She took my left hand in both of hers and held it warmly for a moment squeezing it tightly twice. Then she stroked it carefully, gently, tenderly. She looked up at me, still holding my hand and opened her mouth.
“It’s gout.” She said softly.
“Gout?” I responded incredulously, “I thought that was for feet!”
“It can occur in any joint, I will write you a prescription for medication that you can begin tomorrow.” She made a note or two then stood up to leave.
“Wait a minute – how can you be sure?” I asked.
“Well, we will do a blood test to confirm the uric acid levels and then proceed with the treatment.” She opened the door and left. She had been in the exam room for three and one-half minutes.
So. I went to the lab where two immensely obese young women padded and wobbled about like great bubbles of fat that softly and slowly bounced across the floor. One of them reeked of stale cigarette smoke. I had the blood test and went home. They would call me in thirty minutes and I could go to Walgreens and pick up my medication.
The next afternoon one of the young women at the office called. “Your uric acid levels are completely normal.”
“What does that mean?”
“You don’t have gout.”
“What do I have?”
“Oh, I don’t know.” There was a pause on the other end. “But your medication has been cancelled so don’t go by to try to get it.”
“I didn’t want it anyway.” I responded. “So what should I actually do?”
“Just continue with the medication you were already taking.”
“I wasn’t taking any medication.”
“Then just use the ointment you were using before.”
“I wasn’t using any ointment.”
After a long silence the voice returned, now with a slight aura of irritation, “Well, I guess then that I will have to go back and check with the doctor and we will call you tomorrow! You will probably have to come back for another examination.”
“No, don’t bother. She obviously has more important things to do.” I hung up.
The hand already felt better. I had gone to the doctor because I thought I might have broken the thumb out in the garden the day before, and the whole arm was red and swollen, and I expected x-rays would be taken at the very least. I also knew that her bill for just her 3.5 minute experience would probably be about $145 and that Medicare would probably approve about $48 or 1/3 of the charge. Well, that’s OK, I figured, I probably got about 1/3 of a diagonosis.
I reflected back on the visit now, and about how it seemed to fit pretty well into what I have started to call my encounter with "The Flash Card Generation". That’s seems to be where I have arrived in my life, and going to the doctor is a perfect example. The doctor comes in and stares at me like a child waiting for a new flash card. I get the feeling that my "flash card" says maybe something like, “2 + 2”. The doctor quickly says “four” and writes a prescription, gets up and leaves, and the great computer will send me a bill. I go back another time and apparently show “C - A - T“. The doctor says “cat” and writes a prescription, walks out, and the bill will come later. Maybe I go in with something different, like “A - I - L - E - Y - F - A - Y - N - T”. The doctor may look puzzled and then write out a prescription as he quietly says to himself “elephant?”. Or if I go in with a”card” that reads something like “43.78÷12.3 to the 4th power X 12.732 “, I will get an appointment with a Specialist.
Fortunately, the human body is a wonderful creation capable of correcting many of its own problems. So, as long as the doctor doesn’t do too much damage, it will probably return to its state of normalcy in a couple of weeks. Obviously, serious illness or injury are very different matters, and I suspect most doctors really enjoy bringing about an important healing. But most of the things they deal with are really kind of strange, most of the people who come to see a doctor feel strange just being there. And the examination rooms are very strange too, so it figures that the doctors would have to be kind of strange in order to exist in this strange world, and they have large bills to pay, high costs of operation, insurance, and other overhead, so they have to make their time really add up. Perhaps they suffer more than the rest of us do, and probably have developed their own coping strategies. My take on the matter is that the doctor takes a quick look at your record before entering the exam room. One item which apparently stands out is whether or not you are covered by Medicare. If you are a Medicare recipient, then when the doctor comes in the room his mind is already elsewhere. He may shake your hand he but will be looking for your flash card.
