PBS高端访谈:疫情下的医疗体系

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Judy Woodruff: As COVID-19 has overwhelmed health care systems around the globe, here in the U.S., there's an increasing concern hospitals won't have adequate supplies, staff, and beds to treat those who become seriously ill. In tonight's Brief But Spectacular, we visit Dr. Karen Kinsell. She's the only physician in Fort Gaines, Georgia, where she serves her town's 3,000 residents.

Karen Kinsell: I think a lot of people don't understand that not everyone in America has the ability to go to the doctor. Fort Gaines is in Clay County in Southwest Georgia. We have about 3,000 people. About 40 percent of the people are below the poverty level. I have been the only doctor here for 15 years. The next closest hospital and doctor in Georgia's 20 miles away. I have been called the last doctor in Clay County. So when I die or leave or retire, whatever, does that mean that there really won't be a doctor here? Our office wasn't built as a doctor's office, and really shouldn't be a doctor's office. It was built as a Tastee-Freez in the 1950s. It has tremendous leaks in the roof. We literally¹ keep out trash cans to catch water when it rains. We currently use the former freezer as a drug storage area. It's horrible. But we really don't have the resources to do anything different, and there really aren't any buildings in the county that are acceptable. There was one pharmacy² in Clay County for the last 30 or 40 years, and it closed a year-and-a-half ago. Right now, it's about a 30-mile round-trip to pick up a pill. And as an internist, where our tools are pills, this becomes a very serious situation. Many of the specialists in this area won't even accept Medicaid patients. We frequently get involved in internal medicine, specialty³ care, endocrinology, rheumatology. That's absolutely outside my scope of expertise⁴. I could probably get sued for it if something untoward⁵ happened. But this is the only way we know of to get people that care. We average between 25 and 30 patients a day. Often, people don't have access to transportation. People struggle every day to have food and gas. We ask for $10. If they can't afford that, we see them anyway. We don't turn anyone away. There's no point in me spending my time out here if I cannot go ahead and see everyone who needs to be seen. The pervasive⁶ poverty just affects people's view of the world. We recently had a grant and gave cameras to high school kids and asked them what they want to take pictures of. And what they chose were abandoned houses, because that's what represented Clay County to them. You know, like all doctors, I went to medical school, worked really hard, paid a lot of money to learn how to use the technology to help people live healthy, long lives. To be in a place like this, where you know what needs to happen, and you simply cannot get that for that person, that's devastating⁷. You know, I have very deep roots in this community at this point. I know these people. To just up and leave would be very personally devastating for me, and I think would adversely⁸ affect the health care of people I see. I think I save lives by being here. And, I mean, that's tremendously rewarding. I mean, what bigger high could you have? My name is Dr. Karen Kinsell. This is my Brief But Spectacular take on being the only doctor in a poor rural area.

Judy Woodruff: Dr. Kinsell, everybody like her, they are our heroes. And you can find all of our Brief But Spectacular segments online at PBS.org/NewsHour/Brief.

朱迪·伍德拉夫：目前，新冠让全球各地的医疗系统应接不暇，与此同时，美国有越来越多的人担心议员没有足够的医疗物资、人手、床位来应对重症患者。今晚《简短而精彩》的主人公是凯伦·金塞尔医生。凯伦是乔治亚州盖恩斯堡的唯一一位医生，在这里，凯伦要为3000名市民诊治。

凯伦·金塞尔：我想，很多人都不知道美国不是所有人都有看医生的能力。盖恩斯堡位于乔治亚州西南部的克雷郡，这里大概有3000名市民。这里大概40%的人都位于贫困线以下。15年来，我是这里唯一的医生。距离乔治亚州最近的医院和医生也离我们20英里远。人们都说我是克雷郡的最后一名医生。所以，如果我死去、离开或者退休的话，这是否意味着这里不再有医生呢？我们的办公室也不是按医生办公室来建造的，这里真的不应该是一个医生的办公室。这里是上世纪50年代建造的，本来是要做快餐连锁店的。现在，屋顶漏水严重。我们真地会用垃圾桶来承装雨天的雨水。我们现在现在会把之前的冰柜用作药品的储存区。情况实在太糟糕了。我们真地没有资源来做点什么事情，我们郡没有任何可以接受的建筑物。过去三四十年间，克雷郡是由一家药店的，但一年半前就关闭了。现在，要拿药得跋涉30英里的往返路程。作为一名内科医生，我们的工具就是药，这里的形势十分严峻。该领域的很多专家都无法接受医疗补助计划的患者。我们会频繁接触到内科药、特殊护理、内分泌、风湿病学。这都在我的知识范畴外。如果发生了不好的事，那我可能要遭到起诉。但这是唯一让人们得到救治的办法。我们每天要接诊25-30位病人，通常情况下，大家都没有交通工具。人们每天要获得足够的食物和气体都是件难事。我们收费10美元，大家都付不起，但我们还是会诊治。我们不会将任何人拒之门外。如果我无法给需要救治的人看病的话，那我在这里就没有任何意义。这里随处可见的贫困影响了人们的世界观。我们最近获得了补助金，将一些摄像机送给了高中的孩子们，问他们想拍摄些什么。他们选择拍摄荒废的房屋，因为这代表着他们眼中的克雷郡。你懂的，像所有医生一样，我想上医学院，我曾十分努力地学习，我花了很多钱来学习如何用技术来帮助人们保持健康和长寿。在这样的环境下，在你知道需要发生什么的情况下，是无法为人们实现这一点的。你懂的，我深深植根于这个社群。我了解这里的人们。如果我直接离开，那对我个人也是很大的打击，我觉得这会影响我的病人们的健康。我觉得我在这里就能救死扶伤。这是非常值得的。还有什么比救死扶伤更有意义呢？我是凯伦·金塞尔。这是我本期带来的与在贫苦农村地区担任唯一一名医生的分享。

朱迪·伍德拉夫：像凯伦医生一样的人是我们的英雄。其他期节目，可戳PBS.org/NewsHour/Brief。