Monday, October 13, 2003

Fortunately, there are no sick kids in America who need medical attention

The news today is dominated by the story of Mohamed and Ahmed Ibrahim, conjoined twins from Egypt who were separated by doctors in Dallas during a 34-hour surgical marathon.

I'm a compassionate guy (ok, maybe I'm not), but stories like this really bother me.

To make life better - not to save their lives, even - for these two people from Egypt, some of the most talented American medical professionals swung into action. Consider these facts as presented by Children's Medical Center in Dallas on the website built to fill the public's hunger for information about Mohamed and Ahmed:

• The surgery occurred after a "year of intense preparation" that included "extensive diagnostic tests" and "customized surgical equipment"

• The surgical team included more than 60 members of the hospital's medical staff, including five neurosurgeons, two craniofacial surgeons, a pediatric plastic surgeon, a pediatric general surgeon, an oral surgeon, nine anesthesiologists, six pediatric nurses, six surgical technologists, four respiratory therapists, four anesthesia technicians and support staff

• The separated twins will now spend about a week in the hospital's pediatric critical care unit

• Follow-up care will include reconstructive surgeries that will be done in stages and could take several years. The twins will travel from Egypt to Dallas for the surgeries

• The direct costs of the initial surgery are $125,000, with total costs estimated to be $2 million. The World Craniofacial Foundation raised the initial $125,000 to pay the hospital

• The surgeons, hospital and "hundreds of professionals" involved have donated the time they have spent and will spend on the twins' care

... all to make life better for two people from Egypt.

I don't find references to public money being spent, so I'll assume this project is mostly a private effort - the money comes from donations, the hospital, surgeons and staff chose to donate their time, etc.

But how can the hospital, its surgeons and staff and the people who donated to this cause justify all of this? Sure, it's a feel-good thing to make life better for these twins, but what about the opportunity costs?

I'd hazard to guess there are plenty of children in Texas whose lives could be made significantly better if these medical resources were made available to them rather than devoted to making life better for two people from Egypt.

How about spending that "year of intense preparation" providing pre-natal care for poor women in the state? I bet there are plenty of poor pregnant women who could use "extensive diagnostic tests".

Why not use the 10 surgeons and support staff occupied by the twins to perform neurosurgery, craniofacial surgery, plastic surgery, general surgery and oral surgery for procedures for children who need those surgeries in Texas or elsewhere in the U.S.?

Instead of more reconstructive surgeries and follow-up care for these two people from Egypt, maybe you could perform reconstruction on car accident victims who otherwise would remain disfigured?

Perhaps the $125,000 (and ultimately $2 million) donated to make life easier for two people from Egypt might do more good if donated for indigent care at Children's Hospital?

Couldn't the "hundreds of professionals" who donated all this time for more than a year make more of an impact by donating their time at free clinics or by visiting schools to give poor kids the routine checkups they probably don't get now?

And the hospital could have spent the time and money it took to create the special twins website on a site that provides better health information for the community.

But no.

In the judgment of the hospital, its doctors, nurses, support staff and the people who donated the money for this procedure, making life easier for two people from Egypt is a more important cause than anything else that could have been done with these tremendous resources.

And multiply this by the number of times we see this happen - remember the conjoined Guatemalan twins at UCLA - and there are no doubt thousands of people in the U.S. who could benefit from the time and money being devoted to the care of a handful of people who are fortunate enough to tug at the heart strings of America.

I find that sad.


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