Small Town Despots

I am not a nurse, but I work for nurses, so I know more about the profession than I ever expected. I know about the challenges of the profession, the high likelihood of early burn-out and the shortage looming over the profession that, if not addressed, will lead to more burn-out because of diminishing working conditions.

Still, I depend on them to take care of the people I love. To provide routine care when someone has minor surgery, and to provide palliative care when hope took the last train out and death took the same one in. To fiercely and vigilantly monitor their care.

Part of that means speaking up when things aren’t working. It means putting your money where your mouth is. It means doing the hard thing and picking up the pieces, later.

Too many people only get one chance at quality health care. If it’s not there, they might die. Every hospital admission, whether to the emergency room or a general ward, has the potential to end fatally. The possibility always hangs like a heavy, dark and wet blanket regardless of why one is there.

That’s why the case of the persecution of two west Texas nurses has gotten my dander up so bad. They filed a complaint against a doctor with political connections, ended up indicted because of evidence that was probably obtained illegally (complaints to the Texas Medical Board are confidential) and were subsequently fired and tried.

That’s not prosecution. It’s persecution. And there’s nothing right about it.

They did the right thing, and their lives got turned upside down and inside out.

I am not a nurse, as I said earlier. Nor do I want to be. It’s not a job I could do. My aversion to blood and sickness has led me to a career in accounting where the only bleeding I see is on a financial statement, and hopefully not too often.

I rely on nurses to take care of all the blood and gore. I respect their commitment to their profession and their patients. And to see them in any way constrained or intimidated while they treat and care for patients scares me. It could be my father or mother or partner they’re taking care of.

When my father was dieing, the nurse on duty told me not to bother about visiting time. She’d buzz me in to the ICU whenever I showed up. When my partner was in the CCU and crazy as hell, the nurse showed me the back entrance and told me use it whenever I wanted to. It was always open, he said. Use it.

Both of them did things that defied policy but were in no way criminal. They were taking care of their patients, and in their judgment, the rules could be bent to accommodate loved ones. And west Texas nurses didn’t even do that. They didn’t violate hospital policy unless the policy was to ignore and then punish nurses for expressing legitimate concerns about the quality of care their patients were receiving.

The doctor, hospital administrators, sheriff and D.A. all probably violated Texas law, which has explicit protections for nurses in cases like this. It provides for civil remedies, but not criminal penalties, however.

The problem the prosecution in this case came back up against and couldn’t overcome was that the nurses were ethically, morally and legally obligated to report their concerns. Can one break the law by obeying it? That doing so, even theoretically, was the case they couldn’t make.

They couldn’t make the case because it runs counter to every principle of the rule of law. We are a country of laws, one that the founders, had they been unsuccessful in their attempt to establish, would have lost everything, including their lives. While European aristocrats and petty dictators were ruling by caveat, we were making laws that applied to everyone.

If you lose sight of that, you should probably either have a religious experience (what I call a “come to Jesus” moment) or move to a country that doesn’t respect law. Find one with a petty dictator that you can cozy up to, and then wait to fall out of favor.

Law in a democracy is not arbitrary or capricious. Or at least should not be. When it becomes so, it points to a broader problem: the lack of will to abide by or enforce laws as written. To the peculiar ability of power to corrupt and allow petty despots to ignore them.

That is no more right in west Texas than it is in China, Iran or North Korea.

A small town despot is a despot, no less.