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I thought Tweedy’s reflection on the two patients Henry and Adrian toward the end of the book was really interesting. On one hand, Adrian had a history of alcohol and cocaine abuse. While Adrian had been clean and was taking daily aspirin and blood pressure medication, he didn’t improve his diet or stop smoking cigarettes. As a result he had a mini-stroke that left him disabled. On the other hand, Henry had been diagnosed with schizophrenia and his medication caused excessive weight gain. When Tweedy saw him after losing so much weight, he had worried that Henry went off his meds but Henry had made “real, positive health changes” like exercising and eating healthier (208). Tweedy noticed that “on this day, one man had made good choices and increased his odds of a healthy future. The other hadn’t and, at least partly for that reason, faced a heartbreakingly new life” (209). These two cases just go to show the profound impact that our daily choices can have on our health, but, like Tweedy says “the reasons we make those choices are more complex” (210). I think it’s really interesting how, aside from socioeconomic settings, the doctor-patient relationship can be one of those reasons. Tweedy suggests that he could relate more with Henry and his struggles than he could with Adrian’s. This is similar in the case of Keith, a patient Tweedy was able to find common ground with, despite being of a different race.
courtab, I thought that New York Times article about the three patients was unbelievable, but it did a really good job highlighting how significant structural circumstances are to patient outcomes. I also liked your point about how statistics and stories need to come together. That’s one of the things that makes this book effective, Tweedy combines his anecdotes with other studies/research and anecdotes from books written by other people who have had similar experiences
Tweedy’s encounters with Pearl and Tina at the clinic in chapter 3 were particularly rich parts of the book. Working at the clinic was a transformative experience for Tweedy because it made him reflect on his own health struggles and the contrast between him and Pearl and Tina. Like Pearl and Tina, he has high blood pressure and had had contact with the culture from where they were coming; he was familiar with the colloquial terms of “sugar” and
high-blood” because of his grandmother. Unlike Pearl and Tina, Tweedy understands “the language of medicine”, has access to university gyms and sources of healthy food, has health insurance, and has a stable doctor-patient relationship (73-74).
Here, as he does throughout the book, Tweedy weaves in historical and socioeconomic contexts to supplement his personal anecdotes. He writes “Given these glaring differences, it should come as no surprise that the poor and uninsured as a group have worse health outcomes and higher death rates than people with health insurance” (74) and goes on to cite various studies. Prior to the clinic, Tweedy had no awareness about the uninsured, but afterwards posed questions about the healthcare industry and its responsibility to people. This anecdote and statistical knowledge reveals something that’s hard to believe, that one’s chances of living or dying is heavily impacted by one’s circumstances in life.
