[inaudible conversations] ladies and gentlemen, think you ever so much for coming this evening we have a great lineup of different authors review upwards of 400 so this handy little flyer will give you more information and different events for right now we are so happy to claim her as long as we can

rachel pearson. [applause] >> can you hear me? wonderful. thanks for coming out i'm excited to share the book with you guys and hear your questions if you have any. this is a book and wrote primarily based on experiences in medical school working in texas where i cared for folks in the of free clinic in that prison clinics and border clinics and county hospitals this audience was eye opening and life changing

and i'm excited to share that with you. one thing to know about the book is it deals with heavy things like the problem of lack of access to care. and people have died at the same time stories of my family and friends and that has a different tone within the book. so i will start off with this section but i think is funny. the memoried from one that is a little more serious. >> this is in west texas where did my family medicine

rotation and in this story i'm going into town with the family doctor who takes care of patients in that town. a little strip with 1,000 inhabitants. the clinic in the stone building the doctor said hi to every ready and sent me off to see the first patient. he said talk him down for me. he was a rancher in his 60s he said i think the i tore myself picking up a hail -- a hay bale.

but i did down there. i said i understand this was bread-and-butter of my surgery rotation i did hernias and the family clinic but then i heard the whole story have we picked it up how he had paid in the groin area and it did not go away. i said i will check you for a herd the and he shrugged his shoulders and said okay. fair enough plywood press up and have him cough i said yes that is a hernia. he said well hack and i said yeah. well heck she said it is broken. >> yes ma'am. we can fix it. >> danehy it he said putting

his hands on his hips i hope that she can fix that that's right progressive you can pluck your shorts i stepped out and found it in his office i city has a hernia he got it picking up the hay bale. its lopsided indirect and you checked him for it? i did that with researchers irritation will good for you he said the back of the zero -- in the zeroth is a hernia. well pac. he said he sure did learn. yes, sir.. thank you she did a really

good job. yes sir she sure did. you can pull up your jeans now i reckon we will schedule you for surgery will heck. then she pointed to his general does -- genitals. will they still were? yes ma'am don't let him fool you they will work for perot all right then. then ushered dr. waved and we stepped out. [laughter] so the doctor you just cared so much about his patients. we will also treat all lots of folks who did not have access to primary care succumbing not of that

experience it was of little more difficult. so this story is more from the heart of the book so i went to medical school in south texas in before started med school my island was hit by a hurricane. i ate devastated the town and in the aftermath the hospital which historically was a charity hospital there wasn't a doctor in texas could not get care they

would send them to galveston and know that they would get care. with the hospital changed very abruptly police stopped doing any charity care and patience at galveston were sent four letters that said for example, due to a cost of hurricane ike dr. cameron will no longer be a doctor. that included patients who had cancer or chronic diseases, complicated diseases. and what happened after hurricane make -- ike that defined my experience as a medical student in the doctor was becoming so this story is about the doctor

and she refused to abandon her patients so this is about her. >> what is a surgeon with our operating room? what does the good doctor do with that institution tells her to abandon her patients and they need her help? susan began to find her own answers her gaullists and patients were scattered in areas that were not flooded. these patients got the four-letter. often she cannot reach them by telephone so in the weeks after hurricane ike she would begin to drive the issue was not accustomed to

all the time that hurricane ike gave her. though weather was beautiful sunny and cool the best you to dream of after your town was destroyed. leaving the wreckage behind listening to the of variations on a the harpsichord. they were starting only intact compared to galveston. the restaurants were open people have launchers and swing sets driving to the nearest point she could find it she could not find a house she would ask around that corner stores and churches the patients would stand the with of american poverty summer in a garage

apartments with electricity came from the extension cord they welcomed her she began to learn every house can feel like home. somebody would off her a cup of tap water so after words she was conscious of her own comparative wealth but that was not too shabby oddly there were not surprised to see her there were people at every stage of treatment and to whom weeks before she

said day have a great chance of surviving and now they have the tracheotomy one have done surgery already. so wateree going to do? what is the plan? the trick is she did know what to do some say that's interruption was temporary and they take them back is in his they could others had already begun to seek care elsewhere and others were too sick to do anything at all and she had to tell them that she could no longer treat their cancer. so head and neck cancer if

and treated it chokes you to death there grows back into your brain or arteries you bleed to death and then you drown in your blood unless the doctors there to stop the blood from going into the lungs. she could get herself to tell the truth. not all the details but the truth. she said she will die because of this. i know i told to 75 per tent five years from now but that was with treatment the now without it will be 100 percent. this is not an easy thing to say and sometimes she failed and would dance around the issue talked-about plans even when she knew they would not work.

sova as it was circuitous so then she would try a to say it strongly you will die but that was awful. sometimes the of conversations were arduous and then say tell me again? so she would try to repeat or some time she would sit silently in her car and then turn around and drive pac to galveston to have a conversation again. and they had to do this face-to-face she cannot fathom that formal letter. the patience to served to hear it in person and made plain so she would return to

their home to have the impossible conversation she was an unfamiliar territory as a surgeon she was trained to confront death by diagnosing and tell them the patient was a working or that they could not be cured many had died before but this belt different. she could not blame the cancer the situation felt the natural and she was not sure who to blame the insurance or the state or the hurricane she felt implicated so at times she blamed herself and felt like a worthless novelty that could not operate so she had

some idea that she could stand by her patients and go to their houses and comfort them to clean their wounds and write prescriptions for pain each encounter began with the washing of hands sometimes that meant she had to wash the dishes and put them away because her patients were alone in the dishes were forgotten. as strange as it was a was familiar. the same rituals acted out in a trailer park vital signs sometimes been a bird would be sick and she would see them also.

they do not want her comfort or the laying on of hands follow that ethical imperative that one in surgery chemotherapy and radiation and they wanted to live. [applause] there are some sad stories in here. i will read one more story and this is when an

undocumented lady was super sec and a volunteer would push and push until she got care. the volunteers name was jacqueline. federation was diagnosed with cervical cancer. all too often we encountered do get biopsies but we were not able to get them treatment so we can do chemotherapy with free clinics or radiation or surgery so if there is not a arroba safety net then

people died of diseases that our treatable. jacqueline was raised in south texas. her parents emigrated from cuba and hers was a family of doctors. mother and father were ophthalmologist and did their residency in detroit to be a general practitioner. her mother once refused to move port arthur because it smelled. jacqueline had a nanny and jacqueline's mother often tells her to pray and her father's issue of the dog as a physician once they stop living in the world of black-and-white that you need god.

gloria had a husband and chauffeur in el salvador but she promised $3,000 to bring her number. saving enough money to bring her daughter number the daughter married american citizen certainly they cannot give her enough to pay for her brother to come north. and then move to galveston to live with her nephew. one day she arrived and jacqueline met her. there is the part that i will skip around regarding server code cancer that is

one that the u.s. government has committed to funding diagnosis and treatment that gloria was undocumented so not only the she'll likely to get server go cancer but were likely to die of it is diagnosed. is a dilemma she is of undocumented we cannot get her in. so we start caring for her at st. vincent's. we tried to find her charity care. jacqueline which allowed each of the of women's. and jack chillon -- attacks one was on a charge she

would translate. meanwhile glory was rejected by three hospitals every time jacqueline gave for the bad news. no longer practicing catholic sometimes after these encounters to recall her father he did say this is why you should go to church. she said if this does a workout have to pray to somebody. subject:end gloria began to come up with more elaborate plans to give her the care she needed. somehow jacqueline could convince them to find added she had cancer and the rest of her body. she was dedicating so much

to this one patient is she trying to sway you? so much. when the skean then ask why they had needed it to. and to be pretty careful. and butted did feel that we were stalling or killing time for someone to offer surgery or chemotherapy if admitted to hospital all of those could be done in a day year to. but the cancer was growing. blood would seep through her underwear. jacqueline does not believe

in being well-rounded as the doctor per car she was under pressure to treat madison as a job and leave it at the hospital. her father never left his work at the office he was always on call and part of me but that is just the way it will be. why is it so bad that i want my life to have meaning for my work? i wanted to tell her life is full of meaning we don't have to take all of it from medicine. but i couldn't stop her more than myself. but korea told jacqueline to trust in san tonight.

but then to get coverage care so qur'an had not nothing that showed the address at all. maybe you can be involved in the study. gloria burst into tears or a telling me. want to go back to el salvador to with a family. want to go back to el salvador to die. chocolate with home and killed her sorrow with guilt but like a ripple the answer came the very next day. thanks in large part to her advocacy korea has been accepted for charity care in

is in treatment. >> sometimes we sacrifice hour of leaves the with we push and don't get up but actually you save your patience life. jacqueline and gloria still talk on the phone sometimes.

[applause] but i have noticed has the book hushes the vault the

amassed to tell the miracle story and those are routine care. with those who have struggled in have been denied but at the same time

but is now contemplating a political situation there is so much that we can build on. there is so much we should be proud of and i myself even having experiences like this in restorations turn towards hope over the over. >> considering the current end heated political climate where liberal versus conservative is crashing in the waves.

and the health care issue what will we do as a country? for those who are pro-life or pro-choice so are you concerned that you want everybody to have care. specifically you are pro-choice working in the abortion clinic so are you experiencing. >> that is also a very good question. i do write about working in the abortion clinic finishes stories of the women who got

care there and i tried to do it in a way from either side of the political debate. as a provider of an assault -- sure i will be told by somebody on twitter that is so case of times you have to speak out what i was most worried about was pushed back that one of those overall charges the book makes with communities of color but we think the of

charity work and something that ensures a we are immoral but is harder to think about for those the welfare of her and could defer efficient and because

i had a very gentle and generous the loudly to use the cap on those troops but those are very hard to look at. >> i am curious seventh bad this one and a great choice about the but kidding yatter there.

and anything goes to the structure as garnishes oriented their deceit dedicated to the full verbal and the pain of a share in a chair and one of the agreed to raise and then to you describe the actions after hurricane ike with all of for animals of dogs and cats and abandoned baby squirrels . a lot of animals.

she is such a tender hearted the 80. she said the book is a treasure for her. that is nice that i told the story in a way that they recognize it and felt true for them. civic will your relationship be will you work. >> that is the judge could question so what is reassuring in and gratifying because the book is obviously not a surprise and

it came out of a lot of pain from not being able to get my patients what they needed with the doctors and nurses and other respiratory therapist. and really wanting to do their best but it was the state and texas medicaid. just like 18 other states. it was the denial of resources bin than the natural disaster component which you cannot overlook. is a place that i love but

it is where i became. i think i am all right. [laughter] so i really hope it is an ongoing conversation. >> i turned 80 in december so i have been doing a lot of thinking about death and dying and it is my observation that those people who were able to get a hospice care that we truly believe they will be reunited in with their loved ones that passed on before them or go to heaven to me jesus our god that they believe that. i think it is a lot easier but for people like me that bleeds after negative it is oblivion like it was before.

the thought of death is a frightening experience. >> i am with you on that. i find that very framing. said to become a doctor as well as a surgeon because so many of her patients died she never thought that was okay. and the of preventable death was a tragedy.

and also a happy birthday the book puts north lots explicitly but the arguments are from live leading liberal hard. -- part.

and for those across the political spectrum the belief everybody who deserves to see a doctor when they're ill or suffering i have announced what i knew could characterize it the radio station.

things for coming tonight. [applause] but that alone beograd the