The next day I was even sicker. I didn’t even set my alarm. My workout regimen had been nuked from orbit. What a bummer. I’d been so excited but there’s nothing you can do if you can barely breathe.
On the other hand, the furnace had electricity. It was still almost out of fuel but one step at a time. Glass is half full and all that.
Of bigger concern was that whole… “I’d like to keep breathing” thing. I’d been hit very hard very fast and was determined to do something about it lest it get worse. The next part of this story is just my personal experience with local medical care; if you wanna’ get all political and call me a Deplorable on the wrong side of history that’s just fine. This is my actual world and not a theoretical one and it probably applies only to my area. Beyond that we’ll just have to talk about tractors instead.
What I chose to do was run off to what I call “the rich people doctor”. In the nearest town all the medical facilities (save one) are owned by the same monopoly. The town used to offer roughly average American quality care but it’s been going steeply downhill for about a decade. By now it’s amazingly bad. So bad that Mrs. Curmudgeon refused to go (even to the “rich people” doctor). She’d rather suffer on the couch than tilt at windmills of the local medical bureaucracy. I don’t blame her. We chose different paths and will compare notes in the end.
Most medicine in our area is simply unacceptable nowadays. Mostly it’s cheap but the quality is haphazard, worse than laughable, worse than it once was, just fuckin’ terrible. It’s impersonal, annoying, largely ineffective, and possibly descending into the range of third world quality. It’s delivered by people who don’t care if you live or die, can only diagnose something big and obvious (I’m talking something like a farm tractor accident or a gunshot wound), and any properly skilled doctor flees the scene as fast as they can. I assure you they’ll be moving on to a better gig as soon as they can ditch this rural shithole. Like I said, it wasn’t always like this, but there’s no point in denying what it is now.
The transition between adequate and craptacular has been remarkable. Aside from the fact it may someday kill me, it’s an interesting study of a real life “Fall of Rome” effect.
It’s an ugly situation. You can try for a doctor’s appointment but that’s just a joke. You have to schedule several months in advance. “I think I’ll be sick in June, how about a general medical visit in June.” If you schedule such a visit, it may not happen anyway. The doctor will probably be gone before then. (“If you like your doctor you can keep your doctor.” Remember that? It was gold plated bullshit.)
The emergency room is worse. It’s a horror movie. I’ve been there done that and frankly it’s terrifying. Luckily, I wasn’t that ill. ER would be overkill and I wouldn’t go near those ghouls unless I was damn near shaking hands with the grim reaper.
So, the only game in town (within the ubiquitous medical monopoly) is a clinic. The clinic is cheap but horrid. It’s the main front gate to the monopoly which controls every nearby medical practice (with one exception) that isn’t dentistry or optometry. Welcome to my personal world of Obamacare 2019. Your mileage may vary, it might be just great where you are. Maybe my misery is just an irrelevant rounding error in some “fuck those hicks” calculation that favors population centers. Who knows? I only know what I experience. I also know the only way to find a clinic beyond the reach of the monopoly is to drive further than I had the health to drive. Such is the way of the world.
At the clinic, which is admittedly cheap and open pretty generous hours, folks will be stacked up like a crowd trying to score free concert tickets. It’s always busy. Always has been, always will be. You’ll wait in a room with some seriously messed up people. It makes you wonder what you’ve done wrong in your life to wind up in this sorry state. The crowd is garish and sometimes freaky. Many folks look like they failed “Taking Care of Yourself 101”. There will be a couple dozen snot nosed and impatient screaming kids associated with a dozen odd equally impatient and swearing women… some of whom aren’t actually patients (you’d need a score card to ascertain what kid goes with what person). Given the overall situation it seems like a great way to make sure six siblings are for sure guaranteed to end up with the pinkeye that generated one kid’s visit. The saddest are the really sick kids. They sit silently starting at space (that really worries me, nobody wants to see a sick kid just pining away). In addition, there will be tattooed freaks, meth heads, folks who desperately need a shower, and at least three random extras from Mad Max. All of whom are staring at their phones. I don’t see a lot of geriatrics there… they must have an “in” somewhere? Every time I go to the clinic I wonder where all the normal people are. The whole world can’t be “People of Walmart” or possibly “Cops” can it? Regardless it’s a horrid place when you’re already suffering.
And suffer you will, for hours:
After 3 hours of them coughing tuberculosis on you and you coughing bronchitis on them, interrupted by an occasional toddler shitting itself in the seat next to you, or maybe someone bleeding on something; you’ll get your turn at the grinding maw of the database. A perky non-doctor will process you through fifteen different non-medical forms. This includes lots of stuff that seems to relate to voting districts and welfare statistics. They’ll take your blood pressure and write it in the computer. They’ll ask if you want to be enrolled in a smoking cessation program and write it in a computer. They’ll ask if you have guns and write it in a computer. (Tragic canoe accident.) They’ll check with your wife to see if you beat her (as if Mrs. Curmudgeon would put up with that kind of shit!) and they’ll put that in the computer. They’ll pry into all sorts of demographic data to see if they can hit today’s quota of one armed, Islamic, LBGTXYZ, Urdu speaking, heroin addicts.
There is only one thing they don’t care about. They don’t give a shit why you’re there.
“Ma’am, I’m here because I’ve been vomiting blood and my toe fell off.”
“That’s nice. Do you smoke?”
They’re always comically but genuinely disappointed I’m not helping their “statistics”. I’m depressingly normal. I have insurance. I’ll happily meet the co-pay right now. I’ll pay cash. I’m not high. I usually (and thankfully) have only a minor illness. I’m a good patient that will do my best to get healthy asap. There’s just not a lot of “statistical value” in my reality as a mostly healthy white male. They’re not fishing for me.
Yep, it’s really like that nowadays.
All this non-medical bullshit gets typed into the computer. Once the computer database is filled out, their job is done and they practically forget you’re still there. In fact, they seemed annoyed you insist on treatment. You can almost feel the lack of concern: why the heck do you persist in hanging around bothering them after the all-important database has been satisfied.?
After a while, they’ll grudgingly put you in a different and slightly less crowded room where you wait some more. Then you’ll see not an actual doctor but some sort of “semi-doctor like person”. He or she may have adequate training for my piddly little problems or he or she may a quack who barely managed a gentleman’s C at the worst medical school on the planet. When I’m sick, I can’t tell the difference. This individual will ignore you while they spend a few minutes (tops!) reading questions off a computer screen and typing your answers in the form. They will not look at you. They barely notice you’re there.
I knew it would go like this:
“Have you been sick a week?”
“No only 4 days, I think I have bronchitis.”
“Do you smoke? Take illegal drugs?”
“No, I think it’s bronchitis.”
“C’mon man, look at that beard you’ve got. You been tweakin?”
“No! I’m not even sure what ‘tweak’ means. I’m generally healthy. I was working out before this thing hit me. I’m having trouble breathing. Cough a lot. It’s very painful.”
“Sure, whatever! Come back after it has been a week. After a week we’ll give you whatever the computer says to give you.”
“I already have bronchitis. It’s pretty obvious. What’s the point of waiting? Is there some advantage waiting for it to become pneumonia?”
“The computer says seven days. If you can’t stand it, go to the emergency room and wait there while car crashes and heart attacks come before you.”
“So, the point of treatment is to wait exactly seven days?”
“The computer says a week.” Glancing at a timer on the screen. “In fact, I’ve been talking with you too long.”
“You’re only here for a few years until you can get a better job, aren’t you?”
“Hell yes, this place is a shithole.”
“Nice talking to you Medical Practitioner Hajieesh Pumbar Plxuminothinoth. By the way, where did you go to school?”
“Bangalore, hell of a lot better than this dump. How can you idiots live in this icebox?”
“I wonder that myself.”
“Bye. Don’t let the door hit your ass on the way out.”
Like I said, that’s how it really is. Some things I exaggerate. Not this. It sucks that bad.
Don’t worry, I’m not going to end on a down note. Conclusion to follow…
Mr. Curmudgeon,
You just nailed the whole fudging rural healthcare system. I live in Northen AZ. In Mohave County. The city actually got 2 hospital in 2008. The Mormon mafia the controls the older hospital somehow got the interstate access pulled for the new hospital after it had been up and running for 6 months due to their control of the local city council and country board of supervisors. Within 2 years a brand new hospital was shut down and the local wait times in the Er wer back to 6-8 hours again. The Old Hospital system also said they would be kind and buy the new hospital of 30 million after it has sat empty for 2 years. Many did not realize that once that place shutdown the Old Hospital went back to getting 5 million a year for being the only level 3 trauma center in a 30 mile area from Feds. Then they fill it with all the short term Physican Assistants, Nurse Practioners, and Medical Students they can find that want to be in the rural area for the full student loan repayment program. They hate the hillybill county so they make the 100 mile commute from Vegas. The Hospital System also bought the local Minute Clinics/Doc in a box/Urgent Care System There were five of them in the area that were easy for all to get to. All were shutdown and a new one was open on the hospital property. With about half of the hours of the others. There is now a reason many folks visit the vet clinic and the pet stores and get antibiotics. For after visitis just like you had.
Yes, your story is much like mine. At least in some rural areas there certainly is a “local medical mafia” effect. It’s new too. You mentioned 2008. Mine kicked in not long after that. Not surprisingly, nobody in a city seems to notice (hell, half of us “deplorables” could be dead of Ebola and they’d still be navel gazing over a light rail plan). Especially insidious is that politicians are universally excellent at not noticing the results of the incentive system they created. I’m pretty sure if Nancy Pelosi got care for something mundane like a few stitches at my nearest ER she’d come away with a whole new point of view.
The mormons did the same fucking thing here. The govt gives them money, they take everything you have and then you sign over the house and property that took you 30 yrs to pay off……just in time for everything you worked for to be taken from you.
That’s how they work. They almost completely OWN one of the town’s in my county now.
I am lucky enough to live in a Desirable Rural Area (tourist area near a national park), so our medical care is above average. Lots of doctors want to live here or retire here. And it’s libertarian enough that many of them will give a substantial discount if you want to pay cash, just so they don’t have to deal with insurance. Still, I am the horrible warning outlier freak statistic—I ended up on a ventilator for a week last February after getting the flu and then pneumonia, so I am glad you are still here to write about a (I am assuming) happy ending.
Yowza; a ventilator! That’s some scary shit right there. I suspect I freak out too much about bronchitis / pneumonia. But I rationalize that they’ve both occasionally hit me like a ton of bricks even though I’m not an old smoker. You just sent a reminder they’re the real thing. I feel better about blowing money nipping “minor” problems in the bud now.
Also I’m happy it worked out for you. I hate modern medicine bureaucracy but the actual technology is good shit and (in fits and starts) it’s getting better with time.
Two weeks before I landed in the ICU, I was zooming around being my usual Superwoman self, so yes, it does happen and it happens to otherwise healthy people. You were absolutely right to do what you did the way you did it.
Also, when BC/BS jacked our insurance premiums to $2000 a month two years ago (yeah, that’s not a typo), I ditched it and went with a health care member sharing program (Samaritan Ministries). The bill from my ICU stay was well over $100K. This organization got the hospital to knock it down to half of that and the entire bill was paid in full within six months with no out-of-pocket costs from me. I would have had at least a $12K deductible with Obamacare.
I’m glad it worked out.
And yeah, you can get hit like a meteor strike without any particular explanatory factors. I’m not a smoker or anything, the germs just nailed me with a solid hit. I can see why folks attributed illness to witches, miasma, and demons it seems pretty random sometimes.
Hmmm. Maybe the reason we have so many doctors down here in Florida is because of all the rich “people” who retire down here from the Big Craphole and other similar shitholes across the country???
}:-]
I give a lot of credit to old people. They seem to have the medical system sussed out and workin’ for ’em.
Isn’t it interesting that JK had a 100K bill and the insurance company was able to negotiate it to half that? I had a similar case with Kid #1. Wife in high-risk maternity for a month, kid born and in the NICU for three months, the kid’s room bill *alone* was half a million dollars. They couldn’t come up with an actual bill, an itemized list of doctors and procedures and fees. In the end I had to fill out a form with my income, assets, those sorts of things and I think they checked my savings account balance because oddly enough they offered me a 10% discount if I paid the exact amount in my savings account the day wife and daughter were discharged. It could not be a coincidence.
Avera is the largest employer in South Dakota. Sanford, aka the guy who made money running Premier credit cards and has bought any independent health care organization he could scoop up, is rapidly approaching number 2. Which means if you’re in Sioux Falls you can’t walk a city block and not pass a Sanford or Avera building. Get to where I live, the clinic is open I think four hours a day two days a week. Most of us drive to Brookings (college town, rich folks hospital) or Flandreau (the hospital and clinic serve the Santee Sioux). The difference is astounding. I once cut a finger on a Sunday afternoon while doing sheet-metal work. Nasty cut, could see the bone. I wrapped it in a wash cloth and put a hose clamp on to apply pressure, then drove the Flandreau as that was closest. I spent a moment pondering the locked door on the ER department, then wandered around and entered the hospital main entrance. Wandered around some more in search of a warm body in a uniform. Eventually found a nice nurse who chastised me about the hose clamp and offered to page a doctor who would, I was assured, arrive within an hour to stitch me up. Ponder that. The ER is closed, and a hospital does not have anybody there capable of stitching a cut. When my son did something stupid and cut his leg badly I’d learned my lesson and went to Brookings that Sunday afternoon. Within an hour he was stitched up, the bill was paid, and I was on my way back home.
Every time I hear “health care is a right” I want to take that politician, plunk them down in my neighborhood, and tell them it is indeed and so is public transportation. Get to walking.