Word: rosa
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...Rosa was a Medicaid mother of three with a painful wrist. In her early twenties, with no husband, on child-support, she was a typical patient from "the neighborhood". Rosa was pretty saucy though; she let you know she didn't like waiting, she was snappy during her interview, she made sure I wrote her out prescriptions for all the medication I recommended, even the over-the-counter ones. This way they would all be paid-for. She spoke no English, and she even poked fun at my clinic Spanish. I made a note of it in her chart...
...been living in my country all this time and you haven't learned any English? A lively debate on the merits of a bilingual society gave way to a cortisone shot for the same wrist pain. I had our therapists make her a splint and said 'adios'. I liked Rosa...
...went in and said hello to Rosa. We talked as I examined her. What a change! Well-dressed with her hair pulled back tight and carrying a small brief, Rosa had gotten a job. She spoke English decently. She had gotten her kids into a Catholic school. Some magic combination of seeking out a 'better life for my kids' and Welfare reform had helped her make it - though barely. I tried to show off some improved Spanish while explaining the wrist problem. "Give it up doc" was her response. "Just tell me what is the problem and what...
...next cubicle was a woman more like the old Rosa - no job, no husband. She had been injected and splinted and was still in pain - though less, I felt, than Rosa. I gave the explanation in Spanish with help from my bilingual resident...
...Rosa would have to pay over five thousand dollars to have her wrist fixed. The lady behind door number two would get it for free. There were no "doctor's bills" in these prices; the residents are salaried by the hospital, I work the clinic for free and operated on clinic patients gratis. The hospital did, however, accept Medicaid payments. Rosa was now employed - no longer Medicaid eligible - and she had paid $45 for the clinic visit that day. And because she wasn't in any health plan that could strong arm down the hospital bill - they got about...