Nonsense Verse

They lost my blood

In a few days I’m having minor surgery, and so last week I had a pre-surgery evaluation at the joint hospital. I could write about how that one appointment perfectly encapsulated all that is woefully inefficient about our lovely medical system -- could recount in great detail how over the course of an hour, three different people visited me in the same exam room full of pigs (Beanie Baby pigs, fuzzy pigs, pigs of plastic, even a soap-dish pig) to ask me the same set of questions, the answers to which they then recorded in three separate places  --  but that is all just shockingly commonplace, and so I won’t. What I would like to share is what happened on Monday, when I got a call from the joint hospital.

"Hello, ma’am. Did you come in for a pre-surgery appointment on oh, um, uh, eh--"

"Last week?"

"Yes, last week. You came in for an appointment, and did they, um -- did they take blood?"

"Uh, yeah."

"Well. Our lab can't find it."

"Can't find it? You mean they lost it?"

"Yes. So we're going to need to have you come in again before the surgery so we can take some more."

"I see. So, sometime this week, then? Can I drop by any day?"

"Yes."

"And you're open how late?"

"Oh, till about 5."

"And open at 9 a.m.?”

"Yes."

"O.K., then."

"But wait -- could you tell us what day you think you'll be coming, so we can have your file pulled?"

"Oh. O.K. I guess … tomorrow?"

"Fine. See you then."

First, do marvel at the "duh" factor. “Did they take blood?” Of course they took blood! Is it normal to get a pre-surgery work-up without the taking of the blood? Or is that something the medical staff doesn't bother itself with these days?

Second, there was the dazzling precision: I can drop by any day, sure, except that really, I can’t -- I have to let them know ahead of time so they can pull the file. Because it takes hours to track down those files, dontcha know. They can’t possibly be filed electronically -- or even alphabetically. They must be encoded in Sanskrit haiku and watched over by gnomes in the deep, dark basement who demand a 128-bit-encrypted password and your mother’s mother’s mother’s maiden name in return for access.

But third: How does this happen? I mean, we're not talking paperclips or pens. Blood, you might think, would be treated with a little more care, no? This wasn't even a mobile unit. It's not like the blood took a wrong turn on the interstate or was hijacked by marauding vampires. It's a vial. With a label. It goes into, what, a fridge? And one would hope it would be a fairly secure fridge, with clear labeling to the effect of DO NOT LOSE THIS BLOOD. And one would hope that on the journey from the fridge to the lab (and back), my vial and all the other vials would be kept in some likewise secure-type thingamabob, with more labeling along the lines of BLOOD: DO NOT LOSE! or LOSE BLOOD AND DIE!

I suppose the silver lining would be that this is all happening before the surgery, that they’re getting it out of their system. Except that the silver lining is a bit obscured by the fact that somewhere, out there, is a vial of blood with my name or code or Sanskrit haiku on it, and no one knows where that is. That's just slightly unnerving.

This copywriter needs to be shot

All I wanted to do this morning was buy my $1 coffee and $2 oatmeal with brown sugar and raisins and get along on my merry way. But the calm of the transaction was interrupted by this radio ad (the purpose of which was to publicize tourism in...I'm not sure -- Jersey, maybe?):

"Maybe that's why they call this the tri-state area. We'll TRY anything."

Puke.

My Howard Beale Moment

Warning: Rant Ahead

Every pay day, like so many other working Americans (well, the fortunate working Americans [and here, as you'll soon see, even "fortunate" is relative]), I have a hefty chunk of money taken out of my check for this thing called Health Insurance. Ostensibly, this means that when I need to go to a doctor -- a doctor approved by my Health Insurance, as confirmed by my Health Insurer's Web site -- I should be able to walk in, pay my small co-pay, and be examined and treated, and that should be the end of it. But it never works that way. Oh, no. Because that would require the Insurer to be beneficent instead of evil. And after receiving yet another erroneous notice of "payment due" in the mail today, I am convinced all over again of one thing: The Insurer is evil.

Why is the Insurer evil? you may ask. Well let me tell you.

The Insurer is evil because each time I go to the doctor's office, I do all the right things: I arrive on time, I present the right card, I fill out all the proper and redundant forms divulging an abundance of private information that I'm sure one day will be handed over to the evildoers to use against me. I wait as patiently as possible, I see the doctor, I pay my small fee, and I leave without causing a scene, even though sometimes I really, really want to cause a scene, as in those times I'm kept waiting 45 minutes for an appointment that lasts 5. The waiting time is not the Insurer's fault. (Right? Or maybe it is. I wouldn't be surprised. But because I have no evidence, I won't blame the Insurer for that one.) What is the Insurer's fault -- and this is where the evil part comes in -- is the fact that each time I go through these very proper motions, a few days later, without fail, I receive a notice in the mail: $130 for a doctor's visit, not covered; $180 for blood work, not covered.

Like hell they're not. Remember that thing about paying all that money into Health Insurance? I am definitely covered. But the Insurer, being evil, is extremely savvy. It is hoping that since $130, though a large amount, is not obscenely large, I may decide to forgo the hassle of visiting my benefits office and filling out a claim form and instead just scrape up the money, write a check and stick it in the mail.

I'll bet a lot of people do that. These invoices arrive on official-looking paper, filled with insurance-jargony language that can be difficult to decipher even for an extremely literate person. And when faced with such a formidable document, it can seem so much less stressful to just make the payment and get the insurer off one's back. Because that's another thing: These notices? They come relentlessly. Every week, you'll get a new notice, maybe multiple notices, telling you that this particular appointment was not covered (even though it was), even after you've visited your benefits office and filled out the claim and started the process of getting the paperwork all straightened out. It's harassment, this barrage of evil crap, stinking up the mailbox day in and day out.

It doesn't make sense, of course. If I pay good money into the health fund, it's a reasonable expectation that the money will be there and ready to work for me the very few times a year I actually need it. But no, it becomes this major headache every time, to the point where I don't want to go to the doctor at all. Growth on my foot? Mole on the neck looking a little funny? Pain in my ovary? Eyeball falling out of its socket? I'm going to wait five years to do anything about it because I want to stave off the post-appointment B.S. And that is where this system becomes not just annoying, but dangerous -- when reasonably sane people like me (don't laugh) do rather stupid things like avoiding the doctor, even in the face of potentially serious health problems, because they would rather not deal with the angst. And I say people like me because I know I'm not alone. A lot more people would make a point of going to that annual checkup if visiting the doctor were as simple as making an appointment to have their nails done. When our health is at stake, you would think someone would try to make it that simple. But that would make you logical, which our Health Insurance system certainly is not.

I cannot imagine what it must be like for the people who have far worse health problems than I do -- chronic problems, requiring multiple doctors' visits, and therefore multiple go-rounds with the evil Insurers.

I can only hope that when the day comes that I have joined the ranks of these people with chronic conditions, it will be many, many years from now, and maybe, just maybe (I know, probably when pigs fly, but whatever), the issue of Health Insurance will have become much simplified, much more egalitarian, much more humane. But until then, I am stuck receiving these infuriating notices, to the point where I want to stick my head out my window, a la Howard Beale in Network, and scream for the entire city to hear: "I'M MAD AS HELL! AND I'M NOT GOING TO TAKE IT ANYMORE!"

If you hear me shouting, go ahead and join me. You know you want to.

End Rant

I'd almost rather ignore my foot until it falls off

On the off chance that some professional big-city-doctor-type reads this blog, perhaps you can help clear something up for me: Why is it that without fail, each time I've gone to the doctor here, I've been kept sitting in the waiting area for about 45 minutes, for a check of some body part that, beginning to end, the doctor spends only 5 minutes performing?

Yesterday it was the foot doctor. I have this little thing on the top of my left foot -- a node, a nubbin, a wee growth. It started out a pinprick of a bump about four years ago, but in the past year or so has become noticeably larger. When I walk, it asserts pressure. After a long day of running around or a night of dancing, it goes into dull-throb mode. All along I've known I should have a doctor check it out, but I've been putting it off and putting it off because I despise going to the doctor.

I'm a reasonable person. I know the doctor is there to help, that I pay into health insurance to take advantage of the doctor's help, and so on. But the experience of visiting the doctor is always so angsty, not just because of the knowledge that in going, you might find out something is horribly wrong, but because the entire ordeal of hauling yourself in to be told to wait and wait and wait and wait and come here, quickly, and strip and sit back and extend and stand and walk in place and turn and ambiguous "hmmm" -- it's so demoralizing.

Yesterday, at least, the "strip" part was not required, since all I had to do was bare my feet and ankles. The doc (when he finally saw me) pressed down and told me what I already knew ("Well, it's definitely part of the bone"), then took part of my foot in each hand and flexed it back and forth to feel where things might be rubbing each other the wrong way. The nub's most likely cause: a loosed ligament, allowing the bones on either side of the joint to do a raunchier bump-and-grind than is recommended, resulting in the slow buildup of a bony ridge. Imagine two tectonic plates colliding -- a minor (but persistent) Himalaying of the metatarsals.

The solution (which I also already knew): get an X-ray (to rule out a bone tumor, something this is highly unlikely to be since the bump took so long to grow) and return to be fitted for orthotics -- those things I wore way back in the ballet-dancing days to tame my pronating ankles. Now I must tame my bulging bones, to the tune of several hundred dollars.

But back to the whole From Here to Waiting-Room Eternity situation...

Let's assume I'm an average patient. And let's even round it up a bit and assume the checkup of the average patient takes 15 minutes instead of 5. Even then, doctors, if you're scheduling patients in half-hour increments, that's quite a nice cushion to do whatever it is you do to fill the time in between -- paperwork, eating an apple, playing a round of Tetris, snogging your secretary.

I would also like to suggest, doctors, that if you do keep a patient waiting for that long -- a patient who does, even if you don't seem to realize it, have better things to be doing than flipping through outdated magazines in your waiting room for 45 minutes -- perhaps consider extending some sort of courtesy to make up for it. Offer the afflicted a high-end chocolate truffle, say. Or a gift certificate for a 15-minute back rub. Or waive the co-pay. You did after all suck up your patient's time, time that patient could have spent earning the price of the co-pay and then some. Or time the patient could have spent dispatching of the co-pay on something more pleasurable, like a half-dozen oysters or a nice glass of wine.

Or hell, assuming the patient hasn't come in for blood work or some sort of gastroenterological thing, have some wine and oysters set up in the lounge. Even if the wait is annoying, at least the noshing will help take the edge off.