Today's Adventure in The Land of Medicine

So where have I been all day? In short, I wasted a perfectly good day of internet connectivity so I could go to the hospital -- not as a patient nor as an emergency arrival, although the day was such an abortion that it is surprising that I didn't end up in the psych ER after all was said and done. No, I was there for just one reason: to see my psychiatrist who would then refill my prescription.

This is how my day went.

0600: I am awake, listening to NPR. It's dark. My parrot pals are still asleep.

0700: Get up, take a shower, wash my hair, and feed my birds their gourmet meals of fruits, veggies and sprouts (all of them) and seeds (two of them). Elektra makes her characteristic piercing shriek as I leave my apartment. I want to shriek, too, because I have to make my monthly trek to the hospital to refill my anti-insanity prescriptions.

0800: I board the subway, the doors close, the train moves a little bit and then stops, its soft hum transforming into an ominous rattle. Everyone looks at each other, wondering if they will be late to work today. Eventually, the conductor announces that blahblahblah switching problem blahblahblah A-B-C lines blahblah sorry for the delay blahblah. Damn, I am not sure I will make it to my appointment on time. Why didn't I get out of bed earlier instead of laying around for an hour like a beached walrus, listening to the damned radio?

0930: I am finally waiting for the cross-town bus, which generally runs every three to five minutes. Damn, it's cold out here. I wish I'd worn another coat (I was already wearing two coats).

1000: Still waiting for the bus. Oh, hey, there it is! Oh no, that bus just turned off all its lights, so it's just parking along the curb for awhile. I guess it's the bus driver's potty break. Grr.

1010: Ah, here's another bus. Finally. This one keeps its lights on and stops in front of the twenty or so people who are waiting. Ah, it's warm inside, too. Oh, damn, look at the time. I am going to be late for my 1030 appointment. I hate being late.

1045: The bus was excruciatingly slow, but I finally arrive at the hospital clinic, get all the necessary paperwork filled out and now I am waiting for someone at the front desk to notice me. Someone finally sees me. She promptly informs me that my doctor is on vacation for two weeks, that I cannot possibly have an appointment today. Um, dood, here's my appointment card with his handwriting on it, I think as I silently hand the card to her, my eyes narrowed as I prepare to do battle.

1051: Battle is unnecessary, fortunately. The receptionist decides I am neither a functional illiterate nor a pathological liar afterall as she gives the card back to me and checks me in. She then informs me that it'll "be awhile" before anyone can see me. Oh, gawd, I groan inwardly. "Awhile"? "Awhile" could mean anything .. it could mean .. hours or it could mean .. days. I sit down in the waiting room and a cloud of despair settles over me as I look around at everyone else, all of whom are staring at me as if I have broccoli growing from my ears. I stare back, realizing only just now that I am the only white person here, that not even one of the receptionists, nurses, doctors or police are white. I imagine that everyone is measuring me, judging me, and deciding that I am either white trash or that I am gaming the system.

1125: Another person, an extremely large black man in his early fifties who is sitting one chair away from me, is very angry about his long wait, so he suddenly erupts up and out of his chair and starts yelling and waving his arms around threateningly. A nurse tries to calm him down by listening to him. He ignores her and continues shouting and windmilling. Two police officers show up and stand in the doorway of the clinic, assessing the situation. The man is not violent, just angry and protesting, so they merely watch events as they unfold. Another nurse shows up. This woman apparently knows the man because she addresses him by name, and he complains loudly to her from across the room about his long wait. After a few more minutes of shouting, several psychiatrists pop into view, as if summoned by time-delayed magic. But by this time, everything is settling down into the typical tense but boring routine of the typical hospital clinic waiting room.

1145: Commotion over, the protester has had his say and now is slumped grumpily in his chair again. I feel exhausted so I close my eyes for a minute. Just one minute.

1200: I open my eyes to discover that this is not one of my bad dreams, oh no, instead, it is my one and only bad reality. Sigh. More despair. My stomach growls because I have not eaten today. I think about it for a little while and realize that I did not eat yesterday, either.

1215: A shrink finally calls me into his office to prescribe my medications for another three months. Almost as an afterthought, he looks up from his computer screen and asks me how I've been these past three months. This is the time to be careful, I remind myself, because this is when the psychiatrist can decide that I should be readmitted to the nuthouse against my will (kicking and screaming of course, since I have birds at home to care for). Fine, I say, pretending that the past three months have not happened, pretending that I was not nearly incapacitated with despair for two weeks in November, that I did not suffer those two meltdowns, one in November and the other in December, that I have not been battling depression since the New Year arrived, nor did I mention that I had felt especially wonderfully fabulously excellent for several weeks in October and again in December. Nope. None of that happened. Everything was A-Okay flatline fine. He is staring at me, so I shift self-consciously in my chair. Are you experiencing mood swings? The psychiatrist asks. I hate you, I think. I stutter for a minute or so and finally admit that um, yeah, I am. But only a little bit.

1225: I am in the hospital pharmacy, waiting in line to get a number so I can wait in an even longer line before they call my number so I can pick up my prescription. They assign me number 119. The number board shows number 61. Oh no, this really is going to take all day. I decide to look for something really cheap (er, affordable) to eat at the little street vender's cart on the sidewalk next to the bus stop in front of the hospital.

1235: I discover that the cart has packed up for the day and is gone.

1245: I find the hospital cafe and confirm that the food here is too expensive for mere mortals to afford. It's probably really awful, too. I mean, it is hospital food. I buy a chocolate chunk cookie and a large coffee, black, no sugar, for $2.25.

1255: I am in the pharmacy waiting room again. It is packed and people are spilling out into the hallway. Two little boys are screaming hysterically and racing around between people's legs as they fight over a toy train and neon green rubber snake. I eat the cookie as slowly as possible. It tastes awful, rubbery .. and where are the chocolate chunks? .. but I paid for it, and I am hungry so I eat it anyway, dammit.

1330: Still waiting. One hysterically screaming boy, the one with buzz-cut hair, tackles the other kid to the floor (ouch! That's gotta hurt!), so his mother rescues her flattened son from the floor and forbids the two boys from playing together.

1400: Still waiting. I've found that the coffee is so awful that it is truly gag-inspiring. But this is NYC, all coffee tastes terrible here, so I drink it anyway. The buzz-cut boy is rolling all over the floor like a runaway hotdog, screaming. I stare at my socks, which are peeking out from under my jeans. They are neon orange. I hate neon orange because the color makes my already too-pale face look like a dead albacore tuna. But neon orange socks are alright, I decide, because they are nowhere near my face. Besides, these socks, which are astonishly soft and are made from recycled plastic (I guess), are really warm.

1430: Still waiting. I feel like barfing. It must have been the coffee that did that. The buzz-cut boy is pushing a stuffed toy down onto the face of a baby girl who had been trying to sleep in a stroller -- in front of the baby's mother. Is he going to suffocate her? I expect the baby's mother to slap the buzz-cut kid silly, but instead, she nonchalantly picks the toy off her baby's face and looks over the scene calmly. Wow. The buzz-cut kid then walks over to his former playmate and punches him in the back while shrieking with wild laughter. His former playmate's mother places herself between the two boys. I look around the pharmacy waiting room and wonder if the buzz-cut kid has any parents at all, or if he was just abandoned there.

1445: Still waiting. The buzz-cut kid has been growling and roaring while stalking and pouncing upon people's shoes. My guess is that he is pretending to be a lion or tiger. My neck and head are aching, so I swallow some ibuprofen without water. A man who also is waiting for his prescription to be filled begins shouting in Spanish for the kid's mother to collect her son and make him behave like a civilized human instead of a wild animal. The mother finally emerges from her conversation in the back of the room and claims her brat. Everyone stares at her as she drags him, kicking and screaming, to her chair.

1500: The pharmacy waiting room is still crammed with people, strollers, babies, stuffed toys and kids, but the buzz-cut kid is curiously silent, FINALLY, so things are tolerable -- well, somewhat. I glance over at the buzz-cut kid's mother, wondering if she's sitting on him or has stuffed a toy tiger into his mouth, and was surprised to see that the kid was perched next to her on a chair, behaving like a civilized human child. I overhear another person's conversation and realize that I was supposed to show my medicaid benefits card to the guy who gave my number to me hours ago. I show it to him now and he scolds me for being remiss about this as he types something into his computer. A moment later, he informs me that my card is no longer valid. WHAT? How can that be? I ask him. I just got the card the week before christmas. How can it not be valid? He tells me to go to the hospital's medicaid office down the hall to find out. I look at the number board (108) before reluctantly leaving the waiting room. I am worried that I'll miss my chance to refill my prescription if I leave and that I'll have to get another number and start waiting all over again, but what can I do?

1510: I am in the hospital medicaid office, standing in yet another line before I can talk to someone. But the line is short, so this doesn't seem so bad.

1520: The someone I am supposed to talk to is talking to the man in front of me, who is on crutches, except he really isn't talking to that man on crutches at all, he is talking on his cell phone while the man on crutches leans against the wall in front of his window.

1535: I finally make it to the medicaid man's window and I feel a moment of relief, perhaps a little triumph, even; there, that wasn't so bad, was it? I think to myself. It's only going to take one minute to straighten this mess out. Except the man I am supposed to talk to is on his cell phone again. I resist the urge to shriek while stabbing him repeatedly in the eyeball with a freshly sharpened pencil.

1545: After the man closes his cell phone, he looks at my card and types something into his computer. He tells me that my medicaid card is no longer valid, that it was valid last year. I have to reapply for medicaid for this year. But, I point out, it took more than one year of applying before I got my medicaid benefits card in the first place, and it just arrived, right before Christmas! Look! It's brand new! It's not even worn yet! I take a brief moment to regret missing my golden opportunity to hang around in the nuthouse against my will again, for free. Then I try not to think of all the threats, lawsuits and threats of lawsuits that I endured during the past year because of unpaid medical bills, and I especially try not to think about that one lawyer in particular who threatened to sell all my birds to raise the money to pay my unpaid medical bills. The man gives me a pile of paperwork to fill out so I can apply for Medicaid for 2008. Oh no, I groan inwardly. Not this again! I need a valium for this! As I take the papers, I decide that there is no way that I am putting myself through this hell again.

1550: I return to the pharmacy just as 118 flashes to 119 -- my number. GAH! I go to window 5 and give the pharmacist the script for my prescriptions. FINALLY! It'll only be a few more minutes and then I can get out of here and never ever return -- well, until next month, that is.

1555: After gathering the medications together, the pharmacist informs me that my medicaid card is no longer valid (sigh) and then says that some changes have been made to the usual prescription-filling procedure. It works like this; after standing in line, I give the pharmacist the script for my prescriptions and the pharmacist gives me an invoice. I must take that invoice to the hospital cashier's office down the corridor where I stand in another line so I can pay for my prescription. Then I come back to the pharmacy with the receipt and stand in line again at her window before she'll give me my goddam medications. (Of course, I cannot make this payment in advance, while I wait to get to the pharmacist's window, because the pharmacist needs to give me that piece of paper with the charges on it first before the cashier will exchange my money for a receipt). Oh no, wait in yet another line? I want to shriek. I want to poke a pencil throught the pharmacist's tiny perfect hand. They've never done things like this before; I always paid them directly for my medications. But now, in the interests of wasting as much of our lives as absolutely possible, they've added yet another two lines for us to stand in! When did you start doing things this way? I ask her through gritted teeth. This week, she replies, fluttering her perfect little left hand in front of her face as if I was a pesky insect to be shooed away.

1605: I am in line at the cashier's office only to discover that I am in the "car fare ONLY" line, according to the sign at the front of the line. Instead, I am supposed to be in the other line, the line with the sign that says "pharmacy and clinic payments ONLY". Of course, both signs are invisible, camoflaged behind packages, coats, umbrellas and kids whenever anyone stands in the line. Why can't they put these signs at the entrance to the line where people can see them before queuing up, instead of at the front of the line where we only can see them after we've stood around, waiting, waiting, endlessly waiting?

1606: I've jumped the ropes into the other line and am waiting in the "pharmacy and clinic payments ONLY" line now.

1620: I FINALLY have my precious receipt that shows I've paid for my prescriptions, and now I am back in the pharmacy, waiting in line at window 5 to present this precious receipt to the pharmacist so I can FINALLY claim my medications. I think I should ask my doctor to add a prescription for clonazapam or valium to my medications list so I can better tolerate this new bureaucratic tangle. He'll say no, no doubt, but it's still worth a try. The person in front of me at window 5 is about to embark on her own adventure to the hospital cashier's office. Hurry up and get outta my way!

1630: The ordeal is finally finally finally over. I am trembling as I walk through the hospital corridor to the bus stop. Is this because I am stressed? Frustrated? Starving to death? Who knows. Who cares; it's over for one whole month and that's all that matters. At the bus stop, there are at least 25 people in line ahead of me, waiting, waiting, waiting. Gawd, it's cold out here. The wind makes tears form in my eyes so I can barely see.

1645: The bus finally arrives and .. drives past us all as if we don't even exist. HEY! You forgot something! I want to scream through my watery world.

1650: Another bus arrives. This one stops and opens its doors. By this time, I am emotionally wrung out. I am exhausted. I am frustrated. I am hungry. I am cold. This is another one of those days of my life that I will never get back. I realize (in despair) that my life has been filled with stupid, worthless days that I'll never get back. I wonder what else can possibly go wrong today while I thaw out on the bus.

1705: I have decided to avoid more people and lines and public transit while I blow off some of my excess energy, so I am walking briskly to my post office, 13 blocks away.

1720: I walk into my post office and am confronted with .. another line.



More like this

While I've disagreed strongly with Megan McArdle, she recently wrote one of the more humane pieces I've read in the mainstream media about unemployment and underemployment (italics mine): I was unemployed for basically two years between the time I graduated from business school in 2001, and the…
tags: medical emergency, Finnish Emergency Medicine, Malmin sairaala, Malmi Hospital, Töölön sairaalan, Töölö Hospital, Klinikka 22, Helsinki Finland Ambulanssi Töölön sairaalan tapaturma-aseman edessä, Helsingissä [Ambulance in front of Töölö hospital, Helsinki, Finland] Image:…
The discussion we've had since Friday regarding the Bush administration's latest foray into theocracy brought up some interesting points. We discussed implications of the draft regulations including likely limitations on access to safe and effective birth control. But there is another issue here…
tags: cultural observation, expat life, Life in Germany, Apotheken, Drogerien Expats, immigrants, and people who travel internationally often are impressed with differences between their home country and the country they are visiting or living in. I thought I'd write about some of the daily…

I'm so sorry, Grrl! Can you do some quality cuddling time with the feathered ones this evening? Have you started clicker training? Maybe that would provide some entertainment - see if everyone could be click-treated to do a Rockettes-like leg lift chorus line!

I was worried about you during the Holidays. I feel kind of embarrassed to say that. We don't even know each other. I do know how hard that time of year can be when you've had a bad year though. I find myself wanting to give you advice and ask personal questions, and that's just too pushy for a stranger.

The advice I'll risk, and forgive me if I'm being too personal. It worries me that you aren't sleeping well. Sleep and a good diet are very important things for keeping in balance. There seem to be trust issues here, but consider telling your doctor. You may need to try a different medication or a different combination of medications. I'm not sure if you are doing any kind of talk therapy but if you qualify for it, it might be helpful. My advice is to give it a try.

Okay, enough poking my nose in to somebody else's business. I'm a grandmother; I'm allowed to be a yenta but I exercise that privilege carefully.

By carolyn13 (not verified) on 16 Jan 2008 #permalink

I know what you are going through. Its like you need medication just to get the meds you need.

I know its a damned-if-you-do damned-if-you-don't situation, but if the meds you were taking aren't working anymore let the doctors know.

Its a common experience with BP people taking medication. Its common enough that the term 'breakthrough' is used to describe the situation. I know, I have been through it recently.

God what an absolutely shite of a day for you. I sure hope this one is much better.

Don't read any Kafka-esque novels. Period.
Or....for some might consider writing a few.
You certainly have enough material.
I'm glad all the Repubicans think we have the best medical system in the world. I think THEY are the ones that should be taking the anti-insanity drugs.

I hope you are feeling not so bad now.

Not much I can do to help.

Then again there is :o)
Have a drink on me or even better eat.

By Chris' Wills (not verified) on 17 Jan 2008 #permalink

I'm sorry to hear of all you're going through, both today and over the last year or so. I followed your blog a few years back, got too busy, and just returned yesterday to find this story. Last night I read through your story of the last year, and my heart goes out to you - like others have said, though I don't know you, I sympathize with what you've gone through. I'm glad to see you've pulled through and are still kickin' the (messed-up) system! Best of luck. Know that there are many of us out here whom you've never met, but who are concerned about you. Take care!

By nolabirder (not verified) on 17 Jan 2008 #permalink

Very engaging report.
And boy do I recognise the pull between telling the truth about yourself to a medico and just saying enough to get the medicine that they really had only a marginal role in working out for you anyway.
Why does everything have to be just - so - difficult!

This article could be ammunition for those who are working for a universal public medicine system in the US.

We need national healthcare.

But in the meantime, there's beer.

Be Well, 1&2

By 1hen2ducks (not verified) on 27 Jan 2008 #permalink