On Christmas Eve, I took the dogses for a walk around the block. Precisely halfway around, I got sharp icy pains in my chest.
When you had a triple-bypass earlier that year, that’s a cause for sheer terror.
I wasn’t quite sure what to do, as the icy pain was not entirely unfamiliar. The cardiac rehab folks had informed me that my lungs had likely collapsed during surgery, and the nerves that controlled reinflation had been slightly damaged. Plus, the beta blocker I’m on has a known side effect of shortness of breath; they cannot give it to patients with emphysema. As a result, any time I’ve walked outside in cold air, I’ve had icy pain and an instant asthma attack.
Maybe this was an asthma attack.
But this was bad.
But it was very cold.
I got back to the house, and of course the immediate snap-call is “GO TO THE EMERGENCY ROOM.” Right? Well, except that if you’re a heart patient and you complain of chest pains, you get kept in the hospital for two days while they monitor you. And if it turns out to be wrong, well, we just finished paying off $5,000 in ER charges from a false alert earlier. And I have no sick days left at work thanks to two and a half months of sick leave.
If I’m wrong about what’s happening, we fuck our finances and my job security.
If I’m right about what’s happening, I’m dead.
That’s one hell of a tense discussion to have, but it needs to be had – that balance between “What you should do” and “What you can afford to do.” And if you’re a heart patient, you deal with chest pains all the time – every time you have gas or an ache in your arm, you wonder, is that the end? And you catalog that pain against the pain of the one time you had a for-real heart attack and try to determine if it’s the same thing.
Of course you should go to the ER.
Of course you don’t have $5,000 sitting around every time you have pain.
And you panic, which doesn’t help, so you’re sitting there thinking, “My heart is beating so fast,” which of course it is, you idiot, you’re terrified something really bad is happening, and your wife gets you a warm cloth to breathe through so your lungs warm up a little, chiding you gently that you should have worn a scarf, which of course you should have but in 44 years you’ve never needed a scarf, it’s a habit you need to develop before walking outside, but you had all summer to feel like you’re a healthy human being which of course you’re not.
And she gets you an Ativan, which is in itself a danger because what if you feel so good that you overlook The Big One, and you both agree that you will lie down for fifteen minutes with your wife cuddling you and if the pain subsides then it’s probably not worth $5,000 just to verify.
And I have decent insurance, mind you. It’s just that they run an awful lot of tests on you, if you complain about this sort of thing. They don’t fuck around. And the bill has to go somewhere.
And after a half an hour, we decide that it’s probably just the cold, and sure enough when we go to church the next day on Christmas morning, it’s fifteen degrees out and the same icy pain manifests in my chest when I step outside. That’s a new kind of pain. That’s the asthma pain. I’ll have to ask the cardiac rehab folks about that on Friday.
This is what I think of when people talk about “the health care system works!” and I want to punch them. Yes, I have access to the BEST CARE IN THE WORLD. Literally. The Cleveland Clinic is world-class, and the surgeon I got was one of the masters at bypasses.
But I have to pay for it.
And I’m well-off, man. We’re both professionals in this house. We’re not rich, but with a lawyer and a computer programmer at the helm of La Casa McJuddMetz, we’re above the curve… and we balk at making decisions that could cost us our lives because the bills are a lot. I have a good job that is understanding of massive problems, who were pretty wonderful about not just giving me time off to recuperate but then let me go to Hawaii. (Admittedly, the Hawaii trip had been planned well in advance, but still.)
And I wonder what it’s like for the guy with the $10 an hour job down at the loading dock, or the minimum-wage clerk at 7-11. People with employers who see them as slots to fill. There are people in America who are dying because they have to choose between “Is this pain serious enough to risk getting fired?” and that is a real risk.
Obamacare is a step in some better direction – maybe not the best, but certainly better than the current Republican solutions of, “Well, preexisting conditions and medical bankruptcies aren’t that big a problem.” Yet it’s still too small. The bills still pile up. The jobs can still fire you if you’re too inconveniently sick. And when you have no job, those bills snowball.
I want socialized medicine because I’m one of the supposedly privileged class, and I have to balance risk versus expense. I made it; no worries, I’m fine. But somewhere, there’s a guy who has less ability to pay those bills, and a suckier job, and a real heart attack. And he just died because he made a judgment call that he had to make, and it didn’t quite work out.
That guy deserved to live. Call me a dreamer, but in a country like America with all of our wealth and know-how, I think we should be able to find a way to help that guy. The Republicans keep telling me that guy is the salt of the earth, the kind of real American who keeps us going, the laborer who works twelve-hour days and never asks for help.
I think he deserves better choices.
Cross-posted from Ferrett's Real Blog.This entry has also been posted at http://theferrett.dreamwidth.org/363867.html. You can comment here, or comment there; makes no never-mind by me.