The Joy of Healing: Bimini 1972 – 1975
For me, it has always been a privilege and a joy to help people with their health and health care problems. But my most joyful and productive healing encounters are burned into my brain. These uncommon experiences play over and over again in my mind and they set the metrics for what is simple and good care. Bimini was the setting for a series of weekend trips to cover “the health clinic” to give the full time nurse a break. This is the story.
As a part of our training at the University of Miami, Family Medicine residents had the opportunity to volunteer for weekend duty on the island of Bimini. The deal was simple. Pay your way, buy tickets to fly from Miami to Bimini on Chalk’s Ocean Airways (I think it was less than $50 for a round trip ticket. The airline is no longer operating), stay at the clinic for free, see patients as needed on Saturday and Sunday, goof off when you have time and fly back to Miami on Sunday afternoon. There was no money expected as a part of the deal, but there was plenty of currency exchanged.
The trip was an adventure from start to finish. The seaplane ride was a kick from take off to landing (http://en.wikipedia.org/wiki/Chalk%27s_International_Airlines#History) and Bimini, 50 miles off the Miami coast is a tiny gem of the Bahamas plunked in deep blue ocean. Sweet warm air, sunshine and clear blue water characterize this little paradise. For now, I will skip the exciting details of the journey … we went there to work, not play.
After arrival and introduction to the island and the clinic by the nurse, a quick walk around the island took a few minutes. “Make sure to take the money they offer you.” The nurse would then depart for her weekend off on the same sea plane that brought us there. Then, maybe enough time to take a swim at the beach, a shower and find some food. Of course, the family had some time to play at the beach and wander around the tiny place, but patients would quietly show up and wait on the porch of the simple concrete building from time to time over the weekend. And, patient care was the highlight of this trip.
The clinic was simple … very simple, clean and neat. The raised porch and nearby entry by the steps had benches for waiting patients and sniff the sweet sea air in the process. Supplies and equipment were very limited. Most pharmaceuticals were donated samples and we have a few disposable syringes and very limited sterile supplies. What could a physician in training do there? Not much, but I do recall helping several people despite the limited resources and absence of technology. This was simple care and simply good care … Patient-Physician Care … and I do not recall medical records of any sort, but I did take a few notes.
Here are a few short clips from memory.
The man with a broken arm. Softball injury. Had to make a clinical diagnosis of broken humerus. No X-Ray equipment. Had to refer patient to Nassau for definitive evaluation and treatment.
The little old lady with a chronic medical condition who simply wanted to “see the doctor” to make sure that she was on the right path. I reluctantly took the $3 in quarters that were neatly wrapped in a kerchief and she happily walked out after I took her history, checked her vital signs and did as much of a physical examination as I could with a stethoscope, blood pressure cuff, thermometer, otoscope, ophthalmoscope, my hands, eyes, ears and nose and sent her on her way to continue the care she had been receiving from the nurse. Old school was just fine for these folks … it was then, as it is now for most people most of the time.
The sport fisherman from the mainland who was miserable and swollen up as a result of a generalized photosensitivity rash happily paid $40 for a steroid injection and a few oral anti itch pills.
There were many other Bimini Islanders who came in with their neatly wrapped rolls of quarters. Always $3, always happy to get an opinion from “the doctor” and always content to walk away with it. The money was a part of the deal and part of the contract and, no doubt part of the therapeutic benefit. I had no money in those days, so permission from the nurse … the fact that she insisted we keep the money made it a guilt free way to cover our cost.
For me, it was the joy and the learning that made the trip valuable. The money barely covered the cost of the trip … this was true reciprocity. Patients got what they needed and I got what I needed to keep on keeping on. And we all went on our merry way.
So, the patients got care and I got care for me and my family. It actually cost me a few dollars to take on this duty, but the value was … priceless … as have been other adventures in healing that I will describe as I further elaborate in “The Joy of Healing”.
The take away message from Bimini is simple: Most care is self care, but sometimes simple care from a healer is necessary for many reasons and sometimes more technical care is necessary. Technology is a tool … one of many needed to help physicians and other providers optimize patient care. Technology is NOT a panacea and it is not the universal solution to problems created by The Business of Medicine. In Bimini, the Patient-Physician-Nurse team simply took care of most patients and that simple model can still work today. Let’s get on with breaking down the barriers between Patients, Physicians and other Providers, and get on with Building Better Health and Health Care through Patient-Physician-Patient Cooperation and Cooperatives.
Please comment and
Have a sweet new year.