The Ambulance Down in the Valley

A speaker in my Public Health class read us this poem at the end of his lecture. I think it is a brilliant and funny representation of prevention vs. cure in health care, still applicable today despite being written in 1895. Laugh, but also take heed!

THE AMBULANCE IN THE VALLEY
Joseph Malins

'Twas a dangerous cliff, as they freely confessed,
Though to walk near its crest was so pleasant;
But over its terrible edge there had slipped
A duke, and full many a peasant.
The people said something would have to be done,
But their projects did not at all tally.
Some said "Put a fence 'round the edge of the cliff,"
Some, "An ambulance down in the valley."

The lament of the crowd was profound and was loud,
As their tears overflowed with their pity;
But the cry for the ambulance carried the day
As it spread through the neighboring city.
A collection was made, to accumulate aid,
And the dwellers in highway and alley
Gave dollars and cents--not to furnish a fence--
But an ambulance down in the valley.

"For the cliff is all right if you're careful," they said;
"And, if folks ever slip and are dropping,
It isn't the slipping that hurts them so much
As the shock down below--when they're stopping."
So for years (we have heard), as these mishaps occurred
Quick forth would the rescuers sally,
To pick up the victims who fell from the cliff,
With the ambulance down in the valley.

Said one, in a plea, "It's a marvel to me
That you'd give so much greater attention
To repairing results than to curing the cause;
You had much better aim at prevention.
For the mischief, of course, should be stopped at its source;
Come, neighbors and friends, let us rally.
It is far better sense to rely on a fence
Than an ambulance down in the valley."

"He is wrong in his head," the majority said,
"He would end all our earnest endeavor.
He's a man who would shirk this responsible work,
But we will support it forever.
Aren't we picking up all, jut as fast as they fall,
And giving them care liberally?
A superfluous fence is of no consequence
If the ambulance works in the valley."

But a sensible few, who are practical too,
Will not bear with such nonsense much longer;
They believe that prevention is better than cure,
And their party will soon be much stronger.
Encourage them then, with your purse, voice and pen,
And while other philanthropists dally,
They will scorn all pretense and put up a stout fence
On the cliff that hangs over the valley.

Better guide well the young, than reclaim them when old,
For the voice of true wisdom is calling,
"To rescue the fallen is good, but 'tis best
To prevent other people from falling."
Better close up the source of temptation and crime
Than deliver from dungeon or galley
Better put a strong fence 'round the top of the cliff
Than an ambulance down in the valley.

Hospital Results Take a Long Time

My little second cousin is in the hospital. That doesn't seem very closely related, but she's one of the few relatives my family has in this area. Most of my relatives are back in India. Besides, she's only...I think 5 years old?

Anyways, a few days ago, she was with a babysitter or something after school, and she began complaining of a headache. By the time her parents arrived, she had already vomited four times. The headaches (the back of her head, at the top of the neck) made them worry might be meningitis, so they took her to the hospital.

The doctors decided to do a lumbar puncture to find out whether it was bacterial or viral (if it was in fact meningitis). The problem? It hurt a lot. Even the injection of anesthesia hurt her, and after that, they had to try multiple times to get the cerebrospinal fluid. Afterwards, she complained of horrible pain, so much that she would lay still for hours because she was too afraid of the pain to move. The hospital had to give her morphine every three hours to fight off the pain. The first CSF test came up negative, but the fluid was pink. Whether that was because there was a problem initially or some damage was done by the repeated poking is still unknown.

She's getting better, or at least the pain is decreasing, and she's walking around and playing and eating a bit again, but the doctors decided to take an MRI. The room was booked yesterday, so they kept her in the hospital and took it today. Now the results are finally back, and it's negative. Except that there's one blood vessel that is apparently in the range of normal variation, but the doctors still want to ask a specialist to get a second opinion. Which can't happen until after the weekend. At least it seems negative.

I've been worried for both her and her parents. I'm worried for her because I want her to be okay, and I'm worried for her parents because they're worried for her. How can they stand it, constantly wondering what the result of the test will be, still uncertain about what exactly is happening with their daughter? They haven't left her side for more than an hour, and even then only one at a time, to come to our house, get some food, maybe take a bath, smile for a minute.

All we can do is offer them support, a shoulder to cry on, some home-cooked food so they can be with her all the time. I wish it were easier and faster and cheaper to diagnose a problem. At least they get to go home now for a couple of days, get some rest, and be in a more familiar environment. I hope all will go well.


Edit: She's okay now, back to normal. She was having fun dancing at a friend's graduation party recently, at least, and the pain is gone. They're still not completely sure what caused the pain in the first place, but I think they've settled on viral meningitis.