Slate: Sick missionaries denied medical care

I have personal experience with this. At one point in my mission I got bronchitis and ended up with a fever of 104 my companion asked what she should do and was told to give me some Tylenol and see if it went down. It did go down but at that high of temp I really should have been taken to the er. I was somewhat delerious and couldn’t make that decision. Eventually I did see a Dr but not until a few days later. I served here in the us with easy access to Healthcare btw.

Eventually I did see a Dr but not until a few days later. I served here in the us with easy access to Healthcare btw.

This is the part that seems odd to me; AFAIK, we don’t have a regular MD in the local ward, but we do have a dentist (who has done emergency dental work in the middle of the night for at least one missionary that I know of) and a couple of RNs, and it’s hard to imagine a ward of any size without any medical professional who would at least give a quick checkup for a missionary on request. At worst, the MP should check with the bishop and then the stake presidency to see if there’s anyone anywhere in the stake who could give a professional opinion.

Considering that missionaries are usually on their parents’ insurance, you almost wonder why the decision has to go through the mission president (or wife) at all. It seems like the parents should be a lot more involved, too.

This is a difficult issue for me. I had a few health problems on my mission that weren’t handled adequately. Random thoughts:

1) It all depends on the mission. Leadership roulette, we all understand that angle.

There’s also the question of access to healthcare. My experience was similar to Roadrunner’s. There were some areas that didn’t have any access to healthcare; more pointedly, we did service in the local hospitals on my mission and there was no way I was going to one of those hospitals for treatment. I remember cutting my head on a low hanging branch. Ordinarily it would have required stitches but I didn’t want to come out of the hospital with something worse that what I had going in. I let the cut heal on its own taking care in cleaning and dressing the wound. It did heal, I viewed it as a miraculous healing.

2) It all depends on the missionary. This wasn’t the case in the examples cited in the article but some people won’t go to a doctor for any reason. I have a problem with this now. I tough it out for a few more days to see if it will get better. A missionary might have this attitude and someone in the mission office 500 miles away might have this attitude. Let’s give it a little more time to see if it gets worse/better and go from there.

3) We do have a culture of absolute obedience to authority during missions. That’s probably the only way to get missionaries to obey the rules on top of rules in the mission handbook. Unfortunately that level of obedience translates poorly to placing all authority in someone else to make calls about our healthcare. Jumping the hurdle of saying “forget this, I’m going to the doctor” can be insurmountable, it can be defying the lord for some people.

4) Maybe another contributing factor is that the person in charge of healthcare in a mission (not always the mission president’s wife) doesn’t want missionaries coming to them with every little thing. Maybe a serious problem falls through the cracks during a season when every other missionary has come down with a cold. Most of the diagnosis are given over the phone, it’s difficult for one person to travel out to missionaries spread all over the area.

I also get the impression that there are some missions that are so focused on keeping that shoulder to the wheel that there may be a culture where they are afraid that being too cautious about illnesses might create some sort of loophole where missionaries start to use “sicknesses” to get out of doing work, as harsh as that sounds. Maybe a few fakers using excuses to take a day or two off makes the mission nurse a little more reluctant to step in. It’s a shame that often missions are at the opposite end of an unhealthy extreme with regard to work ethic.

5) I got really sick the last week of my mission. I lost about 10% of my weight. I tithed on gross. I spent a week in bed, too dizzy to sit upright. No one from the office came out to visit me and I’m sure it looked like a convenient “trunky” illness to most. I really wish I knew what that one was. As luck would have it, the problem cleared up the morning before the day I went home. I’m sure everyone thought I was faking.

One point the Slate article touched on briefly is our mythos surrounding missionaries who die on their missions. This is fortunately rare but the cultural response to it is fairly predictable and if the Saints actually had saints, dying on your mission would definitely be a good first step towards canonization.

It does lead to a weird double standard. Catch an intestinal parasite on your mission, lose 50 lbs and have to go home early? You must not have had enough faith. Get hit by a bus on your mission and die instantly? You must have had so much faith that God called you home early!

Thankfully we seem to have let go of the “with your shield or on it” idea that permeated Church culture in the 20th century. But there’s still an element of magical thinking that I think we should let go of.

Even when the issue is really outside their specialty and competency.

IMO, part of the reason for that is that pretty much anyone in any medical field should have enough basic competency to be able to say, with at least more certainty than a layman, whether a problem needs immediate care, (ER) care at convenience, (make an appointment) or a couple aspirin and a nap. They should also know if there’s any sort of first aid or other mitigating actions that should be taken until further care is received. Anyone who’s seen a malpractice claim from the scary side will also be very likely to err on the side of caution.

I read the article and didn’t agree with every word. I disliked that the quote they used for masturbation came from a 1980 SWK talk (35 year old quote? really?). I also disliked the story about the missionary miraculously unscathed after being run over by a bus. I get that we have such stories floating around – but most of us are not fanatical in our approach to such things.

I do however have some stories.

I served in Chile in 2000.

There was some literature about boiling water in my first area but that was so very impractical. You just end up doing what everyone else does as nobody wants to be the sore thumb or squeaky wheel.

First I experienced some burning during urination in my first month in country. My ZL recommended drinking more water. I took his advice and it seemed to do the trick. I only mention this because it represents a hierarchy. The ZL is a 20yr old kid. He gives some common sense “rule of thumb” advice and then asks you to wait and see. If it turns out to be something serious then time might have been lost going through the hierarchy (this was something reported in the article). I can understand how contracting parasites could go untreated for a significant period of time.

Next I was bitten by a large dog. the bite went through my pants and garments (not bite proof) and punctured my thigh. Luckily the dog was behind a fence and had just fit its head through the bars enough to reach me. We went home and called the wife of the MP. She told us to wash the wound with soap and water and take some ibuprofen for pain. She was so notorious for her prescription for ibuprofen that it was good naturedly mocked in a mission Christmas skit.

The final incident occurred when playing soccer on P-day. A sister missionary that was guarding me inadvertently kicked me in the groin. Later my scrotum became deep purple and blue. We did not report this to the mission office. I felt pain but not inconsistent with bruising in a sensitive area. It was some time later (many weeks) when I had sudden pain when taking a seat or other such activities. The bruising had gone away and so this pain was outside of my experience to explain and understand. I emailed my best friend’s RN Mom back in the states and she told me to get checked out.

I told the mission office the whole story and I was sent to a medical office. The Dr. ultimately told me that the pain was the result of scar tissue from the injury but that it should go away. I was fairly relieved because I was imagining something like testicular cancer. After the appointment I reported directly to the MP and I told him the moderately relieving news. I was surprised when he then chastened me. He told me that they had a pretty good feel for what issues were serious and needed medical attention and which were not but that I had taken such discernment and discretion out of their hands by contacting a medical professional against mission rules (no email allowed). How could they then deny me an appointment when I had already been advised by a medical professional.

I left the MP’s office still glad that it had been checked out. It was a major relief off of my mind. I also understood the position of the MP. He had several hundred missionaries in far flung areas to control largely by the force of his perceived authority and persuasion. I had gone outside of the approved channel and he didn’t like that.

I was told that my parents would be billed for the office visit but I do not know if that ever happened. I imagine that the church uses a combination of payment options depending on the circumstances. 1) bill the parents. This option makes sense if the parents can afford it. 2) bill the parent’s insurance. If the missionary is covered then why not? My parent’s coverage of me had lapsed since I was no longer a student. 3) the church can foot the bill. If the bill is so small that it is not worth the hassle or if the family is destitute then I imagine that the church would pay the bill.