Getting to graduation



Charity Care

Family away from home

Getting beyond the red tape

Getting to graduation

Small costs in large numbers

No one else to ask

John Howell’s friends whooped and whistled when the principal handed Howell his high school diploma.

They knew their buddy had been through hell, but they had little idea just how much he was still suffering. Every six minutes, Howell pressed the pain medication pump hidden by his graduation robe.

Just a year ago, Howell had been the picture of health, except for a few digestive problems he had blamed on his typical teenager’s diet. When rectal cancer was discovered—an uncommon cancer and rare in youngsters—it was already well advanced, necessitating a colostomy.

Emory surgical oncologist David Kooby says that whatever came Howell’s way—weeks of chemotherapy and radiation, the unexpected death of his father, more surgery for a small bowel obstruction, the continuing spread of the disease—the boy took it with a strength far beyond his years. In recent months, when the cancer had metastasized widely, what Howell wanted most was to graduate with his friends. That would require as much negotiation—and generosity—as medical know-how.

Medicaid had terminated the Howell family’s coverage because, according to its records, Mrs. Howell was behind on her Medicaid HMO premiums, although she had receipts showing that the premiums had been paid. While social worker Mackenzie Moore worked to see if she could straighten the matter out, Kooby continued with the boy’s care. Howell’s most recent hospitalization already had cost almost $100,000.

But reimbursement was not what Kooby was focused on. Instead, he, Moore, and Howell’s high school assistant principal focused on making the young man’s wish come true. The expensive pain medicines were the easiest to secure, since Emory’s new inpatient pharmacy could provide them without cost to Howell. Emory’s long-time vendors also stepped up to the plate: a special wheelchair from High Tech Healthcare, a portable pain pump from Coram Specialty Infusion Services. The new graduate came back to the hospital that night, exhausted but smiling, to the congratulations of his health care team.


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