Ben Boyer's outraged tweet about the IV bag shortage went viral and sparked an investigation.
The day after Christmas, my wife and I were hoping for a mellow visit to her twice-monthly cancer treatment, chemotherapy infusion, at Moores Cancer Center at UC San Diego in La Jolla, California. It’s always a long day: She gets her port accessed in the morning, then gets her blood drawn for labs, then we wait a while for the results of the labs, then we wait for the doctor to okay the procedure. We wait for the pharmacy to mix up the drugs, then the infusion itself gets underway using an IV bag—we’re usually there a good 6 or 7 hours total.
My wife has been undergoing chemo for nearly two years. For me, cancer was one of those things that really only existed as an abstract until it struck my family. Something that happened to grandparents when I was too young to understand, scenes in movies that made me cry, office fundraiser marathons I donated to.
But when my wife was diagnosed with brain cancer, it became the most real thing in the world, quickly evolving from a broad concept to a series of tiny details: carefully calculated drug dosages; a grid of endless appointments; a million tiny tubes connected to a million tiny bags.
At Moores, we know most of the nurses and have the routine down pretty pat, but there are always surprises. Last time, my wife had her infusion next to a guy who had been brought in from prison; he had two armed guards beside him the whole time but seemed to be cherishing his field trip despite the circumstances.
This particular day, we were happy to find that it was empty enough in the center that she could have a bed instead of the usual La-Z-Boy. The rooms with beds are darker, and you don’t have to worry about a neighbor’s blaring TV—the staff does an amazing job of making things as comfortable and laid-back as possible.
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Right out of the gate, though, our usual routine was disrupted. Our nurse was prepping my wife’s pre-meds—a mix of steroids and medicine to prevent nausea—in a syringe instead of hanging an IV. “You’ll have to tell me if you feel any burning or stomach pain,” he told my wife as he prepared to inject her. “I can slow it down if anything hurts.” He tapped a few times on his Apple watch and prepared a timer.
“Wait—what’s going on?” I asked, noting the change. He answered, “I have to push this manually. Huge IV bag shortage."
“Because of the Christmas holiday?” I assumed. “No, dude,” he replied. “The hurricane in Puerto Rico. Like all of the IV bags in the country are made in Puerto Rico, and nobody has any left. The factories are still a mess.”
My first reaction—a wash of guilt and shame (I hadn’t thought that much about Puerto Rico in the last few weeks, though I could’ve guessed the island was still hurting badly)—quickly gave way to disbelief (why would IV bags only be made in Puerto Rico?) and then anger (you mean to tell me the disgraceful lack of meaningful, forceful disaster relief in Puerto Rico has led to this?).
The nurse did an amazing job, as always, though I felt bad for the guy—he had to stand by my wife's bedside and slowly do a machine’s job because he didn’t have the right equipment, while his other patients waited for him.
The next day, I told my parents the story. Not only were both of my parents nurses for years, but we all lived in Puerto Rico in the late 1970s, on the Roosevelt Roads Naval Station. My mom knew a few broad strokes of back story, about how a large amount of medical equipment was manufactured in Puerto Rico and had been so since the 1950s by a company called Baxter. The day after that, still fascinated by the experience, I about it, thinking a few friends might find it interesting. A few hours later, the tweet blew up.
For the next several days, hundreds of nurses, ER techs, EMTs, lab technicians, and patients from all over the country tweeted to say that they were experiencing the same thing in their respective corners of the healthcare world. People from Puerto Rico tweeted with righteous anger over the fact that it took something that affects the mainland to generate sympathy for their situation.
The tweet generated enough interest to get to verify my story, which they did via an FDA statement that confirmed it: Hurricane Maria’s destruction had directly caused a major shortage of medical products across the United States.
I should also say that I suspect my tweet also went big because it contained a profane jab at the President. But ultimately, this experience served as a more general reminder that cancer is another great equalizer. The wealthy might be able to treat themselves in infusion centers with ocean views and on-site ketogenic chefs, but everybody everywhere is getting the same drugs pumped through the same plastic tubes connected to the same plastic bags.
When it comes to the treatment itself, there’s nothing political about it. Cancer can hit anybody, at any time, and we should be prepared and willing as a country to help the people who pull that cosmic short straw. Just like we as a country should do everything in our power to help our fellow countrymen when a similarly random natural disaster strikes.
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There is some cause for hope in the near term: Last week, the FDA announced that the supply shortage is improving, noting that Baxter's facilities in particular were back on the commercial power grid. Meanwhile, my wife and I will be back at Moores in a few days, and I'll be happy to believe the optimism when I see it.