ESSAY
IMPROVING CARE FROM WITHIN The astronomical cost of health care creates a challenge for even the most financially savvy patients. BY DR . JAY MO ORE
O
n a hot July morning in 2015, my phone rang at 4 a.m. No good news ever comes at 4 a.m., so I answered with a sense of dread. My brother was on the other end of the phone, breathless. “We’re in the car following the ambulance,” he said. “Dad’s heart stopped. They’re doing CPR. They’re headed to the ER.” I’m a doctor. My brain snapped instantly from “son mode” to “clinical mode.” “How long was he down?” I asked. “I don’t know … 15 minutes?” he recalled. “Is that a long time?” My silence told my brother everything he needed to know. “I’ll call you when we know more,” he said. “Get down here as fast as you can.” It’s a two-hour drive from my home in St. Louis to the hospital where they were taking my dad. I was on the road by 4:15 a.m. As the Missouri countryside slid past my window, I had a lot of time to think. My family needed me. I am the oldest son, the first in my family to go to college, and the only person with medical training in the family. I knew they’d need a lot of me over the next few days.
8 | Maverick • Winter 2022
Somewhere in the middle of Missouri, I got the phone call that I had been dreading. My clinical training wasn’t needed as my dad had passed away in the emergency room. My brain snapped back into being a son. I pulled the car off to the side of the road and took a few moments to cry. Then I got back on the highway and kept heading deeper into the Ozarks. HOW DID WE GET HERE?
I grew up in a double-wide mobile home in the little town of Dixon, Missouri, in the 1980s. We lived simply, but we had a lot of pride. When I started kindergarten, I brought home a letter telling my family that we qualified for free lunches. “We don’t need that,” my dad said. “We aren’t poor. Others need that more than we do.” My dad was trained as a land surveyor by his father, and he worked for much of his career for a telephone company in Missouri. My mom stayed home to take care of my brother and me, but we always managed to make ends meet on my dad’s salary. After I started college, my dad finally felt the financial freedom to pursue his lifelong dream: In 1995, he cashed in his pension and opened a restaurant. He was a fantastic grill master—he was always in demand at
company picnics and church events to cook up hamburgers and steaks, which he would season with a secret family recipe that he had invented using simple ingredients that he could buy at the grocery store. The restaurant sat on a bluff overlooking the Gasconade River in Pulaski County. I was a sophomore undergraduate at the University of Missouri when he opened it, managing to get by on scholarships and student loans. I was worried that he was gambling his future, but the bet seemed to pay off; he was busier than he had ever expected. He could afford to buy a motorcycle and take some trips out West, where he’d ride his bike through the desert and imagine he was a cowboy from one of the westerns he’d grown up watching. Things seemed great. But trouble was brewing. The stress of running his own business was getting to him. His blood pressure was too high, and the town doctor who we’d been seeing since I was 3 years old noticed his blood sugar was creeping up. My dad couldn’t afford health insurance, and seeing specialists was expensive. He’d get by with a few cheap generic prescriptions. He felt good, so what could go wrong? In 2008, the economy tanked. The catering jobs and big parties that the
