Jacqueline Kasemsri, Wake Forest University School of Law JD ’22
“Please, God. Please, forgive me for my sins.”
Mary kneeled on the cold tile of her bathroom floor with her elbows propped on the toilet lid. Her knuckles turned white from squeezing her hands tightly. She could taste salty tears running down her cheeks. She was praying harder than she ever had. The toilet was the altar and the little white stick sitting on the toilet lid was the cross. Her mind began to wander, and she thought about how angry her mother was going to be. Her mother was going to kill her. Then she would have to call Jackson. She would have to call Jackson and tell him that she had ruined both of their lives. The last time she had spoken to Jackson was when she had FaceTimed him to see his new dorm room.
Continue reading “Mary’s Battle “
Hannah Norem, Wake Forest University, J.D./M.Div Dual Degree Candidate ’23
Preface: Chaplaincy and End-of-Life Decision-Making
As a hospital chaplain, you have the privilege of experiencing the best and worst parts of patients’ lives. You bear witness to the beginnings of life that take place in a hospital, like births and successful organ transplants. However, you also are in the room when people are experiencing the worst days of their lives. Unspeakable tragedies and accidents, patients coding, and other traumatic events dot a chaplain’s shifts. Hearing a pager go off in the middle of the night and having to rush down to the emergency department to comfort strangers is not uncommon. While this is a normal day in the life of a chaplain, it is not a normal day for the patients and families the chaplain encounters. The difficulty and the ritual found in a chaplain’s everyday life and work do not detract from the sadness of any particular patient encounter but rather attune you to the rhythms of beginning and ending that are integral to the human experience.
From my first days as a chaplain, I heard the same sorts of things again and again. Entering the patient rooms in the ICU, I often found an unresponsive patient teetering in the liminal space between life and death. However, the family that gathered around the bedside, as this was before COVID, painted a robust picture of who this patient was before they found themselves laying in a hospital room, hooked up to countless machines and monitors. So many times, the families that I spoke with said they would have never wanted to be this way. Speaking to families of veteran farmers, resilient teachers, and other pillars of their community, the spouses, siblings, and others portrayed how self-reliantly this person lived but how dependent the patient now was on machines and other people for every facet of their continued existence. How could someone who never needed anything in their life from others now be so helpless? Grieving families looked me in the eyes with their tear-soaked faces time and time again as they explored this painful juxtaposition taking place in front of them.
Continue reading “Living (and Dying) on Your Terms: End-of-Life Decision-Making Before and During COVID-19”
Charlotte Robinson, Wake Forest University School of Law JD ’22
The room feels darker than most. It is cold and uninviting. For someone who works in a hospital, you’d think I would be used to this environment. I should have adapted to it. After all, no one has ever described a hospital as sunny and welcoming. I look around the waiting room of the psychology wing, taking in all the textbooks and self-help books, stewing. As I wait, I can hear every beat of my heart. My ears feel muffled, like when you swim underwater. I finally understand how patients must feel waiting for their doctor to show. Why make an appointment if you can’t commit to the time you offered? The door to her office creaks open, and I hear the small click-click of the doctor’s heels as she walks out to grab me. We walk the three feet back into her office. It’s even darker than the waiting room. Dr. Markin sits down at her desk and opens a folder. It’s thick. I know it’s my patient master file – a simple manilla folder than contains all my patients and their stories. For such a simple folder, it’s mere presence makes me nauseous.
Continue reading “Playing God: Making the Impossible Choices”
Christian Schweitzer, Wake Forest University School of Law J.D. Candidate ’23
Tyger Tyger, burning bright,
In the forests of the night; What immortal hand or eye,
Could frame thy fearful symmetry?
“Alright, time’s up. Put your name on your exam and bring it to the front of the room please. Remember to read pages 288-304 for class on Monday. Have a great weekend everyone.”
Hansen walked out of the classroom to join the sea of students cascading toward the school’s main exit. He brushed past obstacles, human and inanimate alike, with the grace of someone used to being among large crowds but never belonging to the group.
Upon reaching the end of the hall, he took an abrupt right turn away from the exits and ventured into the silent corridor which contained the school’s computer lab. As he stepped into the lab in the direction of his usual seat, he gave a slight smile and a nod to the lab’s sole occupant, Mr. Jenkins. Mr. Jenkins was the high school’s computer science teacher. A kind, heavy-set man with a thin voice, Mr. Jenkins had become well acquainted with Hansen during the boy’s two-and-a-half years at the school. Hansen’s previous weekly visits to the lab informed Mr. Jenkins that Hansen would spend this Friday afternoon hard at work in front of the computer until their silent camaraderie was brought to a close by Jenkins’s familiar pronouncement,
“C’mon kid, I think we both better get home.”
Continue reading “The Tiger and the Lamb”
Madison Boyer, Wake Forest University School of Law J.D. Candidate ’23
Department of Health and Human Services – Project Proposal & Request for Funding
Working Name: Project Talos
I. Proposal Summary
The Project Talos team has collaborated for six years to develop an artificially intelligent physician, or “AIP”. The AIP has the capacity to diagnose and treat all medical conditions complained of by adults. The AIP is a cost-conscious and effective way to ensure access to healthcare for all Americans, who otherwise may be unable to afford the services of a physician. Project Talos is requesting $15,000,000 to complete the necessary coding work, to install Project Talos “Dr. Touring”® AIP stations in pharmacies and primary care offices, and to offset the initial costs of providing healthcare.
II. Project Description
Project Talos will revolutionize the American healthcare system. Currently, approximately one in four Americans (22%) are not receiving necessary medical care due to cost. Over thirty-one million Americans under the age of 65 do not have health insurance. Project Talos will allow those Americans to access excellent medical care at little to no out-of-pocket cost, whether or not they are insured.
III. Goals and Objectives
The Project Talos AIP was built with three goals: (1) to promote health on an individual level (“individual health goal”); (2) to promote the overall health of the American population (“public health goal”); and (3) to promote health across generations (“future health goal”). All three goals are constantly monitored by the AIP. If the AIP detects health issues arising, it is independently capable of correcting for error. The AIP was trained on high-quality medical data that was graciously donated by Harvard Medical School. The data was stripped of all identifying information so that the AIP cannot reflect any possible bias concerning age, race, sex, or gender identification. The primary objective of Project Talos is to provide the highest possible quality of healthcare to all Americans at affordable prices. This will encourage patients to seek preventative healthcare services before their condition leads to a medical emergency. The AIP will help millions achieve better health outcomes and lead longer, happier lives.
With the support of the Department of Health and Human Services, and with the eventual approval of the FDA, Project Talos is hopeful that millions of lives will be improved at an extremely reasonable cost to the United States taxpayer.
Continue reading “Strange Friend”
By Austin Coates, WFU JD Candidate ’22
About mid-day on a Tuesday, Mera sat on a bench, weary and tired, yet relieved. She’d been up late the night before, studying for her computer science final exam into the morning hours. A senior in college now, it was the last final exam she would take as a student. As she sat on the bench, she couldn’t help but be proud of herself. The first in her family to go to college, she’d worked tirelessly to get to this point. She held a 3.89 GPA, would graduate at the top of her class, and had a job lined up with a leading ancestry analysis company, Family Tree, as a biometrics analyst. She knew very little about her own family history and was fascinated by the opportunity to work at Family Tree while learning more about her ancestors. She would start the following Monday; her dreams realized and the world ahead of her. But for now, at least, it was time to celebrate.
Continue reading “Mirrored”
by Darrien Jones, WFU JD Candidate ’22
I. BLACK BOY
Black Boy has grown up in Over The Rhine, a small stretch of a booming city, Cincinnati. Over the Rhine, or as people call it now, “OTR,” is the “place to be”, the crowd is the youngest it has ever been, the restaurants that now line the streets are all between four and five stars, and the bars that accompany them are known for their local cocktail mixes. The crime has fallen to a minimal level, down from its top 25 ranking in “America’s Most Dangerous Cities,” and you can park without worry as you go to the Reds or Bengals game. Yet, as you come back to your car, you know to go towards Mason or Liberty Township, two of the biggest suburbs where most of OTR’s weekend visitors come from. You would not dare go past “The Wall.” Now, The Wall is not to be confused with a physical wall or any type of fencing. The Wall is where the city’s gentrification has stopped, maybe for only a month or a year as they continue to push Black people out of the area, but for now it has stopped. The construction certainly hasn’t, but the evictions, for some time, have taken respite. The difference between “good OTR” and “bad OTR” is so stark. One minute you are driving past The Eagle and Taste of Belgium, two “staple” expensive restaurants in the city, and drunk white college students and young professionals on paddle pubs. The next minute, you are in a territory of homelessness, dilapidated and vacant buildings, graffiti everywhere, and trash unattended. It is a different city beyond The Wall, and this is where Black Boy lives.
Continue reading “Three Black Stories”
by Kristen Kovach, WFU JD Candidate ’21
Michael opened his email on a dreary Tuesday morning. Casually scrolling through the spam messages between sips of coffee, his eyes paused on one message sent to him in the early hours of the morning. “I think your brother is dead,” the subject line read.
Michael froze. His heart pounded in his chest. Sweat beaded on his forehead and dampened his palms. His brother, Todd, had been in prison for drug possession since 2018. The brothers had not spoken in a while. But that’s because it’s just hard to get in contact with prisoners, Michael thought. There’s no way he’s dead.
The email came from his brother’s cellmate, Greg, who said that Michael’s brother had been sick for a while. Todd had been coughing terribly, complaining that his chest hurt, and suffering from a bad fever. Todd thought he had COVID. Two weeks ago, the medics came for Todd. Yesterday, the guards came for Todd’s belongings. Todd never came back.
Continue reading “COVID-19 Has Laid Bare Our Inhumane Treatment of Incarcerated People and Their Families”
by James Hughes, WFU JD Candidate ’22
Due to the infectious nature of COVID-19, our health care system has been forced to evolve in order to appropriately serve patients during this deadly pandemic. Before the public health emergency, roughly 13,000 Medicare beneficiaries received fee-for-service telehealth services per week, while almost 1.7 million Medicare beneficiaries utilized telehealth services in the last week of April, according to Centers for Medicare & Medicaid Services (“CMS”) data. Further, telehealth coverage should be a permanent fixture in our health care system, and the federal government should support telehealth coverage beyond the COVID-19 public health emergency.
Before the public health emergency, the U.S. Department of Health and Human Services (“HHS”) did not provide Medicare reimbursements for audio-visual telehealth visits unless the patient lived in a qualified rural area or was within the confines of certain medical facilities. Reimbursement has historically been the primary obstacle to telehealth services. The Telehealth Services During Certain Emergency Periods Act of 2020 allowed for HHS to modify or waive rules for telehealth under Medicare during the public health emergency, and recently, the American Medical Association asked President Trump, HHS, and Congress to extend some of the telehealth policies used during COVID-19 beyond this public health emergency.
Continue reading “Let’s Continue to Reap the Benefits of Telehealth After the COVID-19 Public Health Emergency”
by Remy Servis, WFU JD/MA in Bioethics Candidate ’22
Amidst the 2020 COVID-19 pandemic in the United States, incarcerated people have been one of the most at-risk subgroups, contracting the virus at a rate five times higher than the national average. Due to overcrowded conditions in prisons and jails, this population has limited opportunity to effectively socially distance, and infection rates are exacerbated by squalid conditions, limited testing, and violence within correctional facilities. Incarcerated persons represent a more vulnerable sector of the population, reflecting the disparities in social determinants of health that affect groups more likely to be incarcerated: racial minorities, those with unstable housing, and those with mental illness. In particular, prisoners over the age of fifty-five experience a uniquely threatening sum of risk due to the uncontroverted finding that COVID-19 has been particularly deadly to older adults, with 80% of deaths in US occurring in patients aged sixty-five and older.
Early in the pandemic, advocates across the country began to call for the early release of incarcerated people who pose a low risk to society, including the elderly and nonviolent. Scholars highlighted how this type of release would assist with “flattening the curve” by removing volume from correctional institutions which are “notorious incubators and amplifiers of infectious diseases.” Regarding the provision of early release, North Carolina has two laws on the books: “Medical Release of Inmates”, passed in 2008 and codified at N.C. Gen. Stat. § 15A-1369, and N.C. Gen. Stat. § 148-4, which provides for state discretion in granting “Extended Limits of Confinement” (ELC). Both of these statutory options have their strengths and weaknesses, but the state has chosen to utilize its more amorphous powers under ELC to mitigate the release of select inmates. However, due to disappointingly narrow release criteria, only about 300 inmates (out of 34,000 total in state facilities) have been granted this ELC privilege. Meanwhile, 3,000 inmates, or close to 10% of the prison population, have tested positive. The ELC law, as it is currently formulated, is a lackluster response from the state of North Carolina to the threat of coronavirus in the state prison population. These ELC policies and eligibility criteria should be appropriately modified given the deadly context of this pandemic and any future virulent public health emergencies.
Continue reading “North Carolina’s Extended Limits of Confinement: Woefully Underutilized in the Face of COVID-19”