I'll Mature When I'm Dead (14 page)

These creatures, of course, were bacteria, which are one-celled animals that thrive in places such as nasal passages, armpits, public restrooms, and yogurt. When van Leeuwenhoek publicized his discovery, medical scientists realized that these tiny organisms in our bodies were the cause of many diseases. This in turn led them to the conclusion that the logical way to treat these diseases was to . . .
sacrifice a goat
. So there was still a long way to go.

By the 1800s, animal sacrifice had been largely discredited as a medical procedure; today it is rarely used outside of Miami. But nineteenth-century medical care was still quite primitive by modern standards. Hospital patients were routinely tied to their beds with leather restraints and told to bite down on pieces of wood while surgeons used unsterilized saws to cut off their arms or legs. And these patients were being treated for
ear infections
. You don’t want to know what happened to people with hemorrhoids.

Things really started to improve in 1895 when German physicist Wilhelm Roentgen, while doing some laboratory experiments to see if anything came after W-rays, discovered X-rays. This made it possible for the first time for doctors to look inside living human beings and spot problems such as cancerous tumors, which, as it turned out, were caused by exposure to X-rays. So this invention came along just in the nick of time.

The twentieth century saw a tremendous improvement in the quality of medical care thanks to such advances as—to name just a few—penicillin, the artificial heart, liposuction, the little hammer that the doctor uses to hit your knee, the answering service, the six-year-old
Woman’s Day
magazines for patients to read in the waiting room, the deductible, the artificial wart, the sphincter transplant, and the consumer-safe pill bottle that the consumer cannot open without power tools.

Today, in the twenty-first century, America is the most medically advanced nation on Earth. And yet many Americans are unhappy with our current health-care system. To understand why, we must first type a subheading that says:

The journey through the American health-care system typically begins when a typical American, whom we will call Mary,
²⁴
is watching television and sees a commercial for a prescription drug with a name that sounds like a
Star Wars
planet, such as “Lipitor” or “Zoloft.” This commercial shows trained actors pretending to be regular humans just like Mary, ruefully telling the camera how foolish they feel because they failed to ask their doctor about the prescription drug—we’ll call it “Endor”
²⁵
—that paid millions of dollars to make the commercial. The commercial does not make it entirely clear what Endor does, but it
is
clear that if you don’t ask your doctor about it, you have the IQ of spinach.

At the end of the commercial, an announcer warns Mary about the possible side effects of Endor, including (but not limited to) headache, nausea, spontaneous combustion of the eyeballs, and death of the patient and the patient’s entire extended family. But Mary isn’t paying attention to the announcer. She’s thinking that, although she feels perfectly healthy, she doesn’t want to be the kind of idiot loser who fails to ask her doctor about Endor.

So Mary calls her doctor’s office and speaks to a semi-medical professional who tells her that the doctor will be able to see her in . . .
(tapping of computer keys)
. . . three months. Mary puts this on her calendar, but there’s really no need for a reminder, because over the next three months she will see the Endor commercial 783 more times. She reaches the point, emotionally, where pretty much all she wants to do in life is ask her doctor about Endor.

On the appointed day, Mary goes to her doctor’s office, where a semi-medical professional conducts a thorough examination of Mary’s health-insurance ID card, then instructs her to take a seat. She is left to season in the waiting room with three or four dozen other patients (several clearly deceased) and old
Woman’s Day
magazines for a period ranging from one to four hours, after which another semi-medical professional calls her name.

Now, finally, after all the waiting and the worry, Mary will have the opportunity to . . . be weighed. Weighing patients is an ancient medical tradition, dating back to the shamans, who believed that a person’s weight indicated how large an evil spirit was inhabiting his body. The semi-medical professional doesn’t even bother writing Mary’s weight down.

Mary is then ushered into a small, stark examination room furnished with a plastic chair, a paper-covered examination table, and a large, detailed color diagram of the human endocrine system to remind Mary that there are many important things about medicine that a layperson like herself cannot hope to understand. The semi-medical professional leaves, closing the door. Mary sits there, alone, looking at the diagram. The minutes tick past. Fifteen minutes. Thirty minutes. Mary begins to wonder if they have forgotten about her. She also becomes increasingly convinced that something is wrong—very wrong—with her endocrine system.

Then, just when she’s about to give up hope of ever receiving medical care, she hears footsteps in the hallway. Suddenly, the door opens, and in steps: another semi-medical professional. She’s there to make sure Mary has not died of malnutrition, and to let her know that the doctor will be with her shortly. This is accurate: The doctor will be with her
very
shortly, because he has 374 other patients to see during that hour, which means he has budgeted 9.6 seconds total for Mary, including pleasantries.

When, at last, the doctor appears, he moves at the speed of an HBO vampire. He emits a .016-second pleasantry burst and immediately starts writing things down. Mary has no idea what he is writing, but she realizes that if she doesn’t ask her question quickly, the doctor will be gone. So she blurts it out.

“I’m wondering if I need Endor,” she says.

“I’ll schedule some tests,” the doctor replies, writing furiously. And then, with another pleasantry (truncated to .009 seconds, as the doctor is running late) he is gone, leaving no trace of his visit except the gentle rustling of the endocrine-system chart on the wall.

What Mary doesn’t know is that the doctor, focusing on completing his paperwork, heard her incorrectly; instead of “I’m wondering if I need Endor,” the doctor thought she said, “I’m wondering if my feet are tender.” So he has ordered X-rays of Mary’s feet, and—to protect himself from a potential lawsuit being filed by the medical-malpractice attorneys who flock around his building—orders a full blood workup, urinalysis, bone-density scan, electrocardiogram, MRI, full-body CAT scan, several biopsies, and a barium enema.

Mary, following the directions on a piece of paper handed to her by a semi-medical professional, goes to a medical laboratory, where needle-wielding technicians in medical attire systematically drain the bulk of her bodily fluids. She then goes home to wait, and fret. Several days later, she gets a call from a worker at her doctor’s office, saying the doctor wishes to speak with her. A few moments later, or possibly forty-five minutes later, the doctor comes on the line personally. He tells Mary that he has good news and bad news. The good news is, there appears to be nothing wrong with Mary’s feet.

My feet?
thinks Mary, but before she can say anything, the doctor springs the bad news: One of the tests has turned up a troubling result—a small, strange-looking spot showed up on one of the test scans:

The doctor assures Mary that the spot could very well be nothing. In fact, it
is
nothing; it was caused when a lab technician, while processing Mary’s images, sneezed up a globule of mayonnaise from the tuna sub he had for lunch. But the doctor doesn’t know this, and he is not about to take any chances with the spot, because looking out his office window, he can see a flock of medical-malpractice attorneys watching him from their perches in a tree across the street. So he tells Mary he is sending her to a specialist for additional tests.

A few days later Mary goes to the specialist’s office, where, after the standard seasoning and weighing, she is ushered to an examination room containing a realistic full-sized model of the human spine that looks like a huge prehistoric insect. She stares nervously at this until the specialist materializes. In his allotted seconds with Mary, he can’t find anything that might have caused the spot, but to be on the safe side, he orders Mary back to the lab for additional tests involving the removal of whatever bodily fluids Mary may have left. Several days later, the specialist gets the results. They do not shed any light on Mary’s spot. The specialist is on the verge of telling Mary it was probably nothing when he hears the distinctive sound of restless attorneys scuffing their wingtip shoes on his office roof. So he decides that, rather than take any chances, he will refer Mary to another specialist.

The process repeats itself, again and again. Mary becomes a human hot potato, passed from specialist to specialist, each of them sending Mary back to the laboratory for more tests because none of them wants to have to explain to a jury, under questioning from a malpractice attorney, why he or she was the only doctor in this chain of specialists who failed to see the need to subject Mary to more medical care.

Mary is now a psychological and physical wreck from wondering what is wrong with her, not to mention giving out more fluid samples than a Napa Valley winery. Also she’s not getting much sleep, because every day the postal person wheezes up to her mailbox and deposits a large bale of insurance-company statements, which look like this:

Mary reads these statements with no more comprehension than a tree frog pondering the space shuttle. She wonders: What do these numbers mean? Is she supposed to pay any of the amounts shown? Which ones? To whom? What if she
can’t
pay?

Mary becomes increasingly depressed, and finally decides to seek the help of a psychiatrist. The psychiatrist, after carefully evaluating Mary’s condition to determine that her health insurance includes psychiatric coverage, prescribes a tranquilizer called Coruscant.
²⁶
Unfortunately, this drug causes Mary to experience a rare but serious side effect in the form of severe tenderness of the feet.

Mary starts skipping work. She spends most of her days sitting in her Barcalounger, surrounded by piles of benefit explanations, watching TV. Thirty to forty times per day she is exposed to a locally produced commercial for a team of lawyers who have dark suits, a complete set of legal-looking books lined up on professional bookshelves, and a burning desire to fight for the legal rights of whoever is watching daytime television.

Finally Mary decides that the fighting attorneys are talking to
her
. She calls the number on the screen and makes an appointment. Within hours she has been fitted with orthopedic shoes, crutches, a wheelchair, and a neck brace, and she is the plaintiff in a lawsuit naming, as defendants, every doctor she has ever seen, every drug she has ever taken, every medical lab she has ever been tested by, and the publishers of
Woman’s Day
.

Mary ultimately receives an out-of-court settlement of $18,000. After the team of fighting lawyers take their fee and deduct their expenses—orthopedic shoes are
not
cheap—Mary is left with $1,263.47. She is now unemployed, uninsured, and broke, with unpaid medical bills approaching $500,000. She feels sicker than ever, but is terrified about what might happen to her if she gets any more professional health care. She has started to explore alternative healing practices. When we see her last, she has contacted a healing practitioner who claims to have obtained excellent results in cases just like Mary’s. All the practitioner needs is for Mary to bring him $50 cash.