A Doctor's Love Letter

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Dan: Ben Taub Hospital is an openly financed safeguard medical facility in Houston, Texas. Most of clients do not have insurance coverage of any kind.

Dr. Ricardo Nuila has actually been operating at Ben Taub considering that he was an intern, a medical trainee. He took me on a trip.

Ricardo Nuila: I began here and, you understand, actually I simply did not wish to leave here cuz I simply, simply truly enjoyed my task here

Dan: He’s simply released a book called “The People’s Hospital” that’s not simply a love letter to the location, it’s a pitch:

Not just is this location method, method more affordable than what we’re utilized to, in lots of methods it’s much better. And it’s a design, a genuine option to what-we’re- used-to.

I ask him to select ONE client’s story from the book to inform, he selects a client he calls Stephen. A dining establishment supervisor, a Republican. A person who did not anticipate to wind up here.

He had a huge swelling on the side of his throat, and his insurance coverage didn’t cover much. He paid money, in advance, to get seen in a regional ER.

Ricardo Nuila: There was a physician who had actually seen a CAT scan and stated, you have tonsillar cancer, cancer, nevertheless, you do not have, uh, insurance coverage

Dan: Tonsillar cancer. Cancer of the tonsils. That landed hard. Did the “nevertheless.”

Ricardo Nuila: He felt shitty you understand, that someone might inform you cancer, however there’s absolutely nothing that we are gon na do about it due to the fact that of, of just how much and …

Dan: It’s like it’s too unpleasant– or too apparent– to end up the sentence: Because of your insurance coverage. Someone informs Steven to attempt the general public healthcare facility, Ben Taub. He anticipates the worst. That’s not what he discovers.

Ricardo Nuila: He concerns like this location. He offers, this resembles so Steven, however he, he offers present cards to individuals welcoming at the door since they’re great and they do their task well cuz they make his day,

Dan: And it’s not simply that he likes individuals at the door.

Ricardo Nuila: He seems like he got truly great health care which he likewise, um, believed that the cost was incredibly factor.

Dan: Stephen lost his insurance coverage when he got too ill to work, and he does not receive Medicaid. He owns a home, he’s got cost savings, Texas has actually strict Medicaid limitations– so he’s paying of pocket.

Ricardo Nuila: His last costs is cents of what he believed he would pay.

Dan: Stephen’s daddy had actually gotten radiation treatment for cancer, and the price tag was 700 thousand dollars. Stephen had actually gotten radiation AND chemo AND surgical treatment– and had actually been hospitalized for a great while.

His costs was 32 thousand, 3 hundred and seventy-eight dollars. Genuine cash for sure, however he can pay it. And it’s less than 5 percent of his daddy’s costs for much less comprehensive treatment.

Ricardo Nuila: And the health care is truly great. Therefore he’s nearly happy that he’s had this experience

Dan: Steven’s ended up being a transform. And as Ricardo Nuila strolls me into a meeting room, it’s clear: He hopes his book will produce more converts.

Ricardo Nuila: you begin to see this design and it makes you believe, can things be various in health care? I believe that that’s a choice. We as a nation have not believed about that. Seriously. You understand?

Dan: And if it appears politically unthinkable that we might have anything like this around the nation– an efficient, effective, CHEAP, publicly-funded health system–

Well, the concept that Houston might have one, that was quite not likely too.

The story of how Ben Taub got here might be the most unexpected story in Ricardo Nuila’s entire book.

This is An Arm and a Leg, a program about why healthcare expenses so freaking much, and what we can possibly do about it. I’m Dan Weissmann. I’m a press reporter, and I like a difficulty. Our task on this program is to take one of the most enraging, scary, dismaying parts of American life and to bring you a program that’s amusing, empowering and helpful.

Ben Taub Hospital sits at the edge of the Texas Medical Center– that’s a huge community loaded with healthcare facilities and medical schools, consisting of a few of the very best in the nation, like the M.D. Anderson cancer center.

In his book, Ricardo Nuila discusses how some clients at Ben Taub can see from their spaces the gleaming structures of Ben Taub’s next-door neighbors.

When I go to, I make him reveal me the view. We keep an eye out from a stairwell at a glass tower, M.D. Anderson’s Sheikh Zayed structure.

Ricardo Nuila: that’s attractive.? you get a peek into the remainder of the medical center here. Ben Taub protrudes, I seem like, since it’s, it’s brick versus glass.

Dan: As Ricardo Nuila makes clear in his book: This unglamorous brick structure gets the task done.

In addition to Steven, there’s Ebonie, whose complex pregnancy– there’s a great deal of vaginal bleeding– gets tracked more exactly than it would somewhere else:

At other healthcare facilities, nurses eyeball the pads that take in that blood and note heavy, medium or light bleeding. At Ben Taub, they’ve embraced an ingenious method: weighing each pad to get a specific measurement.

Another client, Christian, has actually bounced around other systems without anyone precisely identifying the alarming kidney issues that have actually kept him in discomfort for several years. Due to the fact that he didn’t have excellent insurance coverage, it wasn’t worth anyone’s time.

At Ben Taub, insurance coverage isn’t a barrier,

Ricardo Nuila: We arrange things, which is generally, all right, we require to concentrate on your kidneys today and we require to get you to see a geneticist. And both of those things occurred.

Dan: they not just detect him, they get him on a kind of dialysis that he can handle himself in the house.

It’s more affordable, and provides much better lifestyle for him.

Whatever at Ben Taub is more affordable. The system invests about a 3rd as much per client as the nationwide average. In part, that might be due to the fact that no one makes million-dollar incomes here.

Ricardo Nuila makes the case over and over once again that they take the time– since they have it– to make sensible usage of resources.

They do not have as numerous MRI makers as other healthcare facilities. Think what? A great deal of clients do not require MRIs.

Ben Taub can’t fulfill every requirement: One client, Geronimo, requires a liver transplant, and that needs resources the health center simply does not have.

Ricardo Nuila and his associates put a lot of time into wrenching him back onto Medicaid, so he can get the transplant someplace else. They rope in a Congressman to get it done.

Geronimo informs his mommy:” I feel so essential. Everybody treats me like I’m abundant.”

Ricardo Nuila: That’s what I believe a great deal of individuals truly desire is simply the sense that the individual who’s accountable for your care is analyzing the issue with you and conscious that you are not having a fantastic day and wishes to handle that circumstance with you. And I simply seemed like this environment enabled me to like, have those minutes.

Dan: Who pays for this environment? It might be more affordable, however it isn’t complimentary.

Some clients are on Medicaid. Some are on Medicare. Some have personal insurance coverage. The bulk do not have any insurance coverage at all.

Some, like Stephen, pay money. And a great deal of the rest– about a 3rd of Ben Taub’s clients– are dealt with free of charge.

The bulk of Ben Taub’s financing originates from an unique real estate tax in Harris County, where Houston lies. It moneys an entire system called Harris Health– Ben Taub, a 2nd medical facility, and a lot of centers.

And obviously, none of this has actually constantly existed.

It’s just here, like this, since of an actually wild story, with 2 huge characters. Among whom wasn’t even from Houston. He was an author I ‘d never ever become aware of, a Dutch person called Jan de Hartog.

Ricardo Nuila: de Hartog was among the most incredible individuals that you might check out. He was a Nazi resistance fighter, Dutch ship captain.

Dan: And while he was hiding in Denmark throughout the war– in between conserving a couple of Jewish children and running war objectives in his tugboat–

he composed a romantic dramedy that– later ended up being a broadway hit. And after that got adjusted into a Broadway musical called I Do, I Do– which, Broadway-musical geeks in your house– starred Mary Martin and Robert Preston– you understand, The Music Man– and had a tune that your mommy may still keep in mind.

(musical noises)

Dan: Yeah. Intriguing person. And in the early 1960s he concerned Houston to teach playwriting at a regional University. It was a huge time for him. He ‘d simply gotten wed — for the 3rd time, however this one was for keeps- and end up being a Quaker.

Ricardo Nuila: And when he and his spouse Marjorie pertain to Houston, they discover that there’s all these whisperings about this charity medical facility in the area in Houston about how, how horrible the conditions are. That the kids in the maternity ward would weep all night for the, for an absence of milk, therefore as part of his faith, he chooses that he requires to offer there

Dan: When de Hartog discusses the medical facility later on, he explains the experience of strolling in for the very first time as actually mind-blowing.

He’s like: I understand what a healthcare facility smells like. Disinfectant, perhaps some fresh laundry. And I understand what a slaughterhouse smells like: Blood, and shit. And the odor here is slaughterhouse.

As he browses, the sights are something else.

Ricardo Nuila: He sees a cockroach crawling into the tracheostomy of like a client. He sees like individuals being in their own dirt.

Dan: He and Marjorie do not up and give up. They stay. And after that they hire a lots Quakers and a couple of society women to come volunteer with them, and get the Red Cross to train them.

And it’s nuts. This is an abundant city. The ZOO is air conditioned. Not this health center.

And he begins to capture on: Why it’s so dreadful.

Top is bigotry.

The medical facility serves primarily Black and Brown clients. When Jan and Marjorie begin offering, the other volunteers are all society girls, and the entire program is established so they do not touch clients. DeHartog later on states he asked why, and the volunteer organizer states, Southern women can’t have physical contact with black individuals.

She does not state black individuals. She utilizes the n-word.

When he asks personnel why public authorities do not do something about the rotten conditions, they state: What political leader is going to stick up for black individuals? The n-word shows up once again.

And– de Hartog does not make this connection, however it appears quite on the nose: The medical facility itself is called after Jefferson Davis, who led the Confederacy in the Civil War.

There’s likewise a political system for institutionalising this disregard, without ever having to acknowledge the function of bigotry:

Nobody specific political entity– nobody specific politician– is accountable for the general public medical facility, economically. The city of Houston and Harris County are each expected to start HALF. It does not belong to either of them. Here’s de Hartog explaining the city-county dynamic in a lecture he offered several years later on.

Jan de Hartog: And they were constantly at each other’s throats. The one stated, you do not pay enough. The other stated, however you do not. And they went back and forth

Dan: The leading authorities for Harris County in fact has the title County Judge. At that time, this was a person called Bill Elliott.

And you’ll hear in this clip from a regional broadcast, he wasn’t precisely grabbing the expense. Here he is, describing why the some issue with the medical facility is in fact the CITY’s fault.

Judge Bill Elliott: it’s definitely absurd, uh, to state that, uh, this is an obligation and this is the fault of Harris County.

Dan: And the city? A minimum of one.council member is requiring a spending plan cut.

Which actually pisses de Hartog off.

And de Hartog really enjoys the city. It’s an interesting location. It’s thriving– growing super-fast. And it’s not simply an oil town.

Ricardo Nuila: Houston at that time was the house of NASA.

NASA storyteller: Future manned area flight objectives to the moon and possibly the worlds will be commanded from this control space of the Mission Control Center at NASA’s Manned Spacecraft Center,

Ricardo Nuila: It had actually developed this Astrodome, it was the city of the future.

Dan: The Astrodome– you understand, a sports arena WITH AIR CONDITIONING.

Astrodome Narrator: A totally confined structure, big enough for any sport convention program or conclave with continuous temperature level and humidity independent of outdoors weather condition,

Dan: CBS News does a report about the thriving city: NASA, the oil wealth, the Astrodome. And de Hartog is a primary character– speaking about just how much he enjoys the town.

Jan de Hartog:it is a city of, a city of unrestricted chances. It’s a tremendously amazing town, and you feel that anything is possible,

Dan: It covers up with Walter Cronkite discussing how everyone in the area is definitely nuts about football.

Walter Cronkite: Their brand name of football resembles their brand name of city and brand name of life. Play broad open. Gamble, attempt anything. Above all, do it with enthusiasm and do it huge.

Dan: Oh, and there’s this OTHER thing Houston is truly ending up being understood for.

Innovative medication. For twenty years, the city’s been developing the Texas Medical Center– that huge school where more than a lots medical facilities and med schools now run right on top of each other. Baylor College of Medicine really moved from Dallas to Houston to be part of it.

Ricardo Nuila: Houston is an actually deeply medical city. And at that time they’re all dealing with amazing things

Dan: Yeah, in 1964, while Jan de Hartog is seeing the suffering at the charity medical facility, Dr. Michael deBakey is carrying out the world’s very first coronary artery bypass at a personal healthcare facility in the area.

The medical facility were not allies. Jefferson Davis medical facility, on the borders of town, will be changed by a brand-new structure in the Texas Medical Center.

The Medical Society– the regional medical professionals’ association– had not desired the charity health center as a next-door neighbor. They ‘d in fact set up a tally effort to keep the brand-new structure at the old website.

Medical Society Voice-Over: you the taxpayer, will pay the additional expense That’s why your physician advises you choose the brand-new healthcare facility to stay at its present website.

Dan: It had not worked, however together with the budget plan cuts, authorities were now discussing DELAYING the charity health center’s transfer to the brand-new structure, which had actually simply been finished. De Hartog and his pals, smell a rat.

They believe the powers that be are really going to offer the brand-new structure in the Medical Center to some other medical facility that desires in. This has actually been a public discussion.

Jan de Hartog: There had actually been deals to purchase it and they wished to wait on the greatest bidder

Ricardo Nuila: He composes a series of op-eds for the Houston Chronicle that begin to get press, not simply in Houston, however around the nation and in truth all over the world.

Dan: He explains the terrible things he’s seen. And he interest Houstonians’ sense of pride in their dynamic, futuristic city. A city he enjoys, too. Here’s how his very first op-ed ends …

Jan de Hartog: I can not think that it is the will of the people of Houston, that our growing medical center appropriately ending up being well-known all over the. Shall be permitted to harbor the malignant aching of male’s inhumanity to male. It would turn the whole center prepared as Houston’s magnificence into Houston’s embarassment.

Dan: Even simply that very first op ed made a great deal of sound.

Jan de Hartog: the bomb blew up and the nationwide publications and papers and television zeroed in on the health center to learn what was going on,

Dan: … and right away, the healthcare facility DOES move into its brand-new house in the Medical. The financing problem isn’t resolved.

De Hartog keeps pressing.

Ricardo Nuila: He composes a book called “The Hospital”

Dan: He goes to churches around town, synagogues, all over he can, hiring numerous volunteers.

There’s no political development– and conditions at the health center in fact get even worse. Secret nurses get stressed out and stop. Things go to hell.

In a traumatic journal entry, he blogs about complete bedpans left on tables beside trays of food. About a client weeping out for assistance, and hearing back “Shut up!”

Jan de Hartog: Never ever prior to had I understood to this degree, the depth of our damnation, and at that inmost minute of desperation, when we understood absolutely nothing might be done, absolutely nothing would alter for the basic factor that

Jan de Hartog: those who had the fate of the healthcare facility in their hands were not there. Mayor Welsh didn’t work there. Uh, commissioner Bill Elliot Judge, the county judge did not work there.

Dan: THEN, there’s a turn. Someone appears. That’s right after this

This episode of An Arm and a Leg is produced in collaboration with Kaiser Health News. That’s a non-profit newsroom about healthcare in America. KHN is not connected with the huge healthcare gamer Kaiser Permanente. We’ll have more details about KHN at the end of this episode.

Jan de Hartog keeps slogging away.

He lectures at a Baptist church– he checks out that journal entry, the one with the bedpans, and the lack of Judge Elliott and other leaders.

And in the beginning he believes he didn’t discuss so huge. No one even raises their hand to volunteer.

Then it occurs.

Jan de Hartog: When, uh, we will leave, a male showed up with an infant on his hip who stated, uh, do you train individuals in the evening?

Dan: And the man appears to be taking a look around, attempting to make certain no one’s listening. De Hartog informs the man, yeah, we might do that …

Jan de Hartog: He stated, I indicate, a dead of night without anyone seeing.

Dan: De Hartog’s like, “um, sure, I think. Why, though?”

Jan de Hartog: He stated, well, I am Judge Elliot,

Dan: Judge Elliott. The county judge. Most likely the most effective political leader in the area. That’s who wishes to volunteer. In trick. Without anyone seeing. He states to de Hartog

Jan de Hartog: I can refrain from doing it as a judge, however I should do it as a male. Which was the minute that the entire damn thing altered.

Dan: Due To The Fact That Judge Bill Elliott followed through.

Ricardo Nuila: He trains himself in a private way to be an organized, in the evening, and he validates whatever that de Hartog has actually stated.

Dan: de Hartog in fact supervises the judge’s last useful test, where Bill Elliott tends to an African-American male called Willie Small.

Jan de Hartog: the judge with his thermometer went and put his hand on Willie’s shoulder and stated, Mr. Small, sir, I ‘d like to take your temperature level to hear that, to hear a southern judge,, state “Mr. Small, sir”

Dan: It was a symbolic minute. The judge needed to touch, needed to accept, a Black guy. Not just had the judge now seen whatever, he took obligation for what he had actually seen.

There’s a proposition for a county-wide real estate tax, to money what’s called a Hospital District. Now there’s a referendum, and Elliott backs all of it the method.

Jan de Hartog: and all of us waited with baited breaths for the result. And it was no

Dan: Yeah. The referendum stops working. And as de Hartog informs it, once it does, a genuine reaction begins to develop. It gets individual.

Jan de Hartog: those who had actually resented our existence from the really starting ended up being singing. Margie and I, were called communists

Ricardo Nuila: De Hartog simply would not flinch. I indicate, he and his other half’s lives were threatened.

Dan: Someone tossed a bag of excrement at their door.

Ultimately, de Hartog states the Red Cross, which was training and monitoring volunteers at the healthcare facility, pertained to him and Marjorie and stated, “It may be much better for us if you left town for a while.”

They did– went on to all type of experiences.

Costs Elliott kept pressing, and keeps pulling in allies– consisting of, ultimately, the Medical Society.

Ricardo Nuila: he rallies them to support it.

Dan: He gets the concern on the tally AGAIN later on that exact same year. And it passes in November 1965.

It’s a huge minute.

Ricardo Nuila:What’s likewise fascinating is that it’s forgotten. Something that I’ve obtained from all this is that you understand, individuals will forget and you need to advise them.

Dan:And while we’re keeping in mind: In 1965, the entire nation is making some huge dedications to healthcare for a great deal of individuals. President Lyndon Johnson indications Medicare and Medicaid into law in July of that year.

It’s most likely likewise worth keeping in mind that Medicare and Medicaid assist make Ben Taub possible: About a 3rd of the healthcare facility’s clients are on one or the other. It’s a minority of clients, however it’s numerous countless dollars of financing.

The 1960s were an infamously dissentious time. Therefore is this.

Ricardo Nuila does not neglect today’s political polarization– or how that polarization makes it difficult to picture a nationwide discussion about developing a various healthcare system.

Or the function that physicians have actually traditionally played in withstanding that discussion.

It’s part of his story. His household story. And in a book about a location where a great deal of unfortunate things do occur, this might be the hardest one.

Ricardo Nuila: I was born into a household of medical professionals and my papa in numerous methods was a hero to me. I saw just how much pride he took in his work of being a physician

Dan: Over time– as insurance coverage business got harder to deal with– the company side of running a medical practice looked a lot less apealing.

Ricardo Nuila: He needed to work with increasingly more personnel. He employed his mom, my grandma, who is, uh, the kind of individual not to pull back from Chicago, you understand,. Therefore, her task was to be on the insurance provider to ensure that they would not, screw him out of cash.

Dan: His daddy turned away clients who didn’t have insurance coverage. His papa grumbled and whined– about insurance provider, and about clients who didn’t have cash to pay.

When Ricardo ended up college and entered into medical school, he postponed beginning for 2 years. What he views as his daddy’s life in business of healthcare is not enticing.

Ricardo Nuila: the grind endures him, you understand? The combating with the insurer

Dan: I indicate in the book, your papa is a little a stand-in for. For medical professionals as a doctoring, as occupation and the, and the method which medical professionals get pushed away from medication.

Ricardo Nuila: yeah, he is a stand in a bit for physicians. And it’s gon na be, I believe the physicians have a lot to state about how health care enters America,

Ricardo Nuila: And regrettably, the history reveals that they have not been a fantastic piece of that, a minimum of as far as universal health care is worried.

Dan: This enters into Ricardo’s story with his daddy. Father welcomes him to form a family medicine. Ricardo picks Ben Taub. And throughout the years, it ends up being clear: They’re on opposite sides of a political divide. There hurt discussions, and after that they go months without speaking.

Ricardo Nuila: that’s how deep politics run, you understand, it’s truly, it’s truly challenging when you overlay like politics onto like a household dynamic,

Ricardo Nuila: It simply seemed like he resembled completely on board with this concept that, you understand, health care is something that is made and health care is something that individuals, if you can’t manage it, you do not deserve it. Is what I spoke with what he was stating.

Dan: is your father a perfect reader of the book? Is your father sort of who the individual you wan na make that case to?

Ricardo Nuila: That’s actually intriguing.

Ricardo Nuila: I would state this, that, I did not compose this to preach to the choir for sure.

Dan: He’s not sure his daddy would in fact select up a book like this.

Ricardo Nuila: It’s even if I understand my father, he, my daddy’s the kind of individual who checks out John Grisham on a beach, you understand? I’m not a hundred percent sure if he would select up this book, you understand?

Dan: Unless, state, his child composed it. Ricardo does anticipate his father to check out The People’s Hospital. And even if he does not concur with whatever his child has actually composed, Ricardo believes his daddy will be happy.

Ricardo Nuila: I can inform you now as a, as a daddy,, it’s unclear that your kids are gon na come out Okay. You understand what I suggest? I’m simply stating that like he has factor to be happy even if I’m a, a living and breathing individual today, you understand?

Ricardo Nuila: And I’m, I’m operating in as a physician. I, I feel, I feel excellent for him.

Ricardo Nuila: And I believe that he’s most likely extremely pleased that I blogged about medication cuz he likes medication.

Dan: The last chapter of “The People’s Hospital” is called “faith” And in it, Ricardo Nuila explains a day-to-day routine that he states keeps him grounded. It begins with passing a plaque on his method. Naturally I have him reveal it to me.

Ricardo Nuila: I park like right there,.

Ricardo Nuila: I can be found in here and I simply take a look at, take a look at this each time.

Dan: And explain what we’re seeing here.

Ricardo Nuila: Well, we’re seeing, a plaque that, discuss when this medical facility was established, and individuals who built the structure. And there’s likewise the, I forgot this is, this is bad of me, however I forgot the name.

Dan: the snake around the stick?

Ricardo Nuila: I’m in huge difficulty now since I’m on the Caduceus Caduceus. I, it’s the Cadus. Yeah.

Ricardo Nuila: And it’s simply a suggestion, you understand, that we have this structure in location to assist look after individuals who do not have, uh, the ways which, and

Dan: that individuals chose to put this structure here. Yeah.

Ricardo Nuila: Precisely. It’s a neighborhood effort.

Dan: Ricardo Nuila composes that he sees that neighborhood as he strolls from that plaque to his desk– all the colleagues, in every sort of task, doing their finest.

And this is the faith that he states gets verified– checking out from the book here:

If somebody is suffering and there is the capability within the neighborhood to assist, in such a way that does not hurt anybody else, then we not just owe it to that individual, we owe it to ourselves to assist.

Whatever your politics are, I believe that’s quite fantastic.

Dr. Ricardo Nuila practices at Ben Taub Hospital. He’s associate teacher of Medicine, Medical Ethics and Health Policy at Baylor College of Medicine. His book is called “The People’s Hospital.”

Truthfully there’s a lot in this book,– more client stories, more household stories, a really deft summary of a century of healthcare economics and politics.

I’ll inform you: reading this. book, I was advised of a concept I’ve had previously. That it may be cool sooner or later to assemble a type of “Arm and a Leg” book club. Since I ‘d like to have somebody to talk with about a book like this– like possibly you.

Now, that’s simply a concept. The how would take a LOT of finding out.

I’m curious how that concept sounds to you. You can let me understand at Arm and a Leg program dot com, slash contact.

I indicate, that’s constantly a great location to send out concepts and stories and concerns– many of our finest episodes originate from you.

And I’m curious what you consider this virtual book club concept. If you’ve participated in something like this, or assisted to arrange it, I ‘d enjoy to hear how it went.

That’s arm and a leg program dot com, slash contact.

Next time on An Arm and a Leg: A lady called Lisa French asked her medical facility what her surgical treatment would cost her. They stated, with your insurance coverage, about thirteen hundred dollars.

They anticipated about 55 thousand more from insurance coverage.

They got 75 thousand. Then they desired more. 229 thousand more. They desired it from Lisa French, and they sued her for it.

After 8 years, the case lastly got fixed last June. Lisa French won!

The case has a LOT to teach us about our legal rights.

That’s next time on An Arm and a Leg.

Till then, look after yourself.

This episode of An Arm and a Leg was produced by me, Dan Weissmann, with aid from Emily Pisacreta, and modified by Afi Yellow-Duke.

The recording of Jan de Hartog’s lecture is thanks to the Baylor College of Medicine Archives.

The audio of Bill Elliott is from a KHOU-TV broadcast, thanks to the Texas Archive of the Moving Image.

Huge thanks to the archivists who assisted us discover a few of the tape for this episode!

That consists of Emily Vinson at the University of Houston library

Matt Richardson and Sandra Yates at the Texas Medical Center Archives

And David Olmos at the Baylor College of Medicine archives.

Daisy Rosario is our consulting handling manufacturer. Adam Raymonda is our audio wizard. Our music is by Dave Winer and Blue Dot Sessions.

Gabrielle Healy is our handling editor for audience. She modifies the First Aid Kit Newsletter.

Bea Bosco is our consulting director of operations. Sarah Ballema is our operations supervisor.

This season of an arm and a leg is a co production with Kaiser health news. That’s a not-for-profit news service about health care in America, an editorially-independent program of the Kaiser household structure.

KHN is not connected with Kaiser Permanente, the huge health care attire. They share a forefather: The 20th century industrialist Henry J Kaiser. When he passed away, he left half his cash to the structure that later on developed Kaiser health news.

You can find out more about him and Kaiser health news at arm and a leg program dot com slash Kaiser.

Zach Dyer is senior audio manufacturer at KHN. He is editorial intermediary to this program.

Thanks to Public Narrative– That’s a Chicago-based group that assists reporters and non-profits inform much better stories– for working as our financial sponsor, enabling us to accept tax-exempt contributions. You can find out more about Public Narrative at www dot public narrative dot org.

And thanks to everyone who supports this program economically.

If you have not yet, we ‘d like for you to join us. The location for that is arm and a leg program dot com, slash assistance.

Thank you!

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