I'm not in the habit of popping pills, not even the legal ones. And I haven't been to a doctor in three years -- not since the night I caught some asshole rifling through my old Escort in Over-the-Rhine, helping himself to my cassettes like a Halloween grabbag, and I ended up with a shattered middle finger when he made his escape.
Even then I put off the emergency room for a few days. After I popped my finger back into place, I sat at a downtown bar drinking beer with my hand jammed into a glass of ice, recounting my adventure of bravery.
This most recent trip to the ER was occasioned by a persistent sore throat that had been dogging me for a few weeks. I put it off as long as I could, until I was overtaken with fear and ignorance, those prime American characteristics upon which our medical establishment comfortably rests. Fear that if we don't catch it now it will only get worse, and ignorance of exactly what it is that ails us or even of our basic anatomy.
Of course, I did my best to come up with my own diagnosis. My guess was tonsillitis. My right tonsil seemed a bit larger than the left, it was the side where the discomfort was worse, and there seemed to be some mucus coming from behind it. I figured some antibiotics and an avoidance of tobacco and alcohol would probably do the trick.
But, of course, I needed to confirm my diagnosis and secure a prescription from a real doctor. So, on an early Saturday afternoon, I set off for University Hospital, prepared to spend the entire day there in the ER, amid the poverty and dependence of the rest of my brethren who, like myself, have managed to fall through the widening cracks of "the greatest health care system in the world."
I didn't have all that long to wait.
The AIDS patient who came in just after me ended up going into triage before me, clutching his abdomen and utterly miserable, barely able to walk. I suspected pancreatitis, a side effect of some medicines, because he acted and sounded just like my late husband Bill when I brought him to this same ER in 1992.
Another 15 minutes and I was in an exam room, where a doctor informed me that my guess was as good as his (the tonsillitis theory) but that he was perplexed by my lack of a significant cough or fever. He soon disappeared again, and I laid back to wait. I then heard his voice and that of another man talking about bringing me back for a full cancer workup, blah blah blah.
I bolted out of the bed and stood glaring at them from the curtain. I introduced myself and told the doctor -- an ear, nose and throat specialist -- I would appreciate it greatly that whatever they were going to do it be done now. Doc was a real charmer. Great bedside manner. He immediately agreed to check me out on the spot. After retrieving his equipment, he proceeded to insert a small tube up my nose and down the back of my throat. Having never been violated in quite this way, I will confess a mild turn-on at the novelty.
Nope, no tonsillitis, no sores, no lesions, no cancer, not even an infection -- just a bit of redness, which the doctor spoke of in polysyllabic Greek terms, until I forced him to translate. The top of my pharynx was irritated. And he then told me it was consistent with, get this, acid reflux.
The Doc had diagnosed me with a TV disease! I don't wake up with heartburn, I explained. I don't have problems when I eat. I don't go through the day with one of those glowing red strips ready to burst into my mouth like a broken thermometer.
He said I could have it and not even know it, and that the only way to be sure is to write a prescription for the strongest medication so we could rule out anything else if it works. "OK," I told him, "fine."
Until I went to have it filled at my neighborhood Kroger. Twenty pills for $85.09! No generic equivalent, it's still under patent. "Not in this life," I explained to the cashier, who seemed rather amazed that a person would refuse a prescription because of its cost.
"Well, I can put this on your insurance card," he assured me, and was surprised to learn that I had no such card. Such is the standard practice, enabling the manufacturers to charge their outrageous prices. "For a little acid? No way!," I said, wheeling my cart toward the Tagamet.
Maybe more people ought to do the same. How else will the doctors and insurance providers and drug companies learn how fed up we all are with their racket? I guess I'm lucky. Aside from this little problem, I'm strong and healthy. At least until that ER bill arrives.
But can I hold out long enough for a national plan with universal coverage? Can enough of us do the same? Just because every other industrialized nation guarantees the health of its citizens doesn't mean the United States will follow suit. Where else would doctors find the guinea pigs for their research but among the working poor?
So sign up for those research studies now. The greatest health care system in the world depends on you!
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