metta

I happen to run a Free Clinic in NC (I'm an NP), but also have done the mission stuff in Peru too. Depending on where you live, some Free Clinics have gotten coverage through the Federal Tort Claim Act so that if you were sued, they really have to sue the Federal Government (kind of how they do at Military facilities etc.) We haven't gone through all the paperwork for that yet but we haven't had any problems yet either. Our clinic uses 150% of the Federal Poverty level as our guideline and we make the patients "prove" their income as best we can. We also get their meds through the Patient Assistance Programs that the pharmaceutical companies operate. I have found that my patients run the gamut...some really are very poor while others just haven't quite gotten their act together to get a job etc. Some are very thankful and others feel like they are "entitled" to our services even though we don't take a dime of state or federal money....everything is funded through donations, grants and volunteers. One interesting note about foreign mission work...I have gone on a specific trip to the same place in Peru twice. Once in 2005 and once this past year. The first year I went most of the moms and kids were fine---mom just wanted you to "lay hands on them" because they lacked medical care and wanted to make sure they were ok. This past time, however, they have gotten a bit "spoiled" with our coming every year. The moms would complain that their kids didn't eat, or were sick....even though you could tell that they were most (not all) quite healthy--- just because they were so accustomed to us giving out children's chewable vitamins, toothbrushes etc. etc. and maybe they were afraid we wouldn't give them anything if we told them there was nothing wrong. It would make me laugh because they would say "oh, my son is so short" when mom was 4-10 and dad 5-0 tall.

Yes some of us lefties are indeed gun owners...we are all complicated mixtures of views and beliefs that do not fit into neat little titles...or boxes.... . Just like you cannot put Mr Heston's life into one smart ass comment about prying a gun from his cold dead hand. I am sure there are many other things about him that will make his life stand out....I know for sure as a kid I was enthralled by all of is epic movies. May he rest in peace.

Go to Peru....I have been there on 2 medical mission trips that combined both work and fun. Machu Picchu is worth seeing. This link is to friends of mine who live down there and do the travel plans for folks. Very nice people. Only drawback to traveiling outside the US is that the dollar doesn't get very far. This past trip (got back a couple weeks ago) was the first time I had been in Latin America where the locals actually did not want dollars! http://www.viajesdoro.com/english/english.html

I don't know that the feeling of sadness in those situations ever goes away---and I don't know if you would want it to go away completely because does that mean you lose your compassion for people if it does? I think it is a balancing act in some ways...you have to make sure it doesn't completely overwhelm you because you don't want to get to the point where it keeps you from doing your job. The hardest things to deal with usually involve kids. One thing to remember too...and I am sure they have talked about it in your classes...folks in full arrest generally don't make it. I think in all of the times I have been called to a code--in the hospital---not one of those patients lived, and that is where there are all the things that you would need to use, so imagine when you have someone down in the field for a while. But I do have a friend who coded in the gym and made it---because there was a defibrillator close by! My experience is as a nurse by the way---I went to EMT school first, and then ended up in Nursing school.

The problem that you have with them too is that your other med---meloxicam---or Mobic is not always so great as an anitinflammatory/pain med for some people either. You might want to ask your doc to switch you to something that works really good as an antinflammatory like Naproxen or even the stronger doses of Motrin, and alternate them with the Ultracet. There are other strong anti-inflam drugs out there like Cataflam or Voltaren...they can be rough on your stomach like motrin or naproxen can too so you have to watch out for that. You may find that you can have better pain relief with some of those older meds. Of course, keep up with the PT, icing etc. Hope you feel better!

If you do medical uninsured v. insured you can do look at quite a few angles.... the people with insurance have their ins. company negotiating with doctors and hospitals for the rate that you pay. If you are uninsured, and you go to the ER--you actually pay more than the insured people would be billed---to make up for the other people who are unisured who can't pay (and probably for the lost funds that they don't get because of the negotiations with the companies ). People who are really poor and can't pay usually get charity care at a non-profit hospital...but they also use the emergency room as their primary care which is more expensive. So all of those costs come down to everone else in the end. Another thought is that prob about 20% of our medical costs are the overhead for the insurance companies. This site might have whatever stats etc. you might need [url] http://covertheuninsured.org/ Hope this helps....sorry to give so much info...but I work with uninsured people who need medical care!