Submitted by Ali Shefizadeh
Recently, NBC aired a special titled “Farrah’s Story,” a two-hour documentary that drew almost 9 million viewers. It chronicled Farrah Fawcett, the sex icon of the 1970s and ’80s whose hairstyle was emulated by millions of young women, and her struggle with anal cancer.
The NBC special was remarkable for several reasons: It brought to life the personal, rather un-glamorous, life of one of Hollywood’s very own, and it brought the spotlight on a disease that rarely garners as much media attention as the swine flu, HIV/AIDS or any of the other hot-button health issues these days.
Farrah means “joy” in Arabic, and her story illustrates the power of not only resilience and determination to live against remarkable odds but, more importantly, of the power of sharing one’s life and her courage to do so.
Toward the end of her video diary, Farrah reflects upon three questions she has, and one in particular drew my attention: Why, she remarks, does our health-care system not embrace alternative treatments that have proven to be successful in other countries?
Fawcett said earlier in her documentary that she was first treated at UCLA Medical Center, where doctors explained that they would have to do a colostomy because they would be otherwise unable to take out just the cancer cells in the affected region. This explanation from her doctors is one of the reasons she decided to pursue alternative treatment methods and greater “hope,” finding a clinic in Germany that offered her just that, and an alternative treatment to spare her a colostomy.
Why could she not find the same treatment back home and why did she endure the agony of at least six trans-Atlantic trips for her treatment in a foreign country?
The short answer is that the treatments Fawcett pursued in Germany are not FDA-approved. But her question provides food for thought for not only the future of cancer prevention, diagnosis, treatment and palliative care in this country but also for the future of health-care reform in America.
While she is a celebrity with access to the best international medicine, we have a patchwork of health-care systems in our country, public and private, that still leaves almost 50 million Americans without care and millions more under-insured.
Her experience is a lesson for all of us to pursue preventative care for cancer, including mammograms and pap smears.
Preventative measures also include colonoscopies for everyone older than age 50 and not smoking ““ lung cancer is the deadliest type of cancer in the U.S. ““ and a host of other measures depending on your own set of risk factors.
Farrah’s question is an important one as we debate and decide the future of health care in this country.
For all the criticism it gets, U.S. health care is the envy of the world, with some of the best and most sought-after doctors, latest technology, and innovative research that helps introduce some of the life-saving drugs that advance our care for many ailments that were previously treated with palliative care at best.
At the same time, the “lawyerization” of medicine and its status as one of the most litigated professions within the context of the increasing influence of HMOs and managed care has undoubtedly influenced care.
One report found that more than half of all physicians think their ability to provide quality medical care to patients has gotten worse in the past five years, and more than three-fourths of physicians believe that concern about malpractice litigation (76 percent) has hurt their ability to provide quality care in recent years.
These statistics, combined with decreasing physician salaries over the last decade and increased oversight over almost every aspect of patient care, has resulted in a culture of defensive medicine, where physicians order tests that may be unnecessary in order to protect themselves against frivolous lawsuits.
So why did we not offer what Fawcett so desperately wanted? Well, that’s a complicated question, but the answer partly lies in the fact that the mosaic of tightly knit state and federal regulatory mechanisms combined with a malpractice-plagued culture in this country has in many ways hindered the innovative spirit that makes this country so wonderful. We’re so concerned about getting the treatment right that in some ways we have stopped trying different methods that are experimental.
“Farrah’s Story” demonstrates how crucial it is for all of us to be proactive in the current debate over the future of health care in our country.
I’m not a politician, but I know one fact very well from my life experiences: There is no such thing as a free lunch. We as a society must come to the realization that if we are to continue to have a health-care delivery system that is the envy of the world, where people who can afford it have choices, then we must find a way to pay for it. The human talent, technology, pharmaceutical innovation and your doctor’s never-give-up attitude that bring millions of patients from all over the world to our hospitals and medical centers cannot continue without appropriate funding.
Fawcett, like millions of other patients, wants hope, but that hope would be an empty word if it did not come with physician autonomy to care for our patients as we see fit and to administer tests that are necessary without going through authorization after authorization and bureaucratic red tape. It also requires that malpractice reform become a high priority in any broader health-care reform we enact, and that all of us ““ young and old, of all shapes and sizes, and of all socioeconomic backgrounds ““ contribute financially on a sliding scale to our health-care system.
Only then can we have a health-care system where emergency care is the last option instead of being the only option for millions. Only then can we have a more just and equitable society where all, not some, of our people enjoy the benefits of our health-care system. And only then can we have a rightful place for experimental treatments without fear of litigation, so Fawcett, like millions of others, can stay here in her own country rather than go overseas to receive the life-saving treatment she so desperately wants and deserves.
Shefizadeh is a medical student at the David Geffen School of Medicine at UCLA and a representative to the Los Angeles County Medical Association. He is also on the executive board for the Persian American Society for Health Advancement.