You thought it was a true-crime story, right? Or a slasher movie. It might make a good medical drama, with a happy ending, because eventually Briana Lane got her skull back. It only took a few months and some bad press, and now all the body parts of this uninsured 24-year-old waitress are on her person.
I’m not making Briana out to be a victim. She was driving under the influence and crashed her car. But I’m proud that in America we don’t stand around debating whether someone is deserving or insured while they’re bleeding to death. We’re pretty good at the emergency care, and it’s a credit to University of Utah Health Sciences Center that they saved her life. That part was good. They had to remove almost half of her skull so that her brain swelling could go down, but that part was good too. The skull was safely tucked away in a freezer, ready to be replaced as soon as she was recovered.
The nuns at St. Sebastians taught me not to leave things half-finished. You would think that having spent mega dollars and many weeks of care on Briana the hospital would not want to risk disaster by shoving her out the door, but otherwise decent and intelligent people did just that. They sent her home minus the skull. This is not best medical practice. As neurosurgeon Ronald Young said, ‘I don’t like people who are walking not to have their skull.’
I don’t like it either, it skeeves me out bigtime. When I was a nurse’s aid I took care of a man who did nothing but sit and stare. He was a war veteran who had a metal plate in his skull and the plate shifted. I took care of another man who had holes in his skull, it was gross.
Briana might have been one trip and fall away from being like that veteran. She had to wear a street hockey helmet all the time she was up, and when she woke up in the morning her brain would be shifted to one side. That can’t be good for you. I have no idea what they could have done if that freezer broke down and her skull defrosted. Bone is a living organ. Whatever they could have come up with to replace it would have been way more expensive and no substitute for her own body part.
Briana tried for months to get the hospital to do the surgery to replace her skull, but they told her it was hung up with Medicaid. Medicaid said it was up to the doctors. It takes a special kind of bureaucracy to get basically decent people to give someone like this the runaround, but Briana finally figured it out what she had to do.
She went to the local TV station with her story, and it was swiftly discovered that there was insurance coverage for her. Now her skull is back in her head.
Briana made a BAD CHOICE to drive drunk, and she has scars, debts and probably knows when it’s going to rain. Don’t ever do that again, Briana.
We are making a BAD CHOICE by refusing to reform a system that performs a high-tech rescue, and then dumps the patient. If she had suffered disabling brain damage we would be paying for her care in a nursing home for fifty years. We’re good at emergency care, and we usually take care of the totally disabled, but we don’t invest in preventing disability. I think I’ll go see ‘Sicko’ when it comes to a theater in Rhode Island even though I already know the plot. It will give me a stomach ache. I already have a headache. Thank God I’ve got insurance.
Kmareka.com 
Even if Briana had insurance, they may have decided not to pay based on not having knowledge of her undisclosed pre-existing condition — alcoholism, as evidenced by her binge drinking that got her into the accident. Thanks for filling us in on this horrifying example of how the “who pays” issue can make a tragic mockery of our healthcare system.
Amazing! Depressing! Where does the line between malpractice (not replacing a skull) and business legality(letting someone walk around with an open brain)intersect with morality? We can do marvelous things, medically, for some people. We can invent drugs that keep folks with fatal diseases alive almost through a normal life span. We can perform surgeries unimaginable a decade ago. Yet, we cannot provide adequate health care for many if not most Americans at a reasonable cost.
Where is common sense and morality in all this?
When morality and profit are at odds, guess which one usually wins? (Hint: it’s not morality.)
Someone I know, in the final stages of sarcoma (lung) followed by a brain bleed is 26 months into survival and $1.1 million in medical costs. Chemotherapy at $6000 a treatment and $20 scans and an anti-nausea pill for $50 per pill. Yet, the irony is that 10 years ago, her survival would have been 5% for 1 year and 1% for 2. What is a life worth?
It’s a tough question. We are already triaging health care, using ability to pay as the standard. If we have a more fair and rational system, we will need to put the money first into primary and preventive care. We may have less to offer people who need extraordinary treatments. But don’t forget that health care dollars don’t fall down a black hole, they provide employment and get people well and back to work. Elder care allows adult children to continue to work and care for their own children, so there are benefits to universal coverage that everyone enjoys, even if they don’t get sick.