trip. They were bringing their son home to seek rehabilitation, and hopefully intervention for his blindness. Paul’s parents asked me to help clear the medical runway at Wills Eye Hospital in Philadelphia.

I e-mailed the Wills Eye Hospital CEO in Philadelphia. He called me within the hour at my home and asked specific questions about Paul’s situation. He promised to get back to me later that evening. The CEO hung up and evidently proceeded to get doctors and staff out of bed all over Philadelphia. He alerted them about this incoming patient and his situation. A flurry of communications began. Following the e-mail exchanges throughout the evening and into the next morning, the senior medical staff of this world-renowned institution prepared for Paul. Examination times on overly crowded schedules were created.

Place holders for additional medical tests were put in the works. Potential consultations with the world leaders in neuro-ophthalmology were contemplated. Staff, no doubt, was put on notice to pull all the available medical literature on something called “traumatic chiasmal syndromes.” Efforts would be made to gather Paul’s medical records and test results from Australia.

Within hours of being alerted to Paul’s condition and pending arrival, the top doctors at Wills Eye Hospital had a plan in place to examine him and do what they could to help restore his sight. The CEO e-mailed me back with his personal office telephone number, e-mail address, and cell phone to give to Paul’s parents right away. His message to them was simple – please call him as soon as they returned with Paul. Also, he wanted me to convey that the medical staff at Wills Eye Hospital was ready to do whatever was medically possible to help their son.

Not once in the discussions with the medical or executive staff of the hospital in Melbourne or in Philadelphia did anyone ask about money. It was all about what was best for Paul – an incoming patient they did not know. There is an implication in this for health policymakers in the United States. Sometimes, policymakers forget the important intangibles that define our healthcare system and only focus on the dollars and cents. Often lost is the reason many people go into medicine, nursing, and yes, even hospital administration – the idea that they can make a difference by using the miracle of modern medicine to relieve pain and suffering.

We are in the process of reforming the U.S. healthcare system. Some say that medicine today has lost the trust of the patient and engendered fear of the medical experience. This may be true. Nevertheless, there are still outstanding people in medicine and healthcare today that have as their primary aim whatever is best for their patient. This experience with a young man reminds me that the health care we receive is often delivered by the hands of someone who is there not primarily for the pay check. God help us if healthcare reform ultimately drives these individuals from delivering a type of care that simply cannot be measured in money.

About the Author

Robert Betz Ph.D.
Robert Betz, Ph.D., is president of Robert Betz Associates, Inc. (RBA), a well-established federal health policy consulting firm located in the Washington, D.C. area. Additionally, Dr. Betz is an adjunct professor teaching at The George Washington University where he specializes in political science and health policy. For more information about RBA, visit