We almost lost my dad several years ago. It was the very first Thanksgiving our schedules were finally going to allow for my entire family to be all together at my parents’ home in Hebbronville, Texas. For perspective, Hebbronville is a small community in South Texas located about 60 miles from Laredo and approximately 110 miles from Corpus Christi. This seemingly unimportant nugget of information is actually important in my story.
A few days before we made the trip from Austin to Hebbronville, my mother called to let us know that my dad was feeling ill, but they thought it was maybe a stomach bug. We figured by the time we were scheduled to arrive that Dad would no longer be contagious, so we packed up the car on the day we were expected with our luggage and Thanksgiving pies and headed south. When we arrived, Dad was still in bed not feeling well. This is very unlike my father who I truly cannot remember taking a day off of work for any reason when I was growing up.
My father emerged from his bedroom that evening, and my husband and I immediately knew this was not a stomach bug. He was pale, which is hard to accomplish when you have worked out in the hot sun your whole life, and he could barely hold himself up long enough to get a drink of water. As he went back to bed, we offered to drive him an hour down the road to the nearest emergency center in Laredo. He refused.
The next morning, under the threat of complete revolt from the entire family, he agreed to let my mother drive him to Laredo to a freestanding emergency center where a team of nurses and a physician immediately determined that my father was bleeding internally. For over four days, my father had been losing blood from an internal stomach bleed caused by his cirrhosis. Had we not rushed him to the nearest health care facility that day, he likely would have been gone by the next morning.
The good news is that Dad survived after a week in the hospital and 7 pints of blood. The point of this story though is deeper than the scary situation. You see, unlike people like me who live in a city where there is doctor’s clinic every couple of miles, my parents have limited access to any health care. There is one clinic in town that is run by an advanced practice registered nurse, but the wait times, because of the demand, are unfathomable. One APRN, for an aging town of 4500 people is truly God’s work.
When I was growing up in Hebbronville, we had an amazing family physician who cared for the community. In fact, there were two local doctors who cared for the people in our town. Both eventually retired, and a clinic run from Laredo, Texas is all the community has left.
So, much like my father did that week, people in our community wait it out. You see, if it was a stomach bug, Dad didn’t want to waste anyone’s time in the clinic or at home for something that would pass. He certainly didn’t want to make my mom drive him an hour away, only to wait for another few hours in a waiting room to simply be sent home with a diagnosis of a stomach bug and an outrageous medical bill.
Dad’s story is unfortunately not uncommon in a state as big as Texas. Hebbronville is lucky to have one APRN. There are communities much further from health care than Hebbronville, where there is zero access to care, not a nurse and certainly not a physician. And, don’t even get me started on specialty care of any form! Dad now has to take an entire day off of work for monthly doctor visits. And, if his doctor wants a blood draw, he has to take an additional day off of work to drive to Laredo, wait in a clinic for a blood draw, drive back home, only to return two weeks later to once again sit in a clinic for hours waiting for his turn to be told the results of his blood draw. Those months, he is out two full days of pay or sick leave, plus the costs of the blood draw, doctor copay, and a full tank of gas.
So, when the legislature holds a committee hearing on allowing APRNs to practice to their full education and training without having to pay a doctor for a phone call once a month, and the testimony is filled with animosity between nurses and physicians without regard for the millions of Texans like my dad who have limited to no access to a provider, my heart breaks.
The hope that the pandemic would move people to do the right thing and think about the Texans without adequate access to providers has faded. Here we are again, another legislative session halfway through, and the fight over education requirements and ridiculous delegation contracts may once more leave millions of Texans without the access to providers they need and deserve.