For awhile now, we have heard the warnings that we are in a medical crisis. Due to rising costs, many medical facilities across the country have closed. There is a nurse shortage everywhere. The nurses that are still in the field are overworked and burnt out. People are waiting HOURS to be seen in emergency rooms. The news has been dire, but even during the worst days of the pandemic, I thought this was a problem that affected other people. I live in Durham, North Carolina–also known as the City of Medicine. My home is less than 2 miles from Duke Hospital and 10 miles from UNC Hospital with an astounding number of medical facilities both around both and in between. Although I knew friends and family in this area were waiting longer to get appointments with their doctors for routine appointments and procedures or having long waits in the emergency rooms or urgent care facilities in the area, I still thought this area was in a bubble-safe from the crisis happening everywhere else.
Until a couple weeks ago…
One Wednesday morning a couple weeks ago, I went downstairs to let our dog out. Something very routine. Something I do every morning and have done thousands of times as my husband and I have lived in this house over 20 years. This particular morning I tripped or misstepped on the last steps and fell. It is important to note that I am a bit of klutz. My husband calls me a “frequent faller” and if he had his way, I would wear one of those bright yellow “fall risk” arm bands that you get at the hospital every day. This wasn’t my first fall down steps. It wasn’t my first fall down these steps. But it would turn out to be my worst fall! In the past after a fall, I might have a bump or bruise or two and a minor sprain. Nothing that a little ice, rest, and an ace bandage couldn’t fix. This time, I could not stand up at all and we knew immediately I wouldn’t be bouncing back quite as quickly.
After following the advice not to go to the emergency room (because as painful as this was, we knew this was not a life threatening emergency), we went to an urgent care less than a mile from my home. There I was diagnosed with a sprained left ankle and a broken right ankle. I was sent home with a splint on my right leg, a pair of crutches, and a referral for my appointment to see an orthopedic physician in eight days. EIGHT DAYS?????!!!! My case was being marked “urgent” to determine if I needed surgery, but I couldn’t see the doctor to make that determination for eight days? Apparently I fell at the same time as a national orthopedic physician conference so I was told that every doctor in this area was either out of town at the conference or already booked, but we were free to call on our own to see if I could be seen earlier.
My husband immediately started reaching out to our friends for any references and started calling every ortho clinic in town. In the past two weeks, I have seen seven different doctors at six different facilities, had multiple x-rays and one MRI. At the two week mark after being told again that I was an urgent case and needed surgery as soon as possible, I was told that there was not an available surgeon and surgery date for over a week. I had a complete meltdown. Again my wonderful husband advocated on my behalf and I had surgery on this morning (Sunday!) by an ortho trauma surgeon that I did meet until a few minutes before my surgery.
This morning my surgery was delayed for awhile due to a staff shortage in the OR!
This has been such an incredible, frustrating, eye-opening experience! Please note this rant is by no means a commentary on the quality of care I have experienced. I have received nothing but the best care possible. Everyone we have encountered has been extremely professional and helpful. Everyone we have encountered has been just as frustrated with this lack of available care as we have been.
I also recognize how privileged I am in this situation. My employer has been incredibly understanding during this time. I have wonderful insurance through my employer. A quick Google search indicated that approximately 30 million Americans still do not have insurance. Although I do not look forward to paying the medical bills that are already arriving, I am not losing sleep that this situation will put my family in financial distress. Because I live in the City of Medicine, none of my appointments have been more than a few miles from my house. Because my husband owns his own business and is self-employed, he has been able to adjust his schedule take me to these appointments, care for me and advocate on my behalf (which some days has felt like a full-time job in itself). Most Americans aren’t so lucky. I have spent a lot of time over the past few days thinking of others in this country who don’t have insurance, understanding employers, family members with flexible schedules, financial stability, or access to appropriate medical facilities close to their homes.
I have also spent a lot of time contemplating what caused this medical crisis to begin with. In comparison to my current situation, sixteen years ago I was diagnosed with a brain tumor. From the day of my first symptom to the day I had surgery was fourteen days! I had the option of choosing an earlier date, but I chose to wait. My case was not considered an urgent case. In fact on the day of my surgery, my surgery was pushed back to a later time in order to squeeze in an emergency case. I remember joking with my medical team when they apologized for me being bumped that it was better to be the bumpee and not the bumper. My neurosurgeon was and still is known as one of the best in the world. People all over the world come to Duke just to see Dr. Friedman. Today, there are approximately 60 doctors that are identified as neurosurgeons in this area and sixteen years ago, I very easily got an appointment with one of the best.
Now sixteen years later, it has taken much research, begging, and pleading to find an available surgeon eighteen days after my accident. If my husband was not advocating on my behalf, my wait would be even longer. My need for surgery this time is classified as urgent. I will not be on the road to recovery until I have surgery. I will not be able to walk again until at least six weeks after surgery. I did not know my surgeon’s name until this morning before my surgery. I went in trusting my referral for him as one of the best. Today, there approximately 160 doctors that are identified as orthopedic surgeons in this area and due to a medical crisis of medical facilities being overbooked and understaffed, I struggled to obtain each and every appointment.
I do not know what the solution to this problem is, but now I am aware that we are not in a bubble and this problem exists even in the City of Medicine. If the problem is this bad here, I cannot even imagine how frustrating it must be in other parts of the state and country! And I worry what will happen here if the next time it is a life threatening emergency!



On September 1st every year, Mom would call me and ask the same question–“Have you made my cookies yet?” I knew exactly what cookies she meant–my ginger cookies, her favorite cookies. She always said they smelled and tasted like fall. Even though it was probably still 95 degrees outside, to her September 1st meant fall was here and it was time for me to start baking. When I would remind her that she also had the same recipe, she would always reply, “But they taste better when you make them.” So at least once every year, sometime between September 1st and Thanksgiving, I would bake the cookies.
