Kudos and gratitude where they ought to go, and that is to my long time friend Andrew. During a celebratory birthday dinner for another long time friend the other evening, he suggested that, if I had time, he thought of another podcast I could do. The one I do now is about being an Ordinary Catholic in these, quite possibly it feels like, last days. But this one would be purely secular and fun by commentary and humor filled (hopefully) observation on the things that drive me crazy, likely some of the things that drive you crazy too. Things to which in the course of any day, if I were feeling bold and if I thought anybody would listen to me in the first instance, I would shout "I Object!" He even gave me a possible title for the podcast and boy would it be easy to get guests, the first two being the aforementioned two friends.
In that today I experienced an interaction that would make a perfect several episodes related to the medical care system.
As I am sure I wrote around 2019, when it happened, I had a stent placed in one of the arteries of my heart, which was, I was later told, though I sure did not realize it, 99 percent blocked. I am effusive and shall always be effusive about the diagnostic skill of my internist, whose speciality is cardiology.
I like him, but I hardly see him, and each year it gets less and less, and with longer and longer lead times. It used to be that I would see him for an appointment, albeit briefly, before the tests, after a nurse did the obligatory blood pressure, inquired about your medications and vitamins, duly, but never entirely entered correctly into the computer, and about any concerns. He would then come in, energetic as always, so friendly and charming that I could never burden him with my dislike of how medical offices are run, and do another obligatory blood pressure, inquire about my medications and vitamins, still never entirely entered correctly into the computer, and about any concerns. Then he'd be gone and say he'd see me after all the tests for a summary of findings, which usually I have already seen on the site for patients where all your history and results reside. He'd ask me if I had up to date prescriptions, interpret what was on the personal medical bulletin board, which I have gotten pretty good at doing myself, and tell me to make an appointment for the next year for the same tests.
Now, I don't know what happened in 2021, maybe the scheduler wasn't at her desk, so the appointments were not made. We were still in Covid mode. I admit, I would have been happy to let 2022's visitation lapse, as medical offices continue to require masks and I have heard that this is a forever thing, which for me, is a reason not to go. It increases my anxiety along with making it, as I said what, three years ago, nearly, impossible to breathe. There is nothing like having potentially life altering tests, often in small spaces, and having to wear a mask besides. Plus, as you know I have never believed that the masking prevented or prevents the virus or any virus from doing its dirty work, while masking creates all sorts of other medical issues that, I am certain, we will her about, from the late night ads on your streaming service, in a few years. That's not including the psychological issues. I know, my opinion, though perhaps not in the minority, is verboten or mocked, among the current intelligentsias in power.
I was hoping October, and November would pass without the summons, or as was most likely, a refusal to renew my medications unless I got on the medical people mover once again. Yes, I know, doctors are required to check on the patients to whom they give prescriptions. And this time, I wouldn't have previously set appointments. Now, in the past, I was able to get two or three of the tests of the four on the same day. But that ship has sailed. Today I was told that the insurance companies don't like it when that is requested. But I seem to recall and I could be wrong, in which case I will happily delete this observation, that if a patient pays this $500.00 concierge like fee every year, things like appointments and paperwork somehow can be done more . . . .efficiently and conveniently for the patient. But this year, when I called I was told that the doctor was fully booked (now this is like October or November) until February, this month, this year. So, the doctor is booked and I am required to come in. Ok.
Ah, the solution. I would see the physician assistant. That person could renew my prescriptions. Now while I respect those who become professionals like paralegals and physician assistants, and I also admire the techs who do all the tests but can't share anything when they perform them on you, I do not like an assembly line system for this particular process. It creates, well, deep suspicion about whether the good of the patient is truly the goal or just milking the insurance. It's everywhere. When you get to a certain age and you have Facebook, suddenly all these click bait ads come up telling you you should get tested for, Psoriatic Arthritis, Colon cancer, melanoma, breast cancer, dementia, ovarian cancer, tardive dyskinesia, sleep apnea, osteoporosis, and the list goes on and on. If I were to check on all of these things in simple sequence, my days would be filled with doctor, um, physician assistant, technician appointments, which is what was only beginning when my father was being treated for his bladder cancer over 15 years ago. Up to here he had survived heart issues including a quadruple bypass. He had survived well under the less technological conditions circa 1989. Then, suddenly in the shiny modern millenium tests showed he had kidney issues, and he was on another conveyor belt, stents for issues he didn't think and I didn't think he had, and then finally death by sepsis. Despite what his death certificate said, the primary cause of death was not any of the things for which he was constantly going to the doctor. It was a preventable sepsis. I have a whole entry on that back in one of the earlier iterations of this blog back in 2008.
I want to be reasonable about my health but I do not want to be tested for every possible thing a person of my age could have. That's not life. That's insanity. And maybe that's why this last interlude is bothering me, because I see the writing on the wall. And the part of me that doubts worries "what if I don't get on the people mover and something happens and I get sick". They would say and I would probably agree with "them" whoever they are, that I only had myself to blame. But then, will all of this stop me from dying? It's as if the preventative seeks to find something (early, they say), but the end result? The statistical life expectancy is going down. Shouldn't all this prevention make it go up, like, a lot?
So, in November, I think, I saw the physician assistant. Very nice. Took that blood pressure, asked me the questions, had me provide the proverbial urine sample, took my blood for cholesterol and other potential dangers. I did get one of those emails on the link and it was from my doctor himself, that my cholesterol was great, and that included a terrifically low bad cholesterol. And up to today, I have had three of the four other tests. I had one this very day. I have to go back on Wednesday for the final one, which could easily have been done today--but for that nasty insurance issue, where they decide what I need and when I need it. I guess a test is only considered necessary and to be paid by the gods of insurance if it is done on separate days, not on the same or consecutive days.
My appointment with the doctor was made back before Christmas for next week. But in the meantime, thing have happened that made it so that I could not go that day. Two things intervened. I held my breath after I had my third test today (and I assume the prior two tests did not show any problem as I never got a note on my e mail bulletin board), and went back up to the front desk. There are hierarchies in these offices. Only X can do one specific thing and you must go to Y for this other. I was sent to Y. Y was a lovely lady, but I could tell, it was a bad bad thing that I had to cancel one of the five appointments made in October or November 2022. This appointment is with the actual doctor, the one where he takes my blood pressure and asks me all the questions I have already been asked and tells me to come back next year. It's considered I was told "my annual" exam, although no examination to my observation is actually ever done. The tests, the blood work, the urine samples, those were done. Or will be as of this week. I have had a several month annual examination. I sort of noted that without the detail. Suspicions about the system, because it is the same mostly everywhere, rose again. She looks and looks and says that there is nothing with the doctor until. . . . November 2023. That would be a year after I began my "annual" exam. I did not get angry, which is lately a default condition in dealing with pretty much anything in the world. I did not yell, "I Object" because it would only make me look like a crazy old lady. He told me last time we actually saw one another that he hasn't been taking on new patients. So why so long? I didn't ask. Could we do a video thing? After all, it was just to review the findings (and I could do without the blood pressure being taken yet again no?) He doesn't do those. So I decided to go super submissive, and say well, I understand, just a scheduling thing--though I clearly was considered the culprit, the cause of trouble, the intractable patient who just couldn't stay on the permissible track. And I really don't care if I actually see him at this juncture, except to say hi and how are you doing? As I said, he's a nice guy. A talented guy. That's when I did suggest that all these appointments be in the same general time period, and was told that it was that insurance thing. Then the name of Z came up. I am not crazy about Z, and I suspect Z is not crazy about me because I have been ruffled in some of our interactions on ye e-mail bulletin board link thing I have to log into any time I want to "talk" to any of the guards at the gate. I have expressed some. . . .objections. . .to her, which she has roundly ignored. She reminds me of when I was working as an attorney and if you wanted any kind of break, you had to be friendly, downright submissive indeed, to the non-lawyer clerk of the court. Whether they let you file something during lunch, or whatever was the crisis you were having for your client, it was that clerk who decided. It was much like Hollywood had to do when dealing with Hedda Hopper or Louella Parsons. Grovel. Y said "I'll have to talk to Z". Great. And since I wasn't looking to actually see my doctor any longer I didn't actually have to grovel at that moment. Not merely great. But wonderful. Still, I left wondering how it is I am, or am I, going to stay off the people mover that will send me over the medical cliff? The odds are not looking good. I have accompanied quite a few people ahead of me on the belt and it always looks the same. Yeah, yeah, I really do OBJECT! As a Catholic (if you listen to my podcast) I surely can wax philosophical and vaguely theological on the reality of suffering, and challenges, and indifference as we go through life, and the purpose in the road to salvation, and I mean it when I seek to endure, persist, always, well learning to be always, in prayer, but I think it's ok to object because none of this was the original plan. I can object and endure and believe and hope all at once. Or in sequence, object one day, endure another and believe another. And maybe a little humor at the absurdity of it all can help in that endurance.
I had just gotten down the block, across the street, and into the Beverly Hills Garage I like, that isn't too expensive (usually a trip to a doctor means a 20 dollar parking cost), and was just about to get into my car, when Z called. She said, "The best I can do is April 4 at 10:30?" I did not say, "But I thought there was absolutely nothing available until November 2023?"
So, let me figure. If I see him in April 2023, for my imprimaturial visit, sealing all those tests, and assuming all is well, can I push out the next series of examinations until next April?
Yeah. Doing a podcast about the things I object to--bet you object to a bunch of the same things too--sounds like a cool idea to consider. And think of the kvetching me and my friends can do, an endless pool of things that make no sense to discuss.
I like.
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