Waiting Room

“Mr. Hall?”

The nurse gestured toward the open door with his clipboard. I glanced at the clock. Not bad; I only had to wait forty minutes this time.

By this time the bi-weekly visits to the clinic were becoming routine. Get up early, drive to Midtown, give the receptionist my money, wait for a while, get blood drawn, pretend to listen to the doctor tell me how God will solve most of my problems, set a follow-up appointment, get in the car, drive home. I’d been doing this for a few months already, so I barely paid attention to the routine. My numbers had stabilized, so everything was under control. Except, of course, the $500 a month in medication.

A trainee nurse did the pre-exam honors. Hop on the scale — hey, I lost five more pounds! Cool. Blood pressure is fine, so those meds are still working. Temperature checked, pin-prick for the sugar test.

She looked at me, puzzled. “Did you take your diabetes medication this morning?”

“No, because I’m not diabetic. My sugar’s never been high in my life. My father is diabetic, though.”

She left the tiny office and got the primary nurse, and showed him the meter. “Were you fasting this morning?”

“No, this isn’t a fasting visit, that’s next month.”

“Wait here, I need to get the doctor.” He almost ran out of the room.

I rolled my eyes. Damned Pop Tarts. But that was hours ago. How long does cherry filling stay in the blood stream? Whatever. The doctor would clear it up.

He walked in, wearing his gravitas like a robe.

“Mr. Hall, I am calling an ambulance. Your blood sugar is almost five times normal. If we don’t get you into the hospital you will die.”

He turned away without pausing for my answer.

I thought of the inevitable bills that come with a trip to the hospital. Thousands of dollars at a minimum, tens of thousands are more likely. All to save my life; fine, but to save it for what?

“Wait.”

He glanced back over his shoulder.

“I won’t go to the hospital. I’m going home.”

His brow creased as he parsed what I was saying, clearly unaccustomed to a patient asserting their own authority.

“That isn’t an option. This is very serious. Without treatment you will die.”

I was perfectly calm. I may have smiled. “I am uninsured and unemployed. I will not saddle myself with debt. I do not accept this treatment.”

His mask was motionless, emotionless: “Go to the waiting room.”

The nurse escorted me back to the crowded common room. I found a chair in the back row.

I was a bit surprised at my own calm. According to this doctor I was very possibly going to die soon, and it didn’t bother me at all. I felt truly relaxed.

For quite some time my life has been deteriorating, a combination of illness and circumstance and society. I spend nearly every hour of every day under stress, being crushed to death by fist-sized stones. America values nothing but money: you are your bank balance, so I barely exist. Anything that might bring me relief would be welcome, even if that relief is final. That the stress might finally be over was calming.

A short time later I was brought to the doctor’s office. The doctor’s voice resonated with exasperation. “Since you refuse to go to the hospital, we will give you insulin here for four hours. If during that time your sugar returns to reasonable levels we will allow you to go home. If not, you will go to the hospital, with or without your permission.”

I wondered briefly how exactly he was going to force me to go. Was he planning to call the police?

“How much will this cost me?”

He grimaced. “Nothing. Why is that— ?” He shook his head.

“Okay, I will let you give me insulin. If it doesn’t work I will leave.”

Back to the waiting room. I sat and watched the patients come and go around me. It seemed to happen very quickly, like time-lapse photography. Occasionally the receptionist shot me an odd look as I sat in my chair, writing in my composition book.

A shot in the left shoulder.

I waited, writing instructions: contact these people; distribute my possessions like this. I worried if my handwriting would be legible enough.

Test results: no significant change. A shot in the right shoulder.

More instructions: “Here is my primary password. This will let you into the storage for my other passwords.”

Test results: levels inexplicably rising. Back to the left shoulder.

A letter to be delivered to a distant friend: “I warned you this day might come. Here are the instructions on how to retrieve and post the final entry for Hidden City…”.

Test results: levels starting to fall.

A final shot in the right shoulder brought it low enough to call off the emergency. I was hauled away to the doctor’s office again.

He explained diabetes to me as if it were something rare and exotic. My life was now more complicated, I was informed; no more eating whatever I wanted, or whatever could afford. I was handed a photocopied “Welcome to Diabetes!” checklist, a prescription for still more pills, and sent on my way.

I walked to the parking lot through the afternoon sun. I opened the car door, buckled myself in, and sat there, letting the stale heat soak into me. I’d cheated death, or so his educated eminence had informed me. Shouldn’t I be singing hosannas, swinging around lampposts, heart filled to bursting with the joy of life?

The engine turned over on the first try. I drove home to wait some more.

The uninsured life

I suspect most of the people currently discussing health care in Washington don’t really understand the extent to which it dominates the lives of ordinary Americans, particularly those of us who are a bit older. For the benefit of those among you for whom the issue is purely academic — those with reasonable insurance plans — allow me to use my own situation as an example.

When I lost my job I lost my insurance. That isn’t how it was supposed to work, but due to an ongoing series of Kafkaesque entanglements, my employer decided I didn’t want the COBRA insurance offered. (I am still trying to get this straightened out, so I won’t go into more detail than that.) Because of this, in fairly short order my prescriptions all ran out, and I was unable to get more because my doctors’ won’t see patients who don’t have insurance. Consequently, the state of my health is a constant undercurrent to everything I do.

Last night I started to feel some stickiness in my throat. Today it has blossomed into a deep, hacking cough. Normally I would shrug it off and keep working. Now I worry that if I don’t keep myself in bed and kick this as quickly as possible it could turn into something that would ruin the rest of my life through medical bills. Sure, staying in bed is a logical course of action, anyway, one too often ignored. But it is my only option today: no quickly called in prescription for me.

Today my burglar alarm went off due to a malfunction (a bad battery). While I was on the phone with the inept alarm company trying to get them to deactivate the screeching I had to stand on a step-stool with my head less than a foot from the siren. Seven hours later I still can’t hear properly. I hope that it is a temporary condition, but what if it isn’t? Without insurance I’m out of luck.

Like almost every other middle-aged man in America I have high blood pressure. When I checked it a few minutes ago it stood at 183/97, which is pretty much where it has been sitting for a couple of weeks. Even though I am doing as much as I can to keep it under control without medication, what will happen if I have a heart attack? Assuming I can find a hospital to take me in — my last ER trip required cash on the barrel-head before treatment could proceed — I’ll have to devote the remaining years of my life solely to paying off the debt. Frankly, what’s the point of being saved if my life’s purpose would be paying off a bill?

And cancer? Yeah, let’s not even go there.

There are stop-gap solutions to some of these issues, of course, as well as the uncounted multitudes of similar problems facing the uninsured today. And frankly — depressing as it is — there isn’t exactly a scarcity of single, unemployed, childless, middle-aged white males. Losing a few more of us to heart disease isn’t going to be a blip on the national demographic radar, and we make lousy sound-bites. But what about people with families, what about kids, what about people with the misfortune to be born with conditions requiring lifelong medical treatment? Should their lives be destroyed because of bad luck? According to the opponents of health care reform the system is fine as it is, and there’s no need to rock the highly-profitable boat. The national motto is dollars uber alles, you know.

Socrates is alleged to have said “The unexamined life is not worth living.” Having spent a great deal of time indulging in navel-gazing, I have to ask: Is the uninsured life worth living?