Monday, May 14, 2012

Blue or White

I have a buddy who told me that his father took him aside before he began a solo journey across the country. My friend had packed up his vw bug and was about to set off when his dad gave him this three word advice: "Don't trust anybody."

My parents' advice was far more optimistic. My dad was fond of singing the words to "Tis a Puzzlement" which contains the verse,

 "Is a danger to be trusting one another.
One will seldom want to do what other wishes.
but unless someday, somebody trust somebody--
there'll be nothing else on earth excepting fishes."

Who can you trust?  My general sense is that the odds are great that a stranger with whom you are dealing is not someone you can trust.  I figure 80 per cent of the time, you are likely to be dealing with someone who will be willing to take advantage of you.  And if the over-under on the percentage is in fact 80, I would take the over.

I have come to this conclusion not primarily from first hand experience with amoral sorts, though I have had such experience, but primarily because I have regularly conducted surveys with students related to ethical communication  and about 4/5ths of the participants typically contend that moral action is not their default tendency.

My sense is that this statistic crosses every demographic category, save perhaps those about to die. And I suspect those on their deathbed are likely to be more ethical because they are afraid that they could get in trouble with someone important so close to judgment time.  My grandfather, an unreconstructed non-believer until the day he died, once shooed away the rabbi who came to visit him in the hospital subsequently confiding to me that people get religion in hospitals for what they sense are pragmatic, not moral, reasons.

So, I don't believe it matters a whole lot if you are a blue collar worker or white collar worker, or rich or poor, or from Arkansas or California.  The odds, I believe, are that most people can't be trusted.

I had a recent experience with the medical profession which supports this view.  For those who know me and might be concerned as this tale unfolds, I write quickly that I am fine and always was fine despite the beginnings of this story.

On Monday last, I was feeling weak and unsteady.  It was the kind of feeling I associate with the flu. Except I had no fever and when I have the flu I run a fever.  I rarely go see a doctor but I was thinking, why not, I pay a fortune monthly for health insurance, I was feeling weak, had a bit of a cough, why not check it out. It was true that just two days prior I had run three miles without difficulty and had done a long walk on Sunday, so how sick could I be. Still, I had not seen my doc in nearly a year, why not check it out.

So I called on Monday noon to make an appointment. My doc was unavailable at the HMO, but another whom I had never seen previously was available. I made an appointment for 420.

When I arrived at 415 or so, I was called in. A nurse's aid took my weight, blood pressure and pulse. In response to her inquiry,  I told her that I was feeling weak and fluie without a temperature.  Another nurse came in and surprisingly administered an EKG.  I had had one of these a couple of years prior and it had been so good that they didn't bother with a stress test that they normally would have done under the circumstances. So I was not surprised when she looked at the EKG and said something like, "looks good."

Moments later the doctor arrived and without so much as putting a stethoscope to my chest or much of a howdy, tells me that I have to go to an emergency room in an ambulance.

Well, as you can imagine this was a bit startling. However, I had my wits about me and knew that I really wasn't feeling that bad.  I asked why I needed to go to the emergency room.  I was told that there was an abnormality on the EKG.  I had a block (not a blockage).  What is a block, I inquired. Something to do with the way the electrical current goes around the heart.

Well, swell. Still, I think this is odd because I regularly do 45 minutes to an hour and a half on the elliptical without really breathing that hard.  I suggest maybe I should see a cardiologist in the HMO.

 "Not after clinic hours" she says.  But it wasnt after clinic hours. It was 430. Why go to an emergency room when there are doctors right in the HMO facility.  I know emergency room fees are expensive. Someone will have to pay for the treatment there.  Why not take care of me right in the HMO.  I know my regular doctor would never send me to the er for something like this, so I am puzzled.

With my doctor du jour, I prevailed on the ambulance front and drove myself to the er. There I saw

  • a triage nurse (ka ching) who I tell that I am feeling weak and tired.  
  • A guy who takes an electrocardiagram (who sees the one taken at the HMO and can't find an abnormality, nor can he find an abnormality in the one he takes, but ka ching), 
  • a nurse (ka ching) who I tell I am feeling weak, but do not know why I am in the emergency room.
  •  A physicians assistant and her assistant (ka ching) who I tell I am feeling weak but by this time am not sure if I am feeling weak, but just want the story to be consistent.  
  • Then I tell the emergency room doctor that I am feeling weak (ka ching).  He can't seem to find anything wrong with me.
In the meantime the assorted health providers are sticking stuff in my nose and arm, probably wondering themselves why the hell I am in the emergency room. They are all very nice and thorough, but except for feeling weak and flu-like there is not much that they can detect. I am given a bag of glucose (ka ching) because maybe I am dehydrated.

(There are gaps in the visits from the various health providers so I am glad I brought a book to read. The good news is I had the book. The bad news is the book-- "The Year of Magical Thinking"-- is about a man who suddenly and inexplicably drops dead of a heart attack).

The thing is, it is becoming clear to me that it is becoming clear to them that there is nothing wrong with me worth visiting an emergency room.  I am getting my version of ornery in the ER, when finally five hours after I arrived the nurse comes in with my discharge papers.

The discharge papers include what is written in bold as Diagnosis.  Their diagnosis for me, someone who came in to the HMO feeling weak and unsteady, is one word:  WEAKNESS.

I am, they tell me, fine. They also mention when pressed that the original doctor in the HMO misread the EKG.  I am told to drink fluids and rest.

Very expensive wisdom.

This could be a case of incompetence as opposed to unethical behavior, but I am not convinced.  Someone is going to make a lot of money on my emergency room visit. And I do not believe the motivation was to ensure my health. I think a motivation could have been irrresponsibility or laziness. But the hospital and HMO made some money because of it.

I am fine.  Went to work the next day. Just did my hour on the elliptical a little while ago.  But I thank the citizens of the US who pay for the irresponsibility of the medical industry for letting me know that last week I was experiencing weakness.

Who can you trust?

1 comment:

  1. Sorry you felt weak. The system in your case worked beautifully. Various medical hacks and neurotics got some chump change for passing you down the conveyor belt to nowhere. More money was made by the unseen lawyers, lobbyists, accountants, and brokers who everyday connive bigger cuts from every simple to complex medical procedure by their skillfull non medical surgical skill in cutting up the sweet medical profits pie. Boy, they are always hungry. The top of our medical food chain has no medical people but lots of people who enjoyed monopoly as kids when we were having fun on the sports fields. If only I had the sense to be one of those nerds. Too late.