I know the political world is focused on the crisis over raising the debt limit, which is why this diary may scroll into oblivion.
In a sense, I am in a different world. The debt limit negotiations will affect the world into which I have entered, but the reality is much more basic.
For the third year in a row I traveled more than 400 miles southwest from my home into the Appalachian Mountains of SW Virginia, to the town Wise, for the 12th annual health and dental fair cosponsored by Stan Brock's Remote Area Medical and the Virginia Dental Foundation's Missions of Mercy. While I know and respect Stan and his organization, my participation is through MOM, and in these events, I volunteer in dental triage.
It took me a bit over 6 hours to drive here on Wednesday, and since I left home I have spent little time with a TV on, or listening to the radio, or reading news events on the internet. My emails are piling up.
Because I have been dealing with a different reality - the reality of the people we will serve here in 3+ days of volunteering, the people with no medical or dental insurance, with little access to dentists or vision specialists, to people in a part of the nation still suffering economically.
Allow me to offer a very few thoughts, if I may.
I first came here two years ago. This is my 3rd time in Wise, the 7th time volunteering in dental triage - also in Grundy, Roanoke, and NoVa.
Words cannot due justice. Remember, it was visiting this same fair in 2007 that finally convinced Wendell Potter that our approach to providing medical care had to change.
My visit in 2009 transformed me. I will not inflict upon you the various diaries I wrote then or last year.
I am working with dentists who have come every year, sometimes if only briefly, to maintain their connection. Last year Wallace Huff served as a pallbearer for one of his patients in Blacksburg, then drove up to volunteer. In 2009, Carol Pratt took time away from her campaign for House of Delegates to volunteer here. I worked with both of them in the past two days. This year David Jones came up on Thursday, when we were setting up, helped us triage 210 patients, then headed home to Southside because of a wedding this weekend.
People like these, all outstanding dentists, view this not only as a professional commitment, but also a moral commitment.
As do I.
I have dental insurance. I have access to good dental care. I know the difference it can make.
I cannot accept that in a country with as much wealth as ours people continue to suffer.
Much of it is poverty.
Some is cultural, to be sure, but that culture has been demeaned, and the people belittled, in a way not worthy of our nation.
Too much is our ignoring those not visible. We are more aware of the problems of the inner city because our opinion makers live either in the wealthier parts of cities or in the more exclusive suburbs - it is hard for them to totally ignore the problems on their doorstep, although many try.
In the rural parts of our nation, which still contain 1/5 of our people, those in need are often out of sight and thus out of our awareness - our policies do not address the reality of their lives.
There is a further problem in our nation. Allow me to describe it to you.
Stand up, if you will.
Now imagine a steel plate that goes through your adam's apple.
Below that is your body, and it is covered by your regular medical insurance.
What is above that is often excluded - vision, hearing, psychological, and most of all, dental.
I consider my own good medical insurance, provided through the school system for which i work. That is, I consider my three separate insurance policies - medical, dental, and vision. I can see an optician directly. If I need an ophthalmologist I must first go through my primary care doctor, pay a co-pay, and then get a referral.
Periodontal disease can cause heart problems.
As a teacher, I know undiagnosed hearing, vision and dental problems are barriers to student learning.
As one who has experienced severe dental pain of several kinds, I know how debilitating it can be.
And yet we do not provide basic health and dental screening for all Americans, even though undiagnosed medical problems are a threat to public health.
Some say no one is denied medical care because you are not supposed to be denied services in an emergency room. But (a) emergency room treatment is very expensive; (b) the costs of those who cannot pay is passed on in higher costs to the rest of us; and (c) by the time something rises to the level of an emergency room visit, often permanent damage has been done.
I have reminded people of the origin of the notion of triage, French military doctors during the Great War. The top level will get better anyhow, the bottom level cannot be saved, so all you can do is provide palliative care, and your focus is on the middle.
I work in dental triage. Sometimes there is little we can now do, the damage is so great, except pull the teeth, even though that means the patient may go a year or more before getting false teeth, or a partial (although there is new method that enables making false teeth much more quickly, and we are seeing it used here this weekend).
I remember one still somewhat young lady who broke down when she was told her teeth could not be saved. She was comforted by many, both before they were pulled and afterward. But it was still hearbreaking. What if she had had access to diagnosis and treatment and training in proper dental hygiene earlier, could not her teeth and her self respect have avoided the harm she experienced today?
I am rambling. My body aches. I plan to soak in a tub of hot water to ease the aches of standing for 11 hours helping people. I have hundreds of emails I must at least scan to see what really requires my attention. I had several phone calls for my own life - a refinancing of a mortgage and the task associated therein.
I had hoped to visit with a friend tonight, but her brother got sick and we had to put that off.
I should catch up with the 'real' world that seems so distant in this small town, among the ancient mountains around, many being destroyed for the coal still found underneath.
But I could not do anything else without to some degree reflecting yet again on the experience of being here.
What is most awe inspiring is not the great work done by the many volunteers - medical and dental professionals and students, ordinary folk, etc - but how we are welcomed by the communities around.
I could show pictures of how many people and organizations come together - Army Troops erecting tents, Virginia Department of Transportation providing a compressor for the air lines for the dentists, medical and dental vans from Kentucky, North Carolina and a number of communities in Virginia.
Many of the dentists with whom I work in triage are now old friends. One, Bob, comes to many of these events from Indiana, often as is true this weekend bringing his daughter. There is another who lives five miles from the school in which i teach. There have been some from New York and other states.
But my strongest experience is of the people, some of whom are local, some of whom travel long distances through the mountains for the only medical or dental care they will receive all year.
When I came on site Thursday morning to help set up, there were people camping out in tents, others in RVs, or sleeping in their cars.
We have passed the Affordable Care Act, but too many are still in need, and will still be in need when (if) all of its aspects come into force.
And yet some consider cutting back on the social safety net. As it is, many medical professionals will not provide services under Medicaid because the reimbursement rate is often so low.
There is something fundamentally wrong that events like this annual Fair are still so necessary in this country.
There is a fundamental goodness in many of our people who volunteer professional expertise or simple labor to enable others to be served - that includes the members of the local Lions' Clubs who feed us on site every day.
How much better might this country be if we focused on what these good people who volunteer know - that all of our people are deserving of care and consideration - rather than on the political debating points and economic theologies upon which some insist upon operating.
On the one hand, each time I come to Wise, or Grundy, or elsewhere, I am angered by and disgusted with much of what is going on in this country. At the same time, I am uplifted both by the willingness of so many to give of themselves, and the trust of the people who turn to them.
I am in Wise Virginia. It is a small town in the mountains. There is a good College of the University of Virginia here. There are caring people here, as there are everywhere.
What if our nation would consider being equally as caring as it makes its political and economic decisions?