My Nicaraguan pediatrician friend astutely summarized her work: First you make the clinical assessment, then you make the financial assessment. In other words, a clinician may know the right treatment, but what good does that do the patient if the treatment is entirely out of reach financially?
When I retired from teaching in a suburban school district north of Detroit in June 2003, I left Michigan for my hometown of Pittsburgh with boxes of belongings, twenty-nine years of memories, and health insurance tied to my state pension. That insurance has served me well–except when it has not.
“Your ovaries never developed.”
I am trying—and failing—to wrap my mind around those four words, to grasp the weight of their meaning, but every time I try to speak or swallow, the sharpness of the word “never” lodges in my throat. Never, meaning never counting the number of fingers on an ultrasound, never feeling the flutter of little toes against your abdomen, never arguing about whether you prefer the name Sophie or Sophia, never wondering if your baby girl will recognize your voice when you get to hold her for the first time.
Lifted in my hands, his tone is great, his gaze intensely locks on mine. Put back down, his arms and legs flail enthusiastically. Cheeks are chubby, soft skin is pink. He passes the gestalt test – no worrisome sense that something is not quite right.
“Dr. Eisenberg, line 6, Dr. B,” I hear over the office intercom. What? The chairman calling me?
And in that split second, as I braced for impact, my life flashed before my eyes. What did I do? My mind could only fathom the worst.
“You do not need an MRI,” I told my father emphatically as he stood in my living room, explaining to me that his beloved doctor had ordered this for his low back pain. He was hoping for a quick fix before meeting his brother in Spain. “You need physical therapy.”
I dislike playing doctor to my family, not trusting myself to dissociate emotion from evidence, but this was just too much. Sure, his back hurt him sometimes, but there was nothing to suggest anything dangerous going on, nothing an intervention would fix. Nothing but the dreadful aches and pains of growing old.
I married him in-between tours of Vietnam as a Navy junior officer, and even though we divorced after eight years, we stayed in touch and saw each other over the years.
When he emailed two years ago to say he’d been diagnosed with esophogeal cancer, I was concerned. But after radiation and an operation he wrote that his first two scans were good, and the doctors were hopeful. He was always a strong man and had been healthy, so I relaxed my fear somewhat.
When I wrote him a few months later, his reply was strange. He just said, “A lot is going on here,” and didn’t sign the note. He still worked as a lawyer, so I thought he was doing well and busy again. But no followup note came.
© 2024 Pulse - Voices from the Heart of Medicine, Inc. All rights reserved.
