Disability: A Brief Rant On The American Medical Establishment

[Content Note: Pain] 

Yesterday, on a Friday, I had stomach pains so intense that I was convinced I was dying. I did something that I have never done in all my adult life: I went to the Emergency Room. (Emergency Rooms are expensive, Ana. We don't go to the Emergency Room unless it's life-threatening. Are you sure it can't wait until Monday?)

At the E.R., they agreed to give me medication to dull the pain, probably because the muffled screams and moans ripping out of my throat were disturbing the other patients. But this took about thirty minutes to occur, during which they made sure to run my credit card and insurance to make absolutely sure I could pay for the medication.

After the pain medication brought me down from a 12 to a 4, they wheeled me into a CT scan and declared that they had no idea what was wrong with me, but that it wasn't life-threatening. Just very, very painful. Ulcers, maybe. Or Irritable Bowel Syndrome. Or any number of other things. I needed to see a gastro/stomach specialist to find out.

"What about the pain?" I asked. The pain was still clearly there, under the haze of the drugs, and threatening to come back any minute. Not to worry, the E.R. doctor said -- he would prescribe a mixture of Maalox and Lidocaine (a numbing agent they use for tattoo-work) to coat my stomach. It would get me through the weekend until I could see a specialist. They sent me off with a prescription, and the medication worked.

Then I took a closer look at the bottle. "Take every 8 hours." There were four doses. I'd already taken two doses, just to get me through Friday. One in the afternoon when the drugs from the hospital wore off and one that night so that I could sleep through the pain. It was Saturday morning and the pain was coming back. I can't possibly get in to see a specialist until Tuesday at the earliest.

I called the pharmacy, which closes on Saturday at 1 and isn't open on Sundays. They needed the prescribing physician to call in the refill. I called the hospital. The prescribing physician isn't there today. I asked what the process is for calling in refills via another doctor and a nice doctor told me that the hospital "doesn't call in refills" and that if I wanted a refill I would need to come in to the E.R. for another visit.

"But I'll have to pay the E.R. co-pay again," I protested. "I can't afford that!"

"The E.R. is expensive, I'll give you that," he said, in the same tone of voice as if he was admitting that while Florida is a lovely place to live, it is humid (I'll give you that). He told me to call my primary care physician, who isn't in on Saturdays. He suggested that the weekend-on-call physician could help.

I called my weekend-on-call physician. I explained the situation to the nurse. I just need a totally-not-restrictive-nor-dangerous medication called in to last me over the weekend because I'm in terrible pain and I can't afford to go to the E.R. again. "It's the physician's practice not to issue prescriptions over the weekend," she said apologetically. I waited in agony. "I know it kind of defeats the purpose of having an on-call physician," she added with embarrassment. She told me that maybe the pharmacy would issue a refill anyway, if I promised to have my primary doctor call in the prescription retroactively on Monday.

I called the pharmacy. Of course they can't give out prescriptions without a script. The asked the name and number of the on-call physician and promised to call them. "Sometimes they'll talk to pharmacists when they won't talk to patients," she said soothingly. Trying not to get my hopes up. Hearing the tears behind my voice. Promising to call me back.

I'm still waiting for that call. 

I love America. I'm proud to be an American. But I hate every aspect, every detail of the American medical establishment. Not the people who make it up, most of whom seem like nice people. But the for-profit rules and regulations which turn nice people into unfeeling paperwork zombies.

Zombies who will suggest that I spend hundreds of dollars and waste hours of the E.R. staff's time to come in for a "visit" just so I can get a refill on a prescription that is in no way dangerous or controlled and which costs $25 without insurance. Medication I could probably mix myself if I knew where to get liquid Maalox and liquid Lidocaine (neither of which are controlled substances) this time of day.

Meanwhile, I'm in the kind of pain that feels like dying feels like. But it's not life-threatening, so tough it out until Monday. Or whenever you can get someone to take your call.


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