Kate Scannell, MD

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 07/21/2012

Last Tuesday, I was eating lunch in a downtown Oakland diner when a 20-something man entered and politely asked the owner for work -- any work at all. The owner apologized profusely, regretting that he had no employment to offer.

Minutes later, a woman and her daughter sat down at a nearby table and carefully counted what coins they carried -- ostensibly assessing whether they could afford a lunch plate. After the daughter asked, "Do we have enough?" the mother replied, "no," and they left the restaurant, declining an offer of help.

On my way out, I told the owner that I had overheard his conversation with the job seeker. "Awfully hard times," I said.

The owner shook his head and said that he had never had so many people seeking work. And that he had never felt so helpless. "Business is down here, everywhere," he said. "We have no jobs to offer. Last week, a young man with an M.A. came in, begging to work in my kitchen."

As we talked, an elderly woman passed by, pushing a shopping cart stuffed with garbage bags. Echoing a commonly heard refrain, the diner's owner charged, "Washington politicians have no idea what it's really like for most of us. To survive -- find work, live in a safe place, get decent health care -- they just have no idea."

At home that evening, I kept thinking about people from the diner. It had been painfully obvious that they were struggling mightily -- for a $3.50 lunch special, a minimum-wage job, a small business establishment on a worn corner of Oakland. Were these people and their struggles really invisible to "Washington politicians?"

You almost want to believe that's true because the alternative -- politicians seeing but doing little to help -- is even more dispiriting. Still, on street corners across America, joblessness and economic insecurity are on hard to ignore.

Perhaps the seeming invisibility of careworn Americans is a byproduct of cognitive dissonance. That is, while our eyes might detect a family rummaging through garbage bins along Main Street, our brain rejects that as possible; it simply couldn't -- and shouldn't -- be happening in the world's wealthiest nation.

Regardless -- whether unseen, or seen but disbelieved -- impoverished Americans exist, and their ranks are growing. Recent U.S. census data reveal that in 2010 our country's poverty rate jumped to 15 percent -- representing more than 48 million Americans.

Of course, it is not only politicians who may have blind spots on this issue. But it is to them that we look for moral leadership and problem-solving when so many millions of us urgently need a helping hand. Serving as our governmental representatives, they are supposed to be of us, for us, and by us. All of us.

That's why it's so disturbing to hear that several states are threatening to boycott Medicaid expansion as proposed by the Affordable Care Act (ACA) -- our nation's new health care reform law.  Read More 

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 09/10/2011

Ten years ago, I wrote this column about doctoring throughout the week that followed the 9/11 terrorist attacks on the World Trade Center and the Pentagon. Most of the patients I saw had reported feeling anxious, distracted and troubled. Many were overwhelmed by anger, fear, sadness, or existential angst. Cognitive disturbances were epidemic -- trouble concentrating, thinking, and remembering.

I wrote then: "Depression's devitalizing fog cast across the lives of most patients and coworkers to varying degrees, and, on several occasions, the phrase 'Prozac nation' assumed new and prescient significance ... ."

Like many Americans, I was struggling a decade ago to find my way to "some kind of normal" through the communal haze, all the while the Twin Towers' ashes had not yet fully settled. It seemed that for days, the thick dust and debris kept falling, continually layering over what had been routine, obscuring the familiar. Everything became coated with dark surrealism.

Two days after the attack when I arrived at work, I stood hesitantly outside my office a while. I looked through the doorway at my old desk, my crammed bookshelves, my stacked medical journals, the photographs and cards from patients tacked to the walls -- and it all looked so very strange. The daily habit of my life and career felt suddenly foreign to me.

That same day, a patient told me that he felt thoroughly vindicated for not having followed my recommendation to schedule a screening colonoscopy. "After all," he said, "it could've been me in those Towers. And believe me, I would've been cursing you in my final moments knowing that I'd wasted my time having that test while an airplane took me out."
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