This is Amerika?

So, the economic stimulus package has passed. Yipdeedoodle!

Really, I am glad.

But I wonder if those guys who wrote and passed the package have any idea about what's happening on the ground and the needs of us poor slobs working in clinics that take care of people "on the margins." I mean, the people who nobody wants to take care of--homeless, mentally ill, drug addicted patients with a laundry list of chronic illnesses.

My kind of people!

Many nurse practitioners work in clinics in which we have to beg for simple stuff--pens and pencils, ink cartridges for the fax machine, the right kind of medication to treat our patients.... We are working in developing country conditions right here in big cities and rural areas in the land of plenty (or, what was until recently the land of plenty).

When Katrina hit, I was "deployed" to a huge abandoned facility outside of Chicago that housed over 200 Katrina refugees who were moved from New Orleans in the days following the hurricane. Lots of really really sick, really really poor, really really shell shocked people. One woman had sprained a finger and left her insulin behind during the rush to leave her home.

And in this facility, set up by our beloved Uncle Sam, there wasn't a splint in sight. Not a one. I improvised, just like in M*A*S*H, and made a splint out of two tongue blades, some tape and the little bit of gauze I could scrounge up. I felt very pleased with myself for being so creative, but also pissed off that the people were there, but no supplies.

This is the kind of thing many of us do every day in providing primary health care. Improvise. Make do. Get along. Scrape by.

We do it well, but should we have to?

In Amerika?