John died today.

John died today.

He isn’t the first patient of mine to die – not by a long shot. But his death affected me differently than the others.

John was one of the almost 3,900 uninsured individuals served by our clinic. He was a minister, serving two congregations. He had no health insurance for his family. He had been a diabetic most of his life. And for the past 3 years, had been part of the Diabetic Clinic we offer.

This is what I KNOW about John– he was married, had 4 children, 1 grandchild; he had been a diabetic for a number of years – he was a Type 1 diabetic, which means he was insulin dependent because his pancreas no longer produced insulin. His blood sugar log for one month showed everything from 59 – too low, to 513 – way too high.

He was engaging and loved people.

He had been diagnosed with COPD (Chronic Obstructive Pulmonary Disease) but had never smoked. The COPD could have been a result of a hereditary condition that ran in his family. He brought me the information on the condition, and we ordered the lab test to determine if he had it. But….he never had the lab work done.

I would have told you he was one of my most compliant patients – he knew much about his disease, and was meticulous about keeping his blood sugar logs. He had been diagnosed with diabetes over 40 years ago, and really knew his disease – he knew about his diet, about his blood sugar levels and the issues common to diabetics. But he rarely had the routine blood work done that is ordered for diabetics.

I was stunned by his death – and stunned to look back at his records to see how non-compliant he had been. It is one of the real pitfalls with a free clinic – there is no staff to follow up and make sure that ordered lab work is done, there is no consistency with providers so that they know what has been ordered, what needs to be done. Working with limited resources means limited healthcare.

Did that make a difference? Probably. According to a report from the Institute of Medicine, uninsured Americans get about half the medical care of those with health insurance. As a result, they tend to be sicker and to die sooner. About 18,000 unnecessary deaths occur each year because of lack of health insurance.