I have come to the conclusion that if you need health care and can't get it any other way, (i.e., you have no insurance, you have no money, you have no credit cards....) you go to a small town or country doctor. Many people have caught on to this. I don't know quite how... maybe it is word of mouth from their country cousins. All I know is that the small rural practice where I work has recently been flooded with new patients -- from the nearby big city.
It struck me as odd from the beginning. The nearby big city is full of health care providers of every ilk and specialty. They have several large hospitals to which they may refer extremely ill patients. They have excellent reputations (well, some of them, anyway.) It blew my mind to see a patient with several serious, non-routine diagnoses in my office recently. I am not even a doctor, I am a nurse practitioner. Not to belittle my expertise in any way, but hey, I know my limits! The woman listed the names of her specialists for her various conditions. I sat there bemused, and finally asked her, "Why did you come here? You were getting the best of care." Her answer? Money, of course. She had lost her insurance when she was laid off from her job. She couldn't afford the specialists' fees. She couldn't afford her medications. She had heard that we would see patients on a sliding fee basis, and that we would help them get free medicine.
So I got out my books, and with her knowledge of her own condition, what I was able to look up, and her list of her current meds, we were able to map out a care plan for her. She was stable on her meds. I had forms from the companies that made them so that we could apply for free or reduced cost medicines. I did a physical exam and documented her current condition so we could be alert for changes. I looked up what labs to order and ordered them.
She fully understands that I have no expertise in her conditions. I fully understand that she is stuck with me because her financial situation won't pay for the specialists she needs. Perhaps I should refuse to take on the care of a patient so complex, but surely I am better than nothing.
But I deeply resent out current system in which patients must utilize care that is less than optimal. Yes, I'll do my best for her. But she deserves better.
Sunday, June 12, 2005
Sunday, June 05, 2005
Saturday, June 04, 2005
The Angry Greek Man
'Twas a long time ago; so long I am not sure my memory is fully accurate, but let me try to get the story right...
I was desperately in love. I was lonely, bereft, recently abandoned by my ex-husband, and coming to the realization that I was a lesbian. I had had a crush on a woman; a writer with whom I had been acquainted for quite some time. She had moved to Greece and married a Greek man, but I knew she was a lesbian. I didn't know really why she married. It didn't matter though. She seemed a safe distance away, so I professed my crush to her and waited to see what would happen.
What happened first was a wonderful and passionate correspondence between the two of us. Her letters were clever, witty, biting, sarcastic, funny and tender. I suppose mine were doltish by comparison. She was a most talented writer.
Before long it was time for the holidays. She was coming home from Greece with her husband to spend the holidays with her family. And to see ME! I was beside myself. I hardly even acknowledged to myself that she had a husband. I was going to see her. I might touch her. I would smell her hair.
At the time, I lived far in the country down almost three miles of dirt road. I lived in a large house with my two very young sons. I did have a helper -- an old black man named Talmadge. Talmadge looked after us well. I think he felt sorry for me -- a divorced woman alone in the world with no man to look after her. Talmadge spoke in a deep 'Geechee accent which was difficult even for me, a hardcore southerner, to understand. Besides caring for me and my boys, he figures in this story a little later, so I figure I might as well introduce him now.
The holiday came, and so did my wonderful beloved and her immaterial husband. I had worked hard getting my house cleaned and welcoming. I cooked all day. I sent my boys off with their father. I selected wine. I still smoked then, and I smoked a lot that day. They arrived at last. She was beautiful. We talked of many things, but the only one I remember was his hideous foot fungus, the sight of which I was treated to because I am a nurse, and that's what happens when you are a nurse. It grew late. I begged them to stay the night. Somehow, she ended up in my bed, while the egregious Greek man was left on the couch downstairs.
I remember she and I giggled and talked and cuddled nearly all night long. We smoked, though the cigarettes seemed not to agree with her. We finally slept.
When it was morning at last, we sat in bed looking at one another wondering what on earth we had done. The house felt empty except for ourselves -- a fact we discussed in whispers. Finally we gained enough courage to go downstairs to look. Of course he was gone.
We walked outside and could see the distinctive footprints left by the Greek man's shoes in the driveway. They went to the road and took a left turn -- toward Talmadge's house. We laughed nervously at the idea of the Greek with his thick Greek accent meeting up with Tal and his thicker 'Geechee one. My nameless (here anyway) love called her parents' home to see if he was there. He wasn't. So I called Talmadge to see if indeed he had encountered His Greekness. He had.
Talmadge told me how he had just left his home very early in the morning and encountered a lone "white man" walking on the dirt road near his house. Tal picked him up because the man was well-dressed and looked utterly lost and out of place. Apparently it took a while for them to understand one another, but Tal finally understood that the man wanted to go to the bus station. (His wife and I had a guilty giggle over this-- sometime in the previous evening we had laughed over the fact that one thing all small towns seem to have in common is a bus station.) Tal delivered the Greek to the local one, and that was the last anyone ever heard of him.
My beloved had wildly mixed emotions over that, but not I. I was thrilled. She was mine alone now. The way was clear. I wasn't burdened (as she was) by the guilt of having treated him rather horribly. But of course, neither of us knew at that point that she was
pregnant.
I was desperately in love. I was lonely, bereft, recently abandoned by my ex-husband, and coming to the realization that I was a lesbian. I had had a crush on a woman; a writer with whom I had been acquainted for quite some time. She had moved to Greece and married a Greek man, but I knew she was a lesbian. I didn't know really why she married. It didn't matter though. She seemed a safe distance away, so I professed my crush to her and waited to see what would happen.
What happened first was a wonderful and passionate correspondence between the two of us. Her letters were clever, witty, biting, sarcastic, funny and tender. I suppose mine were doltish by comparison. She was a most talented writer.
Before long it was time for the holidays. She was coming home from Greece with her husband to spend the holidays with her family. And to see ME! I was beside myself. I hardly even acknowledged to myself that she had a husband. I was going to see her. I might touch her. I would smell her hair.
At the time, I lived far in the country down almost three miles of dirt road. I lived in a large house with my two very young sons. I did have a helper -- an old black man named Talmadge. Talmadge looked after us well. I think he felt sorry for me -- a divorced woman alone in the world with no man to look after her. Talmadge spoke in a deep 'Geechee accent which was difficult even for me, a hardcore southerner, to understand. Besides caring for me and my boys, he figures in this story a little later, so I figure I might as well introduce him now.
The holiday came, and so did my wonderful beloved and her immaterial husband. I had worked hard getting my house cleaned and welcoming. I cooked all day. I sent my boys off with their father. I selected wine. I still smoked then, and I smoked a lot that day. They arrived at last. She was beautiful. We talked of many things, but the only one I remember was his hideous foot fungus, the sight of which I was treated to because I am a nurse, and that's what happens when you are a nurse. It grew late. I begged them to stay the night. Somehow, she ended up in my bed, while the egregious Greek man was left on the couch downstairs.
I remember she and I giggled and talked and cuddled nearly all night long. We smoked, though the cigarettes seemed not to agree with her. We finally slept.
When it was morning at last, we sat in bed looking at one another wondering what on earth we had done. The house felt empty except for ourselves -- a fact we discussed in whispers. Finally we gained enough courage to go downstairs to look. Of course he was gone.
We walked outside and could see the distinctive footprints left by the Greek man's shoes in the driveway. They went to the road and took a left turn -- toward Talmadge's house. We laughed nervously at the idea of the Greek with his thick Greek accent meeting up with Tal and his thicker 'Geechee one. My nameless (here anyway) love called her parents' home to see if he was there. He wasn't. So I called Talmadge to see if indeed he had encountered His Greekness. He had.
Talmadge told me how he had just left his home very early in the morning and encountered a lone "white man" walking on the dirt road near his house. Tal picked him up because the man was well-dressed and looked utterly lost and out of place. Apparently it took a while for them to understand one another, but Tal finally understood that the man wanted to go to the bus station. (His wife and I had a guilty giggle over this-- sometime in the previous evening we had laughed over the fact that one thing all small towns seem to have in common is a bus station.) Tal delivered the Greek to the local one, and that was the last anyone ever heard of him.
My beloved had wildly mixed emotions over that, but not I. I was thrilled. She was mine alone now. The way was clear. I wasn't burdened (as she was) by the guilt of having treated him rather horribly. But of course, neither of us knew at that point that she was
pregnant.
Friday, June 03, 2005
I have to comment on the woman whose dog's feet smelled like fritos. They did indeed. I had NEVER before noticed the aroma of dog feet, but her noticing that interesting aspect of her dog's composition has had me sniffing dog feet ever since. And you know what? They ALL have frito-feet. I just hope this isn't because they tend to step in their urine.
Animals are odd creatures. I have found out other fascinating things about animals along the way. For example, if you wrap an ace bandage around a cat's belly, it can't walk. It will stumble and fall. I have tried this on many cats. The bandage doesn't have to be wrapped tightly. No cats were injured in any way during these experiments. I swear. I love animals! But it is a weird truth that they cannot walk with any stability with a bandage around their bellies. I do need to do further research though, and find out if this is true of anything wrapped around their middles, or only elastic things.
I have also learned a strange and interesting thing about parrot behavior. My parrot likes to nip fingers, but he won't do it as long as I stare into his eyes aggressively. But if I am doing that, he will duck his head under my hand where he can't see my eyes, and nip my fingers from BELOW my hand. Damn bird. But this is a very limited experiment. I have only used it on one bird. I'll let you know when I have collected more data.
I don't know what it is about animals that appeals to me so much. Clearly, I spend too much time with mine. I often think how much simpler (and less smelly) my life would be with no pets. But somehow, I have managed to always have at least one in my life, and usually far more than one. Even if I do nothing to actively acquire animals, they just show up. Right now the count is pretty moderate: one dog, four cats, one bird, and a couple dozen fish. Not bad really, until I want to go on vacation. It is almost as hard to get someone to keep your animals as it is to get someone to keep your kids...
oh -- to the woman with the frito-footed dog -- give me a call sometime. It might be interesting to catch up a bit. :)
Animals are odd creatures. I have found out other fascinating things about animals along the way. For example, if you wrap an ace bandage around a cat's belly, it can't walk. It will stumble and fall. I have tried this on many cats. The bandage doesn't have to be wrapped tightly. No cats were injured in any way during these experiments. I swear. I love animals! But it is a weird truth that they cannot walk with any stability with a bandage around their bellies. I do need to do further research though, and find out if this is true of anything wrapped around their middles, or only elastic things.
I have also learned a strange and interesting thing about parrot behavior. My parrot likes to nip fingers, but he won't do it as long as I stare into his eyes aggressively. But if I am doing that, he will duck his head under my hand where he can't see my eyes, and nip my fingers from BELOW my hand. Damn bird. But this is a very limited experiment. I have only used it on one bird. I'll let you know when I have collected more data.
I don't know what it is about animals that appeals to me so much. Clearly, I spend too much time with mine. I often think how much simpler (and less smelly) my life would be with no pets. But somehow, I have managed to always have at least one in my life, and usually far more than one. Even if I do nothing to actively acquire animals, they just show up. Right now the count is pretty moderate: one dog, four cats, one bird, and a couple dozen fish. Not bad really, until I want to go on vacation. It is almost as hard to get someone to keep your animals as it is to get someone to keep your kids...
oh -- to the woman with the frito-footed dog -- give me a call sometime. It might be interesting to catch up a bit. :)
Tuesday, March 01, 2005
The nun's belly was so smooth and utterly unmarred. No scars, no bruises, nothing but a modest expanse of alabaster skin. I put my hands on her belly, gently at first, lightly scanning the lovely skin to get a sense of it before probing more deeply. I started over on the left side, the unaffected side. I pushed in with my fingertips, causing a slight wince. Releasing the pressure caused more than a wince. I asked her where it hurt and she indicated her right side. I moved my hands to the painful side. Before I even applied pressure, I could feel warmth and fullness. It wasn't apparent to my eyes, but my hands could tell something was wrong. I pushed in very gently, causing pain. When I released my pressure this time, the nun blanched and gasped. I told her what I thought -- that her appendix was infected. She refuted me -- it couldn't be -- she had Ash Wednesday services the next day, and she was flying to Seattle the following Monday. She simply was too busy to be sick.
But she looked sick. This lovely nun normally had a sparkly, shiny aura. She always smiled. She smiled this day too, but it wasn't a glowing smile. She was grey.
I agreed not to send her immediately to the hospital. She agreed to let me draw blood and arrange a CT of her abdomen for the next morning. (This was late in the day. I could get the CT early the next morning, prior to her Ash Wednesday services.) I was worried. I made her promise to go right to the ER should her pain worsen, or her fever go up. She agreed.
The next morning we got a fax from the imaging department. The nun had appendicitis. The hard thing was finding her. I called her home, the church, her emergency number. All I got was recordings. I left messages, but was not happy about it. I was considering calling the police to go find her, but first asked my doctor what he would do.
One of his talents is knowing everyone. He knew who the nun's best friend was. He called her and told her what was going on. The friend knew where she was. Within 15 minutes she had called me back and we made arrangements for her to go right to the hospital.
Her appendix was removed in short order, and she was home in time to make her flight to Seattle.
And I will never forget her lovely smooth belly. It was the prettiest belly I have ever seen. I think I am in love.
But she looked sick. This lovely nun normally had a sparkly, shiny aura. She always smiled. She smiled this day too, but it wasn't a glowing smile. She was grey.
I agreed not to send her immediately to the hospital. She agreed to let me draw blood and arrange a CT of her abdomen for the next morning. (This was late in the day. I could get the CT early the next morning, prior to her Ash Wednesday services.) I was worried. I made her promise to go right to the ER should her pain worsen, or her fever go up. She agreed.
The next morning we got a fax from the imaging department. The nun had appendicitis. The hard thing was finding her. I called her home, the church, her emergency number. All I got was recordings. I left messages, but was not happy about it. I was considering calling the police to go find her, but first asked my doctor what he would do.
One of his talents is knowing everyone. He knew who the nun's best friend was. He called her and told her what was going on. The friend knew where she was. Within 15 minutes she had called me back and we made arrangements for her to go right to the hospital.
Her appendix was removed in short order, and she was home in time to make her flight to Seattle.
And I will never forget her lovely smooth belly. It was the prettiest belly I have ever seen. I think I am in love.
Saturday, January 08, 2005
I woke up with an Amazon in my bed this morning. A parrot. My son's. Actually, I think the parrot is mine now. The son is planning to move away soon, and he asked if he could leave Veda with me. I am happy to keep the bird -- Veda and I have bonded. It took a long time, but it happened. Veda is so beautiful, and he talks too. He screams my younger son's name frequently, or sits and mutters all kinds of things, or puts together words to form new meanings. I think he is intelligent. He likes to kiss me. Birds kiss by nibbling at or touching their tongues to your lips. After a recent session of bird-kissing, I found my lips to be burning fiercely. I nearly freaked out, wondering what kind of bird-enzyme I'd been poisoned with. Then it came to me -- parrot food has dried hot peppers in it. Parrots love hot peppers. Apparently, Veda had been nibbling one before nibbling at my lips... and the burning faded away after a short time...
Subscribe to:
Posts (Atom)