Yes, I am about to write about my own, but MORE IMPORTANTLY I am writing about (you should read this Op-Ed piece by Dr. David Ansell) The Achilles Heel of our human condition, and, in particular, that of American society.
Early in the summer of 2003, and with a noise loud enough to still the voices of participants and observers alike, I ruptured my Achilles tendon playing three-on-three tag football with young men less than half my age. I wrapped my leg with an Ace bandage, took a couple OTC painkillers, applied ice packs and went to bed. I had no health insurance. In the morning I could not stand or walk – I crawled the length of house to use the bathroom. A couple days later I found a pair of old crutches and drove myself to the emergency room, it was too full to bother so I turned around and drove myself home. I researched the optimal angle for taping my leg, stayed off it, and friends brought me food – for weeks.
What happened next illustrates what is wrong with America’s health care system and offers a shining example of humanity, compassion and of one man choosing to honor the Hippocratic Oath over pursuing personal gain.
Ten weeks later, primarily because I had to fly to Scotland for a job interview, I tried again. On this occasion there were only three people in the waiting room. I got my paperwork processed and was shown into an examination room where I waited, and waited and waited. At the hour and forty-five minute mark I got up, hopped into the hall and flagged down an attendant, informed him that ‘they’ had exactly 10 minutes to have a doctor see me or I would be walking out and they could tear up my admittance paperwork. Within twenty minutes I was in X-ray, forty minutes later referred to, and on my way to see, an orthopedic surgeon. At the surgeon’s my X-rays sufficiently alarmed him to send me for an MRI, with a request for me to return within four hours and to have a friend drive me. At the ten week mark the MRI showed I still had a 10mm tear in my Achilles tendon. The doctor had the Buffalo Bills, American football, and Buffalo Sabres (hockey) teams as clients and couldn’t wrap his head around the pain I must have endured. He gave me a choice of a cast or scar, but informed me that I wasn’t leaving without his caring for my leg. I was explained my lack of insurance and he replied “let’s get you healthy and then worry about that”. My leg was swathed in candy apple red a total of three times over the next two months. He made sure his physician’s assistants brought me basins of hot water at the cast changes so I could pumice my foot, loofah and shave my leg and moisturize. When my treatments were over I had to call repeatedly about my bill, when it finally arrived it was marked “Paid in Full”. I wept.
The Income Stream
Fast forward fourteen years and my friend is undergoing chemotherapy for his lymphoma in California. In the absence of having the ‘right insurance’ he has constantly battled the system to ensure he gets the treatments he needs to live. Jeffrey has been de-humanized, deprived of kindness, and treated as an income stream for the sole reason that dared to get sick and become a burden to profit. I find myself angry beyond reconciliation. Questions go unanswered, or are summarily dismissed on par with ‘mansplaining’ (I am sure there is a word which defines the experience of a patient being treated as an imbecile though I do not know it).
Molina’s personnel have repeatedly hung up on my friend. Amongst their many denials of treatment was coverage for an (expensive) anti-nausea medicine and the substitution of not one but two anti-psychotics (8 mg of ondansetron hcl and 5 mg of prochlorperazine) with the accompanying side effects of reducing the nausea of the chemotherapy, and a slew of other pills he must take daily. The anti-psychotics have thoroughly messed up his brain chemistry. My hysterically funny, hyper-intellectual, highly empathetic friend, who has lived his whole life in a perpetual state of kindness to others is now a sporadically very angry man dropping expressions like “I want to stack these m*th*r*ck*rs up like cord wood.” The responsibility for this rests squarely on the desk of Molina Health’s interim CEO Joe White.
On 1 September he was able to leave Molina Health and their legendary money saving protocols behind. Until that date (and more liberally now) their in-network doctors shared their experiences of Molina Health denying payment, and that only with persistence on the part of patients, nurses, patient advocates, and doctors will they cover drugs, care or procedures. With his new Blue Cross and Blue Shield insurance a single anti-nausea pill which (thank goodness) has no negative impact has replaced these anti-psychotics and Jeffrey is cleansing the former out of his system now – Chia seeds in his protein shakes, lots of water – but ‘normal’ is still likely months away.
Sharing Jeffrey’s experience, even at arms’ length, I wonder if providing care (in every sense of the word) in conjunction with treatment such as my experience of fourteen years ago can even be recaptured. Is it doomed to be the anomaly?
Senator Bernie Sanders did not cease in his commitment to universal health insurance for all when the 2016 primary election cycles left him behind. All 330 million Americans should want, and work toward realizing, universal healthcare for themselves and their neighbors. Are we on the threshold of monumental change, or business as usual?