So, you weren’t feeling all that great, and if you are like most of the population, you tried whatever was on the shelf at Wal-Mart first, second, third and maybe even fourth before deciding that it was time for the inevitable trip to the doctor’s office. You hadn’t ever felt quite like this before, or there was just the little voice in the back of your head that said something was up, and it was time to seek professional medical advice. Especially since last night, at 3 am, when you couldn’t sleep yet again you did the unthinkable and googled “possible causes for migraines” so now you are seeing scenes from “Invasion of the Body Snatchers” every time you close your eyes. Maybe it was none of the above, maybe you are part of the population that simply does what they recommend, and gets a physical every year. Maybe you got a new job that required a physical. For whatever the reason, you wind up in the one place we are told from birth is where we go to get “help”, and where, from birth, we avoid like the plague. Most of us, anyway. Reasons to avoid the doctor’s office include, but aren’t limited to, not having insurance, latrophobia (fear of doctors), but more often than not, it’s simply ego. You know exactly what I’m talking about. It’s not that bad, it will run its course, I’m not sick, I never get sick, I’ll take a couple Tylenol and it will go away, I’ll make Mom’s chicken soup and be right as rain, it will feel better when it quits hurting, it’s not deep enough for stitches, no I don’t think its broken – do I need to keep going? Exactly – you don’t need HELP, because its nothing you can’t FIX. Talk to your doctor sometime and ask him – just on a percentage basis – how many patients he sees that should have been seen a couple of days earlier. The number is relatively high, I am sure.
Whatever the reason, you break down and call for the appointment. Some places you can even just show up, sit around for a couple of hours, and once they get through the kids with strep throat, a rock in the ear canal, a broken toe, the five sinus infections and the three cases of the stomach flu, they will see you. Going on a side trip here – mini rant. When you do go to the doctor, and you are running a fever, coughing, vomiting, sneezing – please be a good citizen and KEEP IT TO YOURSELF! Just about every doctors office I have ever been in has a “well” area and a “sick” area. USE THEM! Some of us are actually there because we aren’t sick, and are preventing getting that way, and we don’t want whatever funk you have! Ok, back on track. So, you get called back, and the nurse asks you a bunch of questions (extra ones if this is your first visit). She leaves you in an exam room to study the wall poster about the things you can do to help control your diabetes (except you aren’t diabetic because if you were, you would be studying the poster of muscle strains). The doctor enters. If you are lucky (and I am), he or she is actually a person, and not a walking textbook. In other words, they have a personality. They ask questions in a manner that suggests they are actually concerned with what is going on with you. There is nothing more irritating than the doctor who speaks in a monotone, asks perfunctory questions, tells you the nurse will be back in with a shot, and walks out. 30 second medicine. Personally, someone like that has no business in a field with the word “care” in the description, and I tend to second guess anything they tell me, because I don’t think they could even tell me what color shirt I have on. Anyway, back to task. The doctor examines you, asks whats going on, and for whatever reason, decides to order some tests. Something isn’t striking right. 1+1 is equaling 4. So you are stuck, your bodily fluids neatly deposited in a well sealed vacuum tube (or multiples thereof), given prescriptions if necessary, and promised a call as soon as the “results” are in, with an admonition to return if you don’t feel better in, say, three days. If you have an obvious infection, chances are good you have gotten harpooned in the butt with an antibiotic, and possibly even a steroid, to kick the bad stuff out of your system even faster than the pills you will get with the piece of paper you hold in your hand.
You go up to the front to “check out”. In many cases, this is where the illness begins. Especially with no insurance coverage. Because that paper with all the different boxes to check now looks like a colored page from a kindergarten class, and has numbers next to each thing. You decide to actually look – lets see, there is office visit, sick – $85; Lab – cultures – $273; Injection – $72. This is a poor example, since most of them now break it down into all 8 lab tests, and each injection gets its own line, but you get the picture. These numbers may also be inflated for sake of illustration, but we have a grand total of $430. If you have insurance with a copay, the nice lady at the desk will simply ask you for your $15, $20 or $30. Some people even have coverages with no copays. If you have nothing, the question is “will that be cash, check or credit card?” That shot you got in your keister must be effecting your hearing. You could have sworn she just asked you for this weeks paycheck! With a smile! Then you remember you don’t have a paycheck. Or a credit card. You have 15 cents and some lint in your pocket. There might be $1.82 in the bank. And you feel even worse than you did when you walked in, and you are at a loss for words. Thoughts race through your mind – including wondering if they will take your firstborn as collateral. But wait – there is light – you specifically asked when you called for the appointment for “arrangements”. Here we go, another side trip – can we not get a better word???? The word arrangements, in my head, always appears with two words – floral and funeral. Back to our story. So you mumble that when you made the appointment, they said they would make arrangements. She then answers in a voice that must be magically magnified just like in Harry Potter, that in that case they ask for 10%, and will take a post dated check up to 2 weeks out. You dig out your checkbook, date the check for the next time you get paid (wondering which bill you will not pay so this check clears), and you head out to your car to go home for the next 2 days like you were told to. But wait, there’s more! You have to go to the pharmacy!
You remember that there is a drive thru at the pharmacy, so you figure that is your best bet. You aren’t feeling all that great, and you are still refiguring the budget in your head as to just how in the hell you are going to cover the check you just wrote. You have heard stories about $4 prescriptions, so you are hopeful – the credit card collecting dust in your wallet has about $20 available on it, and you only have two prescriptions. The doctor was nice enough to check the box for generics, so maybe your luck has changed. Nope. Turns out, you have a strain of howsahusawhatsits that is only treatable by one particular antibiotic, which has no generic. But you only have to take one pill a day for 21 days, and each pill is $5. (yes more exaggeration, you get the picture) However, your decongestant IS on the $4 list, so your medications will only be $109. HOLY MOLY BATMAN! But wait – the nice girl at the drive thru sees your pale complexion, and offers to call the doctor to see if maybe you can take medication C, which IS on the $4 list. So you sit. In your car (which you turned off because your neat little gauge that says how many miles to E is laughing at you) and you wonder if anyone has ever died of mortification – because right now you are about 30 seconds from it. The thought runs through your mind of the nice little neighbor lady down the street, who it seems goes to the doctor about once a week – but that thought is no longer poor dear, to have so many things going on in her retirement years, it is now holy cow, the old gal must be LOADED! The cute little girl on the other side of the glass comes back on the intercom and says, yes, the doctor okayed the lower cost alternative (finally – a positive), but due to a malfunction in the pill press it will be about 45 minutes until your medications are ready – can you come back? You see, there are 4 other cars behind you in the drive thru, and they need to get to them to tell them to hurry up and wait as well. Thank you very much. So you start your car, pull around front and park. And wait. In case you have not had this lovely experience, allow me to explain that the very second she tells you 45 minutes, time stands still. The numbers on the clock cease to move. You are lucky – in your former, not quite so broke life, you got a smart phone, so you check Facebook, and your email. You text your husband and tell them you are waiting on meds, and you have howsahusawhatsits and are supposed to go straight to bed when you get home, and yes, you wrote a post dated check but you will figure all that out when you get there. After all that you check the clock – and 4 minutes have elapsed. Crap. You start people watching. There is a railroad crossing right next to the pharmacy, and about the time you are on the third train you look again – YIPPEE! Times up! So you start back up and drive around – to get in line behind 5 cars. Seems like they were all on the same 45 minute timer as you were, thankfully, because it is pretty quick getting up to the window. You give the little girl your name (a different one this time), she searches for the telltale white bag, and comes over the intercom to tell you “That will be $109, please”. DO WHAT??????? No, honey, the other girl – yes the one with the purple streak in her hair, said we changed that to the $4 alternative. So she goes off to check, comes back and apologizes, you give her your credit card (which thankfully goes through) and head home. You get stopped at every single solitary red light on the way home, but you finally get there, stumble out of the car, and enter the house. You stop at the kitchen sink for a glass of water, grab your new medicines, take one of each, and collapse into your bed.
I know what you are thinking. You are thinking I’m a tad insane, and have a very warped sense of humor. You may be right – but the sad part about this slightly comedic tale is how true it really is. This is just the story of a little infection – probably a sinus infection, bronchitis type thing. The numbers are not as inflated as you might think. If this story stopped here, our damsel in distress would get well, work a couple extra shifts to get the money to pay for her illness, and life would go on. How do I know, you ask? Because I did it for years. Even had insurance for a while. Do you know that the copays for a hysterectomy in January is over $2000? Because you haven’t “met” your deductible yet? I’m here to tell you, I met my deductible and he was a right-sided jackass! Yes I know, another joke, but it’s not so funny when you get sued because you got sick. So, let’s go this one step farther – and add in my favorite patient, the one with the long-term, life altering or threatening disease. You didn’t know you had a life threatening condition – you just knew you felt bad. But your chest x-ray to rule out pneumonia came back with a spot on your lung; your blood work came back with a whacked out white count, your lymphocytes are off. It’s not funny anymore. The drugs that treat life changing illnesses aren’t $5 a pill – they are in many cases $50, or $500. An infusion treatment can cost upwards of $10,000 per treatment – and many who need them have them at least once a month. X-rays, bone scans, MRI’s, CT scans, PET scans, Nerve Blocks, and the myriad of tests, consults, specialists, surgeons – each one comes with its own bills. You suddenly need a wheelchair, a cane, a walker, a hospital bed – your house remodeled to accommodate your new “toys”, a van with a lift. You have been thrown, quite unceremoniously, into the world of grants, charities and Social Security. Your doctor said what you have is life changing, life altering or at the worst, terminal. Your brain is a whirl of new words – many of which you don’t have a clue what they mean, and are too flabbergasted to ask. So you think of the things you can wrap your mind around – but no, that isn’t a good way to go, because now, when you need your income more than ever before, you see it evaporate before your very eyes. You need to concentrate on taking care of yourself – but what about your spouse, your kids? Who is going to do what you do every day for you until you can do it again? You are introduced to social workers, chaplains, nurses, more doctors – specialists this time, even possibly surgeons – all of whom assure you they have your best interests in heart and mind. You do your best to keep working – but the drugs they have you on make you so sick you can’t even stand to be around you. You take days off when you feel you must – try to schedule treatments for Friday so you have the weekend to recover. It finally gets to be too much, and you give in and apply for disability.
Whoops! Did I say apply for disability? Yes, people, I did. You have all heard the horror stories – the “I’ve been turned down 8 times because my gangrenous foot just isn’t bad enough”. I’m here to tell you they aren’t all horror stories – many of them are horror truths. There are good people who work at Social Security, and you will be blessed if you find one. Most of the time, they act like you want to access their personal bank account. Human nature hates to ask for help – people don’t ask for help they need when they feel humiliated and degraded. Sometimes it seems like the only people who work in the social programs designed to help those in need are the ones who have the art of making others feel 2 inches tall down to a science. Not always! There ARE good people out there! But, like my friend Mike said the other day, sometimes you are just too sick, or too tired to jump through their hoops. Personally, I don’t get it. Seems pretty straightforward to me – if you have “A”, you meet the criteria for disability – done. But it doesn’t work that way. There are subcategories, causes, reasons, whatever! You wore purple in the 3rd grade so we have to turn you down. In a nutshell – this is how it should work. You have “X”. There is a booklet (and it is very extensive) – all they should need is a doctor with lab work to back up the claims that you have “X” – look “X” up in the book – those are the benefits. Cut and dried. But wait – the doctor forgot to cross the third T in the second sentence of the fourth paragraph in his initial report so you must not be disabled. Sound facetious? It isn’t. It’s the way it happens, every day, multiple times a day. The “care” in healthcare is, in many cases, a joke. How can you tell a sick person you “care” while you are ensuring that in a month they will be homeless? have no car to get to the doctor? have no way to pay for their next surgery? How can you sleep at night when you know a persons only option is that surgery that you told them today they can have, if they put a 30% down payment on the $75,000 cost!? How do you look at yourself in the mirror knowing that little boy will DIE because of MONEY???? Harsh – damn straight. Real? Unfortunately, yes.
So what do we do about it? Well, I’m not going political on you here – to me it’s very simple. We have the ability, we have the technology, we have the medications. We should treat those who are sick. Period. You cannot tell me that it costs $472 for two Tylenol in the hospital, when I can get a bottle at the dollar store. We return CARE to healthcare. We return to compassion for our fellow-man. We shed light on these horror stories – not in a way that makes them seem like rare instances, because they are not. The rare instance is when someone gets approved first time through, no hassles, no hoops. That is how it should be for ALL verifiable illnesses. If your illness is on the list – you are disabled. Period. Did you know you can currently be turned down for disability because your spouse makes too much money? Yes you can. Tell me this – how is the amount in your bank account related to whether or not you are disabled? Only poor people get sick??????
If you are on this roller coaster, hang on. Be a pain in the butt. Don’t give up – don’t let “them” tell you no. Enlist family and friends to be advocates for you – if you feel up to it do your own research. The only steadfast rule is that the only stupid question is the one you don’t ask. When someone turns you down, appeal. Bottom line – don’t try to handle a life threatening, life altering or terminal illness alone. Its mind-blowing, I know. But keep a file, a notebook, whatever you are comfortable with. Get a little memo pad to carry in your pocket or purse, so when you think of the question you want to ask the doctor next time at 2 in the afternoon while you are waiting to pick the kids up, you can write it down. I have NEVER met a doctor who had a problem with my notes – if they have a problem with you writing down questions, find another doctor. Find a support group or system that works for you. Do your homework – or have someone do it for you. I have found that if I have a small bit of knowledge about what my doctor is trying to explain to me, he knows I am taking him seriously, and is more apt to explain things more fully. No matter how you handle it – don’t give up!!! NEVER!!!!
It all goes back to awareness. Pride goes before a fall, they say. I say pride – or shame – is why fewer people are furious at this. Some celebrity gets Cancer, and we see him or her leaving the treatment center, makeup perfect, brilliant smile, and they are “cured”. 12 second news clip, and the average person gets the idea that Cancer is treatable, curable, enough said, on to who won the baseball game. We don’t see the news clip of the father who cries over his son every night, wondering where the money for the next surgery is coming from. Or the mother who wonders who will raise her children. Why not???? We are bombarded by images of poor neglected animals that need just 36 cents a day; little starving children that YOU can feed for less than the price of your daily coffee????? Oh, wait, there are images out there. St. Jude Children’s Research Hospital does a good job – but even their images are sterile. Plus, they do what relatively few organizations do – they simply treat the disease, without dollar signs. I wonder if anyone has ever done a study of how many home foreclosures or car repossession are because of medical expenses? We see stories on the news all the time – how many soldiers died in whatever war, how many gang members died on the street. What if we did a nightly “ticker” on how many cancer patients lost their battle today? How many MS patients were put in a wheelchair permanently today? How many children were diagnosed with an illness today that means they will never grow up? Depressing – you bet. But we can’t change the bad – we can’t fix the problems – if we ignore them, or paint them pretty colors and call them flowers!
So now I turn my ramble over to you. What will you do? Will you read this, get a smile or two, but when it comes down to the serious stuff flip the switch in your brain to off and go on about your day, because it doesn’t “affect” you? Or will this flip another switch – the righteous indignation switch – and make you want to HELP your fellow-man. People – normal, ordinary people, in all walks of life – married, single, young, old, male, female, rich, poor – are diagnosed every day with life threatening, life altering or terminal illnesses. Will you help get the awareness out there? Will you end the stigma? Or will you play ostrich, bury your head in the sand and wait for someone else to do it for you? It’s very simple – you took the time to read this – take a couple more seconds and share it. That is your first step in promoting awareness – wasn’t hard, was it?
Thank you for your time.