Monday, May 19, 2008

The Best Health Care System in the World

A few minutes before 11 a.m., I arrived at the reception window at my doctor's office.

"Hi, just checking in for 11 o'clock with Doctor Bladiblah."

"Your name?" asked the smiling attendant. I gave it to her. "Hmm, something's not right here. When did you make the appointment?"

"Nearly a month ago. I was told he couldn't see me until now."

"Did you get a call last week confirming this?"

"I don't think so."

"Well I'm sorry, but you're not in the system at all and there's no way we can fit you in. Dr. Bladiblah is already two patients behind. The best I can do is get you 11:30 with our visiting doctor, Dr. Soandso."

"I'll take what I can get. But I'd wanted Dr. Bladiblah to take a second look at this skin blemish he deemed benign a couple of years ago when it was less than half the size it is now."

"I see, well, we can get you in with Dr. Soandso at 11:30. Will that be all right?"

When I agreed, she gave me a form to fill out. That was quick and easy, because under insurance I could simply write "none." When they didn't immediately grab me by the shirt collar and seat of my pants and heave me out, I figured I'd passed the first hurdle. I leaned back in the waiting-room chair to nap.

Well before 11:30, someone fetched me in to have vital signs taken, and showed me to an examining room. Dr. Soandso appeared shortly. I exhibited my deformities. He examined the skin blemish with a strong light and magnification and said it looked like it was probably harmless, but had some color variation, so it would be best to have a dermatologist look at it. Who the hell gets a beige melanoma? But I don't even have normal abnormalities.

Next we got to the scarier stuff. I've had this little squishy lump on the side of my neck for years, but when my wife noticed it from a distance and asked me what it was I suddenly realized I'd been taking it for granted. You mean everyone doesn't have one? Oh, shit!! This is right out of every cheesy melodrama or horrible bit of gossip you ever heard. "He had no idea. He felt fine."

Once I decided something wasn't right and found out I had to wait a month to see my physician, all I could feel was that part of my neck. It felt like a goiter, or a second head pushing out obscenely. Everyone must see it and wonder how I could put up with such an obvious deadly tumefaction bulging from my flesh. After a few trepidatious prods around its vicinity, I grew afraid of my own neck and avoided touching that side of it as much as possible.

Dr. Soandso came to grips with it unhesitatingly. He squished it from top and sides.

"Any pain?" he asked. "Does it hurt you?" His fingers nearly met in the flesh of my neck, but I didn't think that was the pain he meant. I didn't bother to explain the pain that went with my fixation. When a classmate of mine lost her leg to bone cancer when I was in high school, my own leg ached unrelentingly for a year. I am just supremely freaked out by the random hideousness of cancerous growth. Except for a very few lifestyle-related factors to certain specific cancers, you really don't seem to be able to do much of anything to deflect that particular bony finger of death. Death is something we all have to face, but what's the hurry? Pain? Factoring out neurosis and your pincerlike grasp, no.

He seemed fairly confident it is a lipoma, a little blob of fat, rather than a malignancy. But he did say I should show it to the dermatologist when I'm there.

"They might feel it's worthy of a small-needle biopsy," he said.

Well. As long as it's only a small needle, heck, let's all have one.

Duly discharged into the hands of the front office staff again, I sat with a very friendly and helpful woman while she tried to get me in with a dermatologist. Remember that we're supposed to hate socialized medicine in part because, "it takes forever to get to see a specialist, unlike in our free-market system for profit."

Okay. It's May 19. The first dermatologist we tried didn't have an opening until August 4. We scored at the second one, though. June 30. No sweat. I just have to drive about 40 miles each way, but that's what you get for living in the country.

The bill was modest. The estimate for the dermatologist is less so, but still within budget. The crappy policy I used to have would have covered none of this, and the premiums would have gobbled up the money I would have wanted to pay my own bills, so I continue to cling to my ledge and defy the elements.

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