Living with American healthcare

There was once a frog who had been captured by his country and put in a cage. As he was a very scared and naive frog, he believed it when told it was for his own good.  The frog was happy to be safe and not have to worry about predators. He loved the easy food, fully processed, preserved and always available – even if unhealthy. Slowly he put on weight, didn’t exercise, and became very sick. His chronic conditions caused him to see the veterinarian and go to the hospital often. But the hospitals that he went to were focused on rules, regulations and money. They were set up as gate keepers, to control healthcare access and make sure no one did anything wrong. They did not really care if he lived or died. They prescribed drugs that were expensive and poisoned his body, but the makers of the “medicines” made a lot of money on them and they shared that money with the veterinarians and hospitals.

The frog didn’t know any better, he accepted his fate and didn’t realize just how much the system was causing his demise. He became sicker and sicker. The sicker he got, the more he went to the veterinarians, who did not council him on healthy eating, well-being, community and exercise, but instead locked him in more cages for hours on end and fed him medicines that helped in the short term but did nothing to cure his conditions. They did not offer him comfort or empathy. The veterinarians did not know of a better way to help people, they had never experienced healthcare that was healing, empathic and health based. They too, were trapped in the system. The frog had no friends, he had no hope. Truly he felt like he was being boiled alive in chronic pain.

One day the cage door was left open. The frog ventured outside and thought that maybe he needed to find a better way. He ran far away from the country that imprisoned him and found a new place to live. At first life was hard, as he had to capture his own food or trade for it. But he worked hard to become active, fit and the process itself was invigorating. He found a local community. He found friends. His new companions gave him a reason to hope.  He felt alive again. Connected. Now, when he needed a veterinarian, which wasn’t very often – he found caring, empathic help, who could help heal him. The frog slowly regained his life back.

Cut to the present: we went on a working vacation to Greece recently with friends. It was truly an experience of a lifetime and I am so grateful for the opportunity to build friendships, community and to visit those magical, etherial islands.

One of our friends on the boat needed medical care due to a small accident. So, when we got to Athens, our friend and her husband found their way to a hospital.  Below is her husband’s story of their experiences with the Greek healthcare system, compared to what he has experienced in Los Angeles.

I also have a request. After reading the story below, I ask you the reader, to think and write about how healthcare in the USA can be improved, how the individual can improve their health and wellness care within the system we have and to share your thoughts in the comments section. Let’s learn from each other.

”The Boiled Frog and the Lifeboat”
Authored by: B. Voltaire

A few months ago, my wife tripped over uneven pavement in Los Angeles and broke her teeth. She spent five hours in an emergency room holding a bloody towel to her lacerated chin before they stitched it. The usual gruff, chaotic acute-care obstacle course embedded in my hospital visit DNA includes sullen receptionists; power-hungry renta-cops guarding the ER like wardens in a Turner Classic Movie prison flick; the ominous sit-down triage to confirm you had insurance, all while wounded or nauseous. Then the formal passage from waiting room to inner sanctum, where you began the wait all over again, then feeling some relief that you were at least in a lifeboat, even though you knew it was filling with water. These experiences are the American way of healthcare. It is what I know.

CUT TO: Athens, last week. 

My athletic wife – who hasn’t been having the best year, accident-wise – injured her knee while being towed on a banana boat at high-speed on the Aegean sea. So much for a supposedly fun thing she’ll never do again. Pulled from the water (an appreciative nod here to the inventor of life jackets), she immediately knew something was wrong. Not scheduled to be on land for a few days, the knee was painful and swollen, and we were grateful for the compression bandage found onboard. It could have been so much worse. But the next day, a doctor who was a guest on the cruise took a worrisome look and said the knee should be looked at right away to rule out cellulitis, a serious condition that would require antibiotics. We still had ten days left to our trip, which included walking tours, something my wife loves. I found myself plotting the logistics of a return to the States. It was a colossal bummer. 

We called a friend in Athens – a native of that stunning city – who met us at the dock. We drove straight to the ER of a major hospital. Because of Covid they allow just two people to enter; I waited outside while our friend escorted her. He knew his way around. 

What happened next was a string of utterly incomprehensible events. 

 The hospital was bustling, yet my wife was seen by a physician within 15 minutes. She texted me that the doctor thought it was a torn ligament but wanted an x-ray. I reflexively settled in for a three-hour wait. We’d been wondering about the cost on the drive over and we were prepared to put thousands of dollars on a credit card, carefully taught by American healthcare to anticipate “super-bills” for later (usually futile) submission to Blue Cross. Back home, the cost of healthcare pricing radically fluctuates from modest high range to the outright gouge. I was prepared for the worst.

In Athens, the examination, x-rays included, was $190. Fifteen minutes later, she texted that the x-ray was done – but how? How could that be true? – and an MRI was already scheduled at a different location. I thought ahead, as I’d been trained: the drive to another place, the waiting, the MRI, the more waiting... an estimation of three to four hours at the very least, that is PCSHT (Pacific Cedars-Sinai Hospital Time). Our kind friend took us to the facility, where a man in a white coat was the “guard” outside; he looked exactly like a doctor on a break. We were allowed to park in front of the building the entire time that we were inside; no glowering men in police uniforms shaming and shooing us to a dank ten-level parking structure. 

After 40 minutes, we left with a CD and photographic images of the MRI results. The cost: around $275. 

 We returned to the ER and this time I went in with my wife. It was small and there was the requisite chaos but something was different. The first thing I noticed were two doctors in conference, hands upon each other’s shoulders, a warm tableau that softened the intensity of their quiet exchange. Nurses came and went, comforting those in distress. What’s wrong with this picture? Nurses offering comfort in the waiting room - I have honestly never witnessed this before.

It was a classic cognitive dissonance because I was still on SAHT (Standard American Healthcare Time). The gentleman in charge – a sort of pit boss with medical training – greeted my wife like an old friend, eyeing the packet she was carrying. “Ah – you have the results!” We handed the CD/images over and he quickly brought them backstage. Ten minutes later, he emerged from the draperies to explain exactly what was going on: “In a few minutes, the doctor will look at them and we will ask you in. Then he will assess what you need.” He looked at the knee, adding that she’d most likely be getting a stronger, bulkier brace to keep it in check. This strategy was repeated; patients continuously brought up to speed by a caring staff on exactly what was going on. Timelines are important when you’re vulnerable. I compared it to my Kafkaesque experiences in AMMH (American Medical Machine Horror) Time– not just my own but those of loved ones – and the anti-healing of purgatorial waiting rooms; years of watching strangers, who’d been sitting for hours, nervously approach the imperial reception guards (I had done the very same), begging to be seen. I remembered all the times I’d read about people literally dying in waiting rooms, even calling 911, only to be told by the operators that “We cannot legally send paramedics to emergency rooms.” 

The same doctor who saw her the first time brought the images to her gurney and said the injury was indeed a torn ligament; she would be given a stronger brace; and – most importantly! – we could continue our journey without fear of further injury via walking. Caution and mindfulness, of course, were still required. He also suggested crutches. When we asked where to get those things, he said there was a store close by but the owner would bring them over. I thought to myself: “This will take an hour-and-a-half.” I was still on WFAH (We’re Fucked and Helpless) Time. Within ten minutes, a woman cordially appeared. She put the brace on my wife and one of the doctors gave an unhurried demonstration of the proper use of crutches. The woman said I could pay with cash or with credit card and to follow her to the shop. Not eager to have my wife do any superfluous walking tours, I asked if we could skip shop if we paid in cash. “Of course.” The crutches and impressive high-tech brace cost $200. This was one of the private hospitals; at the public hospitals, our friend said the cost would have been zero dollars, “but we may have had to wait a bit longer.”

Maybe we were lucky and this was a very good day at the hospital – and I mean a very good day. The warmth and tactility – the humanity – witnessed in that waiting room was epiphanic, revelatory: tenderness, human touch, and empathy are essential to healing. But the truth is that the aura of the place radiated that this is an exceptional place of healing. That this is the normal way healthcare is conducted in Greece.

That tenderness, human touch, and empathy are essential to healing is something I knew, something all of us know, but has been deleted and nearly forgotten. In America, that oath has been completely dismantled by victim culture and the fear of rapacious lawsuits. Corporate greed and its handmaidens: steely indifference at best and resentment of those in need of care at worst. 

We arrived at the ER at around 830AM – and were out by lunchtime. We had our meal in a lovely restaurant in Piraeus, overlooking an azure sea. The fish was glorious; but the anger and shame of what the American healthcare “system” has become was awful.