ComebackTown is published by David Sher to begin a discussion on a more prosperous Birmingham.
Today’s guest blogger is Dr. Jack Trigg. If you’d like to be a guest
blogger, please click here.
I’m afraid.
While there are many positive things happening in Birmingham and throughout our state, there are negative forces at work.
You have to wonder if our state politicians care about the lives of our citizens or if they just don’t know better.
As a physician I’m dismayed by recent actions of our state government with respect to matters of public health.
Alabama losing lives in rural areas
I entered The Medical College of Alabama (now UAB) in 1953 and was privileged to experience the marvelous development of medicine throughout our state, including a number of convenient small town hospitals enabled by the Hill Burton law.
Now there’s an epidemic of rural hospital closures.
Our state’s refusal to take several billion dollars from the federal government for Medicaid has contributed to the crisis for small rural hospitals. Other states that have accepted these funds have thrived.
The state’s larger cities (Birmingham, Montgomery, Dothan, Mobile, Decatur, Tuscaloosa, etc.) have excellent healthcare and service, UAB being the crown jewel.
But unfortunately many of the rural facilities fostered by the Hill Burton legislation have closed.
We are losing and will continue to lose Alabama lives as more and more rural hospitals close.
I’ve witnessed horror imposed on woman and children most people have never seen
Most people today don’t know what life was like before Roe v. Wade was passed in 1973. Many of today’s physicians don’t remember either.
Alabama’s regressive new abortion law risks thrusting us back into a pre-Roe v. Wade world, in which dangerous criminal abortions were commonplace, as were resulting infections, infertility, and deaths of thousands of women who sought and had illegal abortions.
After starting Medical School in 1953, I worked in clinical services beginning in 1954, later serving on the medical, surgical, obstetric, and pediatric wards, as well as others.
Before Roe v. Wade I was either witness to or responsible for the care of patients suffering from pelvic infections related to illegal abortions. Few survived, and many of those who did were completely infertile thereafter.
These were women with families, jobs, and loved ones who were now dead or impaired due to preventable infections!
This scene stopped immediately after Roe v. Wade became the law of the land.
My clinical experience with this lasted nearly 20 years (1954-1973).
I have not had such a patient since. This horrible illness disappeared with the passage of Roe v. Wade (which, was passed by a 7-2 margin by the U.S. Supreme Court.)
Now, maternal mortality due to illegal or unsafe abortion is almost zero per year, whereas before Roe v. Wade, it was at least 5,000 deaths per year, according to a 1966 study by the Guttmacher Institute.
Presently abortions are done in an operating room or delivery room by skilled personnel using sterile technique.
We need not return to a pre-‘Roe’ world in order to reduce abortion rates
On June 19, 2019, al.com ran an insightful article by Ben Baxter who was born to his teenage mother in the “abortion landscape of the 1980’s”. Mr. Baxter quotes many statistics documenting marked decrease in the abortion rate in women across the board and reduction in the birth rate for the past several years.
This is largely the result of the effort of churches, Planned Parenthood, and many professional and volunteer organizations that advise women about birth control and contraception and do a huge service for our indigent community with regard to women’s health issues.
Pregnancy is a medical condition and should be managed by the patient and her doctor. It is not a crime. Mr. Baxter is an example of the satisfying results of gentle persuasion of a mother to have a normal delivery when she may have initially wanted to end the pregnancy.
In conclusion, I feel that Alabama is a great, progressive state with multiple opportunities for growth, education, professional satisfaction and recreation.
However, it behooves our government to avoid taking self-defeating actions like declining Medicare funds and passing extremely restrictive abortion legislation.
Dr. Jack Trigg is a lifetime resident of Birmingham who trained at UAB Medical Center and then served his country as a physician at the hospital at Eglin Air Force Base. He engaged in the private practice of medicine from 1964 until 1998.
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David Sher is Co-Founder of AmSher Compassionate Collections. He’s past Chairman of the Birmingham Regional Chamber of Commerce (BBA), Operation New Birmingham (REV Birmingham), and the City Action Partnership (CAP).
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Dr. Trigg, you have made an extremely important. Having though about this and heard about it for many years, for me the main point is that this is a matter between doctor and woman.
The one thing that really needs to be done is to take the matter out of politics. The Republicans should leave this aside and so should the Democrats. To me it is not political in any way. Political debate is only adding to the damage being done and that must stop.
Democrats would be very happy to leave this matter to a patient and her doctor. It’s Republicans who are making it political.
While Dr. Trigg has a point, he failed to mention all the baby deaths that have occurred at the hands of the physician and/or mother simply because she “wasn’t ready” or “didn’t want” the poor child. 99% of the time (go look it up) pregnancies are preventable and have some very unfortunate consequences for the adult mother. That is sad. But I care more about the innocent baby dying than a few discomforted, ill, or inconvenienced adults.
I don’t want to be tryt but 99% of the times getting locked out of your house is preventable also but once it’s happened what are you going to do, well you call a locksmith. This may be a simplistic answer to a complex problem but after all it is your house.
If you really cared about the “innocent babies dying” you’d be hounding Mmontgomery for pre-natal care and Medicaid expansion. What do you do about the 50% or more that perish in the womb “naturally?”
If abortions are outlawed, would you send the sheriff to make sure these failed pregnancies weren’t “helped along”?
What about the politicians who (1) wish to prevent women from affording pregnancy prevention by cutting funding for birth control counseling services and medication, (2) force a women whose pregnancy is a product of rape or incest to carry a child which will be a constant reminder of the horror she has undergone or (3) lose the life of an “ill” (whose life is threatened by her pregnancy) woman who may have children who need her? Too many men have not the ability to have empathy for circumstances which they will never encounter and, likely, can not understand.
I work in the distressed debt business and Alabama is not the only place where Community Hospitals are struggling. It is a much wider problem driven by our dis-functional healthcare system. While our former Governor did opt out of accepting the Federal funds I think the rational was solid. Once you accept the funds you accept the open ended responsibility into perpetuity with no guarantee that the state would continue to receive the funds. Yes the states that did accept the funds are better off today but if the funding does not keep up with increasing cost or gets reduced by the Federal government in the future those states budgets are blown apart.
We will just have to agree to disagree about abortion. My Faith teaches me that all innocent life is precious and should be protected. That belief is based on the Word of God in his Holy Bible. That is the Rock I Will Choose to Build My Life Upon.
I agree with the previous writer. The community hospitals are dying, have been for decades and will continue to do so. Doctors need to look very carefully in the mirrors as they are part of the problem. Very few want to move to small rural areas and set up as the “country doctor” of years past. Instead they want to specialize, moving into the biggest cities and over charging for the least effort.
To help these rural areas we need to encourage more PA’s and Nurse Practitioners to set up shop in small towns. The federal government and state governments could also help this by giving PA’s and Nurse Practitioners more freedoms to practice medicine. Of course medical schools and doctors will scream bloody murder because they don’t want this. Both because of sheer greed.
You need to actually talk to rural doctors and hospital administrators because what you said shows you have no real clue what the rural needs are and how hard rural doctors, NP’s and nurses work and still can’t meet all the needs.
While I totally agree that more PA’s and Nurse Practitioners should be available to perform many of the duties physicians otherwise perform, there must be a physician available to oversee and answer questions the assistant cannot. However, I think it is disingenuous to assume “sheer greed” on the part of many physicians. Many go into medicine because of a genuine desire to “help”. Much like underpaid teachers, social workers, nurses, etc. Also, our governor by refusing federal dollars, bears a great deal of responsibility for the loss of billions of dollars that would be helping to keep our rural health facilities in business.
I totally agree with Dr. Trigg. I cannot speak to the funds we declined, but the government of this state has no right over a woman’s body.
Agreed. But I also should say the state also has no rights over anyone’s body. Everyone’s! It is now, and should be now and always, completely personal and private.
Once a rural community loses its hospital, the mortality rate must go up. Access to healthcare and longevity track on the same trajectory. If we use a stroke as an example, time is of the essence. With the invention of the miracle drug, TPA, one doesn’t have to die or be permanently damaged by a stroke. However, time is of the essence. If your nearest facility is far from where you live, you are giving up precious time. The average life expectancy in Shelby County is 79.5 years; whereas, the average life expectancy in Perry County is 72.3 years. Poverty rate is the number one cause of these life expectancy numbers, but access to healthcare is number two. In my opinion the refusal to take the Medicaid funding is equivalent to denying care to many in our state.
Dr. Trigg for whose commentary I am very grateful, has clearly opened a can of the nastiest worms that can be imagined.
Corrections need by our Alabama culture:
Freedom of religion, never replacing religion with government. As my belief stands, that is Christian following biblical scripture, and I strongly recommend that for all.
Issues such as abortion are therefore not to be put into the field of politics, The reason for this now is that it continues to appear that most politicians are there for themselves rather than for the people. Furthermore the need too much money so much so that their pride and the focus on money takes over. They spend too much time on campaign funding to get money to ask for more money. No government happens when that is going on. They become their own god and money their face of god.
Abortion should never be made legal nor made illegal. I agree that personal religion understanding is a part of what must be a personal matter
Must there be some rule or law about when I am required to cry or required not to cry? I say that as a way of explaining what I men about abortion not being not a matter for politicians nor bureaucrats. I would always want abortion not to happen if at all possible or reasonable. And there are many reasons and alternative solutions to the matter, many of which are not so good for the child to be born. Prevent pregnancy in the first place.
However, any kind of unprofessional practice of medicine is and should be illegal. Allowing that to happen is truly bad, dangerous, potentially equivalent to murder.
Rural hospitals are needed. Because there is a true need for rural clinics and hospitals. As real people really do live in rural places, there should be a good incentive and or marketing plan for getting clinics, hospitals with emergency service and their doctors there. For example sell the pleasure of living and enjoying really close friendships in a rural village or town surrounded by the beauty of nature and farming fields, open space and fresh air, all more peaceful living.
Also remember that without these rural people how might we be be receiving good food? So many do that. Growing it, collecting it, delivering it in a wide variety of ways. They are important, a valuable hard working people. Many small towns also include factory workers.
So leave of of government those things that should not be there. Hear ye, hear ye, politicians!
And use government as only one way to support what is truly appropriate to support.
The baby should not pay for the sins of the state, federal government, or the mother. I don’t care how you spin it, we cannot keep allowing abortion to be a means of birth control, and as I stated earlier, that’s PRIMARILY what it’s used for.
To the person above who likened this to being locked out of his house above. If calling a locksmith meant sacrificing my child, I’ll just live on my porch. I’ll suffer long before I make my precious baby pay for it.
Rural areas are suffering no doubt. But so are many sections of Birmingham which are very close to quality healthcare. The abortion rate there is just as high if not higher.
This is NOT fundamentally a government money problem, it’s a moral problem. Sure, some education and money can help, but pouring money into rural hospitals that cannot sustain themselves (i.e. too poor to operate without tax help) won’t help.
Perhaps these people should move closer to quality healthcare? We’re already seeing a mass migration to most large metros. It’s not really happening in Birmingham so you have to think, they’re choosing to stay rural. With that comes consequences unfortunately.
Again though, I know there are 100+ rationales, but the baby should. not. pay. with it’s precious life because we cannot get our crap together.
My principles are: self control, birth control, no abortion if avoidable for any reason,. good life ahead for any baby in a loving family with a bright future.
Anything else considering religion faith as the basis of my principles is off track.
No< we disagree about rural hospitals. They can be funded better without taxes. They can be good enough to draw enough patients in to sustain them and they need not be public, but endowed by sensible generous kind and thoughtful wealthy people. Thomasville Georgia has one. Dothan has one.
The Some of those do exist.
And not to miss this point also, I too would stay on my porch to keep a baby alive. Any baby.
Do not get yourself locked into a bad and hopeless idea please.
I agree, Doc
Your religion or religious beliefs have NO !!!bering on medical procedures Period!!! Your beliefs end at your nose birth is a medical procedure no a biblical one an that bible god is the No.1 abortionist with all the miscarriages self abort or if your husband suspects you of cheating, take you to priest make you drink bitter to abort baby your God
Sorry you know so little Will. You do clearly know what you think and I do know what I think and exactly why, with much experience as evidence. Here you are in an earth bound mind trap and it saddens me. Of course abortion is a medical procedure. That can be good or bad and by all means the bad should be prevented.
What is the meaning of ‘Medical Bureaucrat? They are rule writers and defenders. I know because I have actually been one, not in medicine however, who realized I had no business doing it and hardly does anyone else. Are all Doctors perfect? Why not? Our world is badly warped in large part because of bureaucrats’ manner of thinking. The worst is when rules for ‘games’ already underway are changed at sometimes huge cost. Some are absolutely life saving. (I certainly do not think it is out of line to abort a child that clearly will be born with no head.) But a beautiful child because the mother had some ‘ naughty fun?’ That is not fair, is loving couple ay physically unable to have one of their one. The ones I know most about are about building. It indicates that they operate without much awareness of the impact of what they decide or approve. There are a few good people who are bureaucrats with whom I have had rational experiences. But Medical is definitely different territory. The Doctor, religious or not, is making often making life and death decisions. I do not believe religion has no value in this field. What is so wrong with religion for you Will? I know a 40 year old Doctor who works at Mayo Clinic and is a devout Christian, an Episcopalian. and heads one of the major research fields, now internationally regarded as a young man at the top of his field. Also he did a rotation at UAB, and recognizes it as one of the best on the country, only 24 steps behind Mayo!
The interference in such matters by power seeking politicians is hideous, and can be deadly. Please come back to the real world Will! You could not bear to read all of that? I am sorry about that.