What the botched execution of Christa Pike reveals about Southern Healthcare

Some of you aren’t going to like this column. If you are the type of person who equates criticism of our health care system with being un-American, you should probably go catch up on the drama in your neighborhood Facebook group. If you’ve never sat in a hospital and advocated for a loved one because their care was being bungled, you need to sit this one out. I have had to do this, and I have the receipts.

If you’re still here, let’s talk about Southern healthcare. Right now, there is a woman in Tennessee was supposed to die during an execution. An execution, that was overseen by a Southern doctor. She was then taken to a Southern hospital where she was declared brain dead by Southern doctors. Before they could pull the plug, she started talking.

Now, I’m not a doctor, but I was not aware that people who were brain dead could speak. I’ve seen several politicians who might be brain dead speak, but never somebody who was in a hospital bed, about to be taken off life support. Since the brain dead don’t generally speak, the most logical conclusion is that she wasn’t actually brain dead and the doctors botched their diagnosis the same way her execution was botched.

You may think this is some freak accident or rare exception. However, as I said before, I have the receipts. I lost my mother, my baby, and my father-in-law to Southern healthcare. They aren’t the only ones, and it isn’t getting any better.

My mother was diagnosed with early-stage Alzheimer’s in late 2024. Every expectation was that she would have at least five years before the disease ran its awful course. She was dead less than six months later. Her doctor put her on a new Alzheimer’s drug that the manufacturer had recently lowered the recommended dosage on because it was causing brain swelling. The doctor was not aware of this change. She lost her ability to speak and ended up in the emergency room. The doctors there were baffled by this.

It wasn’t the doctors or the nurses who figured out what had happened or linked it to the drug she was on. It was my wife and I doing some Internet sleuthing and talking to my father about what had been happening over the last two weeks to piece it together. That’s right. A grieving family had to do what medical professionals weren’t equipped to do.

If you’ve read this column for very long, you know that my wife and I lost our daughter, Eliza, the same year. She was stillborn. Here’s the rest of the story. My wife can no longer carry children. We scrimped and saved and went the route of surrogacy. Our baby was stillborn because of a massive infection early in the pregnancy and no one was able to detect it. By our count there were at least four points during the timeline where she could have been saved… or at least where we could have known it was happening. How many times have you heard of a baby dying in the womb from a massive infection? It is tragic — and it shouldn’t have happened.

And then there’s my father-in-law. He died during the pandemic but not because of COVID. He was being treated for cancer and had gone into remission, but he was apparently having regular heart-attacks and blood clotting issues that medical professionals just never picked up on. He was only 61 years old.

Three people. Same family. I’ll bet if you live in the South, you could probably find just as many people on your family tree who didn’t just die but were victimized by a failed health care system.

The numbers tell the same story my family lived. The South has nine of the ten states with the highest rates of preventable deaths in the country. Mississippi, Louisiana, Alabama, Arkansas, and West Virginia consistently rank at or near the bottom of nearly every major health outcome measure — life expectancy, maternal mortality, infant mortality, cancer survival rates, heart disease deaths.

The maternal mortality rate in the South is staggering: Black women in some Southern states die from pregnancy-related causes at three to four times the rate of white women, and the overall maternal death rate in states like Georgia and Louisiana rivals that of developing nations. Mississippi has the highest infant mortality rate in the country.

The American South also carries a disproportionate share of the nation’s diabetes burden, with rates in Mississippi and West Virginia running roughly twice the national average. Rural hospital closures have accelerated the crisis — more than 130 rural hospitals have closed across the country since 2010, and the South accounts for the overwhelming majority of them. In some rural counties, the nearest emergency room is now more than an hour away. When rural residents have no other option but to go to urban centers for health care, it puts strain on the health system in those urban areas, too.

So why is it this bad? It isn’t the doctors. Southern doctors are no less qualified than doctors elsewhere, but the system that surrounds them does not give them the tools they need to adequately care for patients.

The systemic reasons stack up the way the failures do. Medicaid expansion is a significant piece of the puzzle. The Affordable Care Act gave states the option to expand Medicaid coverage to low-income adults, and most Southern states refused to do it for years, leaving millions of working people with no coverage at all. When people have no insurance, they don’t see doctors for routine care. They show up in emergency rooms when something has already gone catastrophically wrong. Both of Georgia’s candidates for governor now favor some expansion of Medicaid.

Doctors and nurses leave rural areas because the pay is lower, the resources are thinner, and the hospitals are underfunded. Medical schools in the region graduate physicians who overwhelmingly choose to practice in urban centers. The states that most need robust public health infrastructure are often the same states that have spent decades politically hostile to funding it.

Poverty compounds everything — it is harder to manage a chronic illness when you are choosing between your medication and your electric bill. And then there is the South’s pull-yourself-up-by-the-bootsraps culture of not wanting to seem like a burden, of toughing it out, of distrusting a system that has historically given the poor every reason to be distrustful. The system failed those communities first and most often, and those communities internalized the lesson that the system was not for them. That distrust is not irrational. It is the entirely rational response to generations of evidence.

The health care system in the South isn’t going to get better by waiting and hoping “things” improve, or by fooling ourselves into thinking that this is just the way it is. It isn’t just the way it is. Other states and other countries have acceptable health outcomes. The South doesn’t. Many of the South’s health care issues could be fixed with a few policy and law changes.

The truth is, elected officials have no incentive to solve a problem unless their reelection is on the line, so it is up to voters to demand better. If you think healthcare needs to improve, write letters to your state legislators. You don’t even have to demand they do anything, but you should ask them what they are doing to improve health care. Improving health care should be the top issue in every election in the South until our family members stop dying because of inadequate care.

If you aren’t buying that health care here is really that bad, or if you just want to learn more about it, The Georgia Sun has been running an ongoing series for about two years now called Healthcare in Crisis, where we have documented health care issues in Georgia. It has now surpassed 50 articles. The sad truth is that health care in the South is in the emergency room, and the prognosis is grave.