I have had sinus infections a couple times a year my whole life. I finally broke down and went to an ears, nose, and throat specialist a few years back. He told me I had a deviated septum which prevented proper draining. He said that the surgery would be covered by my insurance, but he noticed that the bridge of my nose was also deviated. He said that it is common, if the deviation is bad enough, for insurance to cover a rhinoplasty as well. While my case didn’t require one, he believed he could get my insurance to cover that.
He wanted me to get an unnecessary procedure and appealed to my vanity. He was willing to persuade my insurance to pay for it!
I didn’t go back. I still get sinus infections. I don’t want to be synthetically “perfect”. I want to be me. And on top of that, I would like a medical doctor to act like it.
A few months back, my dad and I were trying on shoes together, and he noted a bulge on my ankle. I relaxed my ankle into its normal position and the bulge disappeared. I am pigeon toed, a little worse on my right foot. I try to straighten it, which makes one of my ankle bones stick out a little. He asked me if I had always been like that, or if it was due to the surgery after my broken leg. I told him it was always.
For those who don’t know, I broke my leg in Sweden. I really like how it was handled.
I went to the emergency room at night. The receiving lady was so upset apologizing, I could barely understand what she was saying. She rambled about how she’s never done this, was so sorry, and it was because of the EU regulations, and something about taxes. Finally, I got her to say straight that she had to charge me. I laughed, told her I was used to it, and handed her my credit card. She apologized some more and said she didn’t agree with this and would never do it if it were up to her. You could tell she was appalled at the thought of collecting for something like basic human care.
Because it was late, there were no surgeons there. I was given a shot and some pills and told they would wake me in the morning. In the morning, there was a new doctor there. He explained that they were going to give me local anesthesia, and fix my fracture. He showed me the x-rays from the night before. I told him I was in a foreign country and scared. I asked if he would just knock me out. He laughed and agreed.
I was wheeled to surgery, where there were doctors in masks and all the normal beeping machines. They walked me through sticking all the little sticky monitors in various places on my chest without touching me themselves, put in an IV, then a woman put a mask on my mouth and said, “Breath deep”. I did, then she asked, “Are you ok?” I said, “Yes…” but started feeling funny. She put it over my face again and said, “Breath dee…”
The next thing I remember was a small woman shaking me and saying, “You have to pee. You have to pee,” over and over. I told her, “No, I don’t,” and moved my arm away from her. “Yes, you do. I took an ultrasound and your bladder is full. You are too tired to feel it. You must get up and pee.” Not urinate. Pee.
I tried to motivate myself to believe her and slowly opened my eyes. There was a mural on the ceiling of an underwater scene. It was as though I were under water, with the sun was shining through, and there were fish. I felt my stomach, which was wet from the ultrasound jelly. “What the fuck?” I thought. “Who takes an ultrasound of your bladder to tell you to pee? Honestly now…”
After, I was taken to my room, where I spent my time sleeping, eating, and chatting with a hot med student volunteer. He wanted me to try all of the best food, then apologized that it was hospital food. When he wasn’t bringing me extra, I was asking for it… the most delicious cucumber sandwiches…. man…. There was an area on the bottom of my foot which hurt, and they thought it was my cast pushing in because I described it as a “sharp pain”. After they cut the cast off to ensure its smoothness, they said it was fine and recasted me. I had a hard time during physical therapy, learning to use the crutches, because my leg hurt. My physical therapist yelled at me, telling me I needed to take stronger pills and decide to work through the pain, because I wasn’t going to get stronger by sleeping all day. She came back later to apologize, but my doctor switched my medicine, so I knew she wasn’t really sorry.
The new medicine made me sick and sleep a lot, so time flew by. When I woke up to the nurse for meds, I told her I wanted my old pills back, because I was loopy and couldn’t stay awake. She didn’t understand (which was half language and half me slurring), so I pushed her hand away. She got a doctor. He asked what was the problem, why I wouldn’t take my medicine. I told him they made me sick, too sleepy, and not feel right. He laughed because the nurse made it sound like I was terrorizing her, and put me back on the lightweight ones. I did better in therapy because she called me out on being a crybaby. Probably also because I didn’t like the drugged stupor and knew she was going to win this battle.
After an emergency room visit, x-rays, 3 nights and 3.5 days, general anesthesia, surgery, 3 screws, many staples, 2 casts, lots of pain pills, physical therapy, and crutches, they sent me out with a bag of pills and a DVD containing a description of my treatment and high res images of my before and after x-rays “for [my] American doctor”. Grand total?
$350.
Not even close to shitting you.
Taking my cast off in the US? Over $500.
The assistant cut my leg so bad removing my cast* that I had to send my mother out of the room and spend some time “communicating my displeasure” to the nurse. They refused to use the x-rays on the DVD, so it was extra.
The real thing I want to make clear in writing this, is that my ankle is just as pigeon toed as it was before. They might have been able to set it straight, but didn’t. Didn’t even ask if I knew or cared. Didn’t assume I was perfect and fix it as if I were. They fixed an imperfect ankle like the imperfect ankle it was… and did a perfect job. It never hurts, I have all my range of motion, and the scars are even minimal.
The doctor were well trained. They had great equipment. They had proper medication, facilities, sanitation, training, and technique.
It IS possible to nationalize healthcare and keep it at a high standard. Although, there would be no deceitful nose jobs being upsold.
I also think how we got here is a matter of American culture. Doctors “sell” unnecessary procedures because we are vain as a culture and accept. They get paid more for more procedures. We value perfection more than other countries. We worry about body smells, body hair, body shape, and body color so much there are “medical spas” for everything from tanning to hair and weight removal to fake boobs. And the whole thing is taken as if we would be unhygienic if we didn’t partake; as though it is as necessary as washing our hands and brushing our teeth. Free nose job? Sure!
But that nose job has to be paid for by somebody. Insurance. My rates will go up, I won’t be able to afford it, and what happens if I really need it? Even if I didn’t get the free nose job, I bet somebody did. The doctor wouldn’t pitch it if it didn’t make him money. He’s not on salary, he’s paid per job.
And how fucked up is that? That a medical provider would offer something you don’t really need to be healthy? Is it our desire for perfection, his greed, or the system we have created?
How many dentists have offered you whitening? My mouthguard that keeps me from grinding my stressed grad student brains out costs over $300 because my insurance didn’t think it was necessary. Because they don’t KNOW anymore.
And now that I don’t HAVE insurance, I’m part of the fucked portion of this country. Me. A graduate student, who is researching cancer and contributing to the common welfare of society as a whole. I am not a drain on the government. I am not squandering my life or the nation’s resources.
But last year I could’ve had a free nose job.
How is it, that a country not listed in the top percentage of wealth can offer me an emergency surgery with top quality care for less money than it takes a glorified technician to cut my leg with a buzz saw? Why is that? Are we so afraid of change that we are willing to say what we have now works? Who does it work for? Who is it best for?
If you think America is superior at everything, you haven’t left the country. I’m not saying everyone needs to travel to understand, but at least take time to research the issues and how others deal with them.
It’s funny to think that all people need food, water, shelter, and medical care. We deal with our problems for each environment that we’re in. We eat what’s fresh and easy, we use condiments that taste good on it. Some people use catsup, others use cock sauce; some live in homes on stilts, others underground. But we can take these ideas and see that people like condiments, and there is a common theme of using wood in homes. Let’s learn about others’ solutions to healthcare, because ours has some obvious weaknesses, and the baby boomers are coming to the age when our system is going to be hit harder than it already is.
We can’t blame the insurance for being elitist, or the doctors for being greedy, or us for being vain. Like in fixing my ankle, we need to recognise that we as a culture are imperfect, accept that, a treat the imperfections in an acceptable way. Ignoring that our system is flawed, we as Americans do have a culture, and mankind is not perfect, we can’t come up with perfect solutions. I urge you to both identify problems we face, and how others deal with these problems, then ask if that will work for us. Make YOUR decision about healthcare reform.
*Ok, so the deal with the girl cutting off my cast in the US:
In Sweden, they have observantly assessed that a person doesn’t go around ramming their broken leg into things, and so they only use one roll of the hardening cast material to make the cast. The purpose of the cast, after all, is just to hold it in place while it heals. A nonbroken leg couldn’t wiggle in one layer. They do, however, put a shit ton of padding gauze in there, like a pillow. On the other hand, American doctors use one roll of gauze, and three times as much of the hard shit. Yes, that DOES mean your broken leg is trapped in a nonpadded overly protected prison for 6 weeks. No matter what you lay your leg on, it’s still hard.
The problem with this is that the casts are relatively the same size to the untrained eye. While Swedish doctors use the circular saw to perforate the length of the cast, then have huge scissors to make a big cut. Note the use of the singular cut. They then pry it open, and it cracks down the back. The heel needs a little extra work, but the idea is the same.
Now, in America, the standard operating procedure involves using the saw to cut the whole length of the cast, twice. The two halves then fall apart and the “padding” is cut with the overkill scissors the Swedes use to cut the cast off.
So, the little American assistant girl with the circular saw pushed on it to cut my one little layer, like butter. She didn’t stop there, but did it several more times, holding it against my leg to cut its length. I told her the first time the cast wasn’t as thick as she thought and asked her to be careful. When she decided to go the distance with it, I needed my mother to not have to be there watching anymore. I had a “talk” with her explaining that it was indeed that thin throughout (duh) and ended in me explaining the scissors were enough, then asking her to help me pry it open instead of her cutting me some more. I had a cut about 5cm on the back of my leg, which is quite a feat. Those saws aren’t sharp; they merely sand the cast. It was like she was TRYING to piss me off. When it cuts through super fast the first time, most intelligent people wouldn’t PUSH on the fucker the WHOLE length of a person’s leg! And we all know how forgiving I can be, especially in the case of incompetence.