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Assaulted by “Health Care”
Sandra Shea
I’m no stranger to dealing with the medical world and its billing systems. I’m a triple cancer survivor, had knee surgery in 2012 and now have ulcerative colitis. All told, I’ve had eleven surgeries and fourteen colonoscopies. Paperwork is practically my middle name.
But the last twenty-four hours have been ridiculous.
In that time, I’ve had three different encounters with healthcare billing–each absurd in its own way, and each more challenging than the last. Things got to where I almost had to laugh. And if almost $10,000 of my money hadn’t been at stake, I would have.
Yesterday morning and early afternoon were punctuated by the following events:
Popping the Question
Mitch Kaminski
Mr. Dwyer isn’t my patient, but today I’m covering for my partner in our family-practice office, so he’s been slipped into my schedule.
Reading his chart, I have an ominous feeling that this visit won’t be simple.
A tall, lanky man with an air of quiet dignity, Mr. Dwyer is eighty-eight. His legs are swollen, and merely talking makes him short of breath.
He suffers from both congestive heart failure and renal failure. It’s a medical catch-22: when one condition is treated and gets better, the other condition gets worse. His past year has been an endless cycle of medication adjustments carried out by dueling specialists and punctuated by emergency-room visits and hospitalizations.
I’m Happy
Raymond Abbott
On my voice mail is a message from Donald Wyatt. He doesn’t often call, but every Monday morning he comes to see me at the Louisville, Kentucky, mental-health clinic where I’m a social worker.
His message is brief: “I’m not feeling well, and I am planning a trip to either St. Louis or Elizabethtown.”
I smile, wondering at the odd pairing. Elizabethtown is a small city of 50,000 people. And, well, St. Louis is St. Louis, a metropolis.
This behavior is not unusual for Donald. He’s disappeared before, always out of state and by bus. He doesn’t have the money to travel any other way, although once he took his parents’ van and drove to Ohio. (He has no driver’s
Casting Out Demons
Jef Gamblee
As I stand beside the bed in Mr. Jerome’s living room, his pit bull puppy sniffs the body bag lying on a stretcher nearby. His cat curls up on the bedside shelf.
“That dog gonna be a problem?” asks Jude, one of the crematory guys.
“She might get underfoot,” says the neighbor, whose name I can’t remember. “But she’s a lover, not a fighter.”
Jude and Chuck are here to pick up Mr. Jerome, who died of prostate cancer today. His body lies on the bed–the wasted husk of a once lively, athletic man who had taught history in a New Jersey middle school.
I’m a hospice chaplain; Mr. Jerome was my client. I’d known him for about six
Friday Before Christmas
Deborah Pierce
On the Friday before Christmas, I received an unusual gift.
Like any job, being a primary-care physician has both challenges and rewards. The challenges are many, and the rewards are often fleeting–a smile or a “thank you” from a patient or coworker, for instance. And I’ve found that being a teacher of medical students and residents brings an additional layer of rewards and challenges.
One Friday before Christmas, these arrived in an especially potent mix.
Chemo or Lourdes? Welcome to Cancerland
Michael Carbine
Dr. Peterson, the radiation oncologist, gets right to the point.
“The medical center’s tumor board has concluded that your cancer is inoperable, incurable and untreatable,” he says flatly. “Any chemotherapy or radiation treatments would be palliative in nature.”
He begins explaining the reasons behind the board’s verdict, but everything he’s saying washes out. My mind stopped working as soon as I heard the words “incurable” and “palliative.” I am sliding into shock.
Dr. Peterson pauses.
The Case of the Lima Bean
Matthew Webb
“Matthew, go see this lady about her breast mass,” says my attending physician at the clinic where, as a third-year medical student, I’m doing a family-medicine rotation.
Okay, I think. I’ve done my ob/gyn rotation; breast masses are no big deal.
I don my short white coat, freshly baked from sitting in the back of my car as I drove to work on this oppressively hot morning. As I sling the stethoscope around my neck, I feel my inner voice (my constant companion amid the stresses of medical school) gearing up, ready to offer insights, questions, distractions….
Two Timelines
Timeline One
Day 1: For over thirty-five years my strong, spirited spouse, Carlo, served around the world in the Air Force. Now retired from the military, he still serves at the air base as a civilian security police officer.
His neck hurts. A lot. He blames the pain on the unbalanced weight of the bulletproof vest that Uncle Sam added last year to the uniform he proudly wears every day.
Exam-Room Follies
Anne Whetzel
Pamela sits on the examining-room stool, looking at me expectantly.
I am in my first year of medical school. I do as I’ve been told to do in Medical Skills class: I observe my patient–without judgment or assumptions–and try to figure out what questions to ask, based on the information I am given.
Pamela has curly, strawberry-blonde hair and looks to be thirty, just a few years older than me. Her infant son lies in a carrier beside her.
Dr. Clark, whom I’m shadowing, has just given Pamela osteopathic manipulative therapy for her chronic headaches. Now the doctor is treating Pamela’s older son, age seven, for back pain; he fell off the school jungle gym a few days ago.
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