A short but sobering story:

A 51 year old female smokes 30 a day and has not yet ever had a mammogram. She found a breast lump and after needle biopsies, she went to her GP to hear the very bad news of her Grade 3 invasive ductal carcinoma. This was on a Wednesday and her GP wrote in his notes:

“Wants referral to Dr A the breast surgeon as Dr X does not have a public place [i.e. hospital bed and surgery appointment gap] for her breast surgery till 3 weeks; otherwise [he says] can be done in private [by Dr A] this Monday”

The next note was obviously made after a call from the patient: “patient cannot afford private, wants public”.

What must this patient have had to go through emotionally: to feel the real urgency for surgery, to understand the real danger of waiting with such an aggressive tumour, to make the calls about private treatment, only to find out it’s beyond her financial reach, to make the crushing decision that public surgery is the only option?

So many people think money will just magically come out of thin air when things go wrong. Or that doctors will look after you no matter whether you have the means to pay or not. Reality is so maddeningly different from perception.

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