美国国家公共电台 NPR Have Cancer, Must Travel: Patients Left In Lurch After Town's Hospital Closes

 

SARAH MCCAMMON, HOST:

People are more likely to die from cancer in rural America than in more metropolitan¹ areas of the country. The reasons range from higher rates of smoking to a lack of places to get tests and treatment. The historic small town of Fort Scott, Kan., lost its busy cancer treatment center when the hospital closed there. Reporter Sarah Jane Tribble went to Fort Scott to see how patients are coping.

SARAH JANE TRIBBLE, BYLINE²: Karen Endicott-Coyan is 65 years old. She was diagnosed with a rare form of multiple myeloma four years ago. Her weekly chemotherapy treatments used to be at the Fort Scott hospital 15 minutes from home. She would run errands in the morning, stop by the hospital for her shot and then drive herself home before the fatigue³ and nausea⁴ hit. Now, though, it's a trip to another town for treatment.

KAREN ENDICOTT-COYAN: Yup - right here - not the first stoplight or a stop sign but the second one.

TRIBBLE: So I join her and her driver, sister-in-law Debbie Coyan (ph), on a weekly trip. At this new place, cancer patients go in the back door.

ENDICOTT-COYAN: I told somebody, it just feels like we just go in right by the trash. It isn't very welcoming.

TRIBBLE: The cancer center is an hour-long drive from Karen's farm. In between, we pass pastures, cows grazing and fields of crops. The two-lane highways are narrow and uneven⁵. And when a big truck carrying livestock⁶ barrels towards us in the opposite lane, the Chevy Equinox we're in shakes as it passes. But the drive is actually the least of Karen's worries as she walks up to the nurses. Cancer care is complicated.

UNIDENTIFIED PERSON: Hello.

ENDICOTT-COYAN: Hi. How are we ladies?

UNIDENTIFIED PERSON: Wonderful - how are you?

ENDICOTT-COYAN: We're good. Well, I say we're good. I went to the emergency room Tuesday.

UNIDENTIFIED PERSON: Oh.

ENDICOTT-COYAN: I was dehydrated. I had the pukes.

UNIDENTIFIED PERSON: Oh. Did they give you fluids?

ENDICOTT-COYAN: They gave me - well, yeah. I went to the doctor first. But over there, they don't have any way to give you fluids at the doctor's office now.

TRIBBLE: She's lucky. Friends and relatives take turns driving with her for the typically two-hour round trip every Monday. And they patiently wait on days it takes longer, like today. Karen's lab results weren't ready. So instead, we get back in the car and drive to another hospital building for lab work. This hassle to get care is hard on cancer patients, says Joe Unger, a cancer researcher who led a study last year.

JOE UNGER: Not only are they suffering the anxiety of their diagnosis⁷, they're then suffering the anxiety of how do they get their care and how do they travel to get it.

TRIBBLE: Unger's study confirmed that the work rural cancer patients like Karen had to do to find and get care is a major reason they die more often. Rural hospital closures, he says, don't help patients.

UNGER: You know, the issue of travel also creates income disparities in terms of access to care because those with more income are going to be more likely to travel to get their care more readily. And so these issues of income disparity and geographic⁸ disparities start to overlap⁹.

TRIBBLE: Krista Postai has seen this firsthand in southeastern Kansas. She leads a group of health clinics in the low-income region.

KRISTA POSTAI: It's not unusual for us to see someone walk in end-stage cancer that they put off because they didn't have money. They didn't have insurance, or it's just the way you are. We wait too long here.

TRIBBLE: For now, Karen is coping. After her sister-in-law ferries her from the treatment center to the lab and back, we wait for the lab test to be processed. And then Karen gets her chemo shot. Now, we are back on the road. And Karen is prepared.

ENDICOTT-COYAN: And I have found that if I eat a few Ritz crackers¹⁰ or crackers on the way home, I don't get as nauseated¹¹.

TRIBBLE: For the next hour, she quietly munches¹², swallows hard and doesn't get sick. I'm Sarah Jane Tribble near Fort Scott, Kan.

MCCAMMON: And Sarah Jane Tribble is with Kaiser Health News.

1 metropolitan   

adj.大城市的，大都会的

参考例句：

• Metropolitan buildings become taller than ever.大城市的建筑变得比以前更高。
• Metropolitan residents are used to fast rhythm.大都市的居民习惯于快节奏。

2 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

3 fatigue   

n.疲劳，劳累

参考例句：

• The old lady can't bear the fatigue of a long journey.这位老妇人不能忍受长途旅行的疲劳。
• I have got over my weakness and fatigue.我已从虚弱和疲劳中恢复过来了。

4 nausea   

n.作呕，恶心；极端的憎恶(或厌恶)

参考例句：

• Early pregnancy is often accompanied by nausea.怀孕期常有恶心的现象。
• He experienced nausea after eating octopus.吃了章鱼后他感到恶心。

5 uneven   

adj.不平坦的，不规则的，不均匀的

参考例句：

• The sidewalk is very uneven—be careful where you walk.这人行道凹凸不平—走路时请小心。
• The country was noted for its uneven distribution of land resources.这个国家以土地资源分布不均匀出名。

6 livestock   

n.家畜，牲畜

参考例句：

• Both men and livestock are flourishing.人畜两旺。
• The heavy rains and flooding killed scores of livestock.暴雨和大水淹死了许多牲口。

7 diagnosis   

n.诊断，诊断结果，调查分析，判断

参考例句：

• His symptoms gave no obvious pointer to a possible diagnosis.他的症状无法作出明确的诊断。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做一次彻底的调查分析。

8 geographic   

adj.地理学的，地理的

参考例句：

• The city's success owes much to its geographic position. 这座城市的成功很大程度上归功于它的地理位置。 来自《简明英汉词典》
• Environmental problems pay no heed to these geographic lines. 环境问题并不理会这些地理界限。 来自英汉非文学 - 环境法 - 环境法

9 overlap   

v.重叠，与…交叠；n.重叠

参考例句：

• The overlap between the jacket and the trousers is not good.夹克和裤子重叠的部分不好看。
• Tiles overlap each other.屋瓦相互叠盖。

10 crackers   

adj.精神错乱的，癫狂的n.爆竹( cracker的名词复数 )；薄脆饼干；（认为）十分愉快的事；迷人的姑娘

参考例句：

• That noise is driving me crackers. 那噪声闹得我简直要疯了。
• We served some crackers and cheese as an appetiser. 我们上了些饼干和奶酪作为开胃品。 来自《简明英汉词典》

11 nauseated   

adj.作呕的，厌恶的v.使恶心，作呕( nauseate的过去式和过去分词 )

参考例句：

• I was nauseated by the violence in the movie. 影片中的暴力场面让我感到恶心。
• But I have chewed it all well and I am not nauseated. 然而我把它全细细咀嚼后吃下去了，没有恶心作呕。 来自英汉文学 - 老人与海

12 munches   

v.用力咀嚼（某物），大嚼( munch的第三人称单数 )

参考例句：

• He tried to talk between munches on the sandwich. 他试图在吃三明治的当间儿讲话。 来自互联网
• A flying squirrel munches a meal on terra firma. 一只鼯鼠在地上贪婪的咀嚼着它的食物。 来自互联网