A Serious, Perhaps Dangerous Case of Reform Fatigue

I have avoided writing here about my new healthcare problem because I thought it would be too self-serving, but I don’t feel I can hold this in any longer. I am just really, really tired, overwhelmed, a little scared, sometimes even exhausted. I know, I know…I am an oh-so-popular-big-time healthcare blogger (one person other than my Mom read last week’s entry!), and the power players of healthcare reform are just hanging on my every word. So I am supposed to be energized, passionate, and committed to reform. But I am just so fatigued—ready for all of this to be over—ready to change the proverbial channel.

Honestly, I’ve been ignoring these symptoms for a month or more, but I finally called my doctor’s office to try to get an appointment last week when I saw something online about how serious my Reform Fatigue could be. I thought it was just stress, but who knows, could be much more serious than that. After all, Google came up with 198,764,145  possibilities. I’m not that worried, but, then again, it could even be terminal, according to my friend’s brother who heard something about this kind of thing while playing golf with a doctor’s sister’s friend. So I figured I better have it looked into by a professional.

I am relieved to report that Dr. Hurray finally fit me in this morning after I left twelve voice mails for his nurse and faxed over the stack of lab results given to me by the specialist Dr. Hurray had asked me to see before I came to see him again. (I think I left some of the papers in the specialist’s waiting room, but how important could those be anyway?) Traffic was just awful this morning going over to the clinic. It was a miracle I got a parking space—some guy in a wheelchair tried to slip his van into the space that I had been waiting on for ten minutes. Sheesh!

The waiting room was a can of smelly sardines with everyone sneezing and coughing in my face. My god, there were sick kids running everywhere acting like 4^th graders or something. “I waited a week for this?” I thought to myself. There were eight people in front of me for the check-in, but after ten minutes, I had finally made my way up to the little sign telling me to “Please Wait Here Until Called, Out of Respect for Other Peoples Privacy.” (What is it about people not using apostrophes correctly anymore?) More waiting. And I could have shot the idiot in line in front of me who couldn’t find his insurance card, had had unprotected sex with a woman he met at a bar last night, and was there to see a doctor about potential STDs. I mean, that is so 1980s. All of us in line were embarrassed for him.

Finally, I got up to the window which the attendant slammed shut in my face, pointing to the pen and notepad to sign in, as I frantically looked around for hand sanitizer. The window swept back open with a grating metal noise, and Darth Receptionist thrust a clip-board in front of me. “I need your insurance card, and fill all of these out, and we’ll call your name in a little bit.” She retreated behind her glass fortress, closing the drawbridge to lock out me and my band of personal space invaders. I was concerned about the words “a little bit.”

I had just filled out the same form last month when I was in for the flu. But I dutifully tried to remember and spell the nine medications I take regularly, the last decade I had had a tetanus shot, and whether it was 1973 or 1974 when I had broken my elbow from that terrible fall off my bicycle when Billy Jones pushed me. Hmmmm….“reason for visit today?”…I wondered what to say. I mean, if I marked anything in the “Mental Health Problem” section, then someone…my wife, my boss, some sneaky blogger, even the CIA…might get the data somehow and jump to the wrong conclusion. I’m not depressed, after all! So I just put down “fatigue” and “shortness of breath” in the blanks provided at the end of the form.

I stepped away from the window, searching for the most solitary seat I could find. It’s like scanning across a police lineup looking for the person who is least guilty of being sick. Ah, finally, the back left corner where the light bulb was burned out and the air conditioner blower was setting a new wind tunnel record. “I’d rather be cold and alone than sitting in the sick section,” I thought to myself with a sense of satisfied victory. I sat down to wait. About 15 minutes later, this huge woman with Kleenex stuffed in the top of her blouse tried to sit next to me and grab the dog-eared copy of People magazine that was on the table, but I was there first. I frowned and grabbed the magazine (unfortunately, it had Michael Jackson on the cover…from 12 years ago…when he was still alive and looked almost human). Then I hocked up the best tuberculosis-sounding cough I could muster, which drove her into full retreat. My drama degree was paying off.

About 30 minutes meandered by, and I didn’t hear when the nurse called “James!” until about the sixth time. I go by “Eric,” my middle name, but they just can’t seem to get that straight after 10 years of my going to the same clinic. She escorted me back, thrusting the thermometer into my mouth and nudging me up on to the scales to weigh me.  I almost gave a “moo” for effect, but decided I better not tick off the person who might have to give me a shot or blood draw later. “189 pounds!” she disdainedly (that should be a word!) announced to the entire office staff. She didn’t seem to care that I was wearing heavy clothes, my Ipod, my cell phone, my wallet, and what must have surely been 18 pounds of change in my pockets. Whatever happened to scientific rigor and accuracy in measurement?

She rustled me into the arctic chill of exam room 5, told me to put on a gown (now she asks me to disrobe, once she has already bungled my burdened weight!), and said, “The doctor will be in, in a few minutes.” I knew that wasn’t true. I could hear him trying to explain to the poor woman in the next room, who clearly didn’t understand much English, what a hemorrhoid was. I took a mental note not to shake his hand. I don’t care much for Sports Illustrated (interestingly enough, there was an article in it about bicyclists avoiding hemorrhoids), but hey, Tiger Woods was on the cover, so I read the April 2006 issue to catch up on my current events.

Finally, Dr. Hurray hurried in with “Hello, James, how have you been?”

“Eric,” I replied.

“Huh?”

“I go by Eric,” I repeated.

“Oh, yes, sorry Eric. What can I do for you today? It says here you are having stomach cramps.” He seemed reticent to touch me. (The feeling was mutual.) Come to think of it, I can’t remember when Dr. Hurray has actually touched me in the past two years of visits. He just asks me questions and gives me prescriptions, but never actually does an exam.

“No, that’s someone else’s chart. I came in because I’m a little, well, um, fatigued and have some shortness of breath.” He sheepishly put away his papers, scrambled through some other official-looking papers in a chart, and said, “Ah, yes” with confidence that didn’t convince me he was really looking at my chart. “Tell me what seems to be the problem. When did you notice the shortness of breath?”

“Should I tell him about the mood swings?” I thought to myself. No, no. Not yet. “Well, I was reading a newspaper at the time…it was the Wall Street Journal…about the trillions of dollars of debt expected over the next decade from the healthcare reform bill.”

“I see,” he said he saw. “Anything else?”

“Well, I am just really, really, really tired. More so than usual. Just overwhelmed a bit…not really sad or depressed mind you…but moody.”

He jotted down a note with a concerned look in his eye. I wished I hadn’t said the word “moody.” “Tell me more about the moodiness,” came his next question. Damn.

“Well, uhm, one minute I am really excited about healthcare reform, then I’m way down about it…though, of course, never actually depressed…and then I am way up again.”

“That could be something,” he mused. “Any other symptoms?”

“My blood pressure medication usually keeps things pretty stable, but I just find it boiling at times. Like when I was watching the news stories on the death panels. And when I heard talk radio going on about communism while driving home from work the other day.”

I thought then, at that moment, he would actually touch me, actually do something, you know, an exam. But he deftly wielded his stethoscope to listen to my breathing without his hand actually making contact with me. It’s not like I wanted a bunch of probing, mind you, but I’m thinking this guy is in the wrong profession if he is scared to touch patients.

“Sounds interesting. I’ll be right back,” he promised as he scurried out of the room like a cockroach running from the hallway light.

About 20 minutes later (I could hear him re-explaining hemorrhoids to exam room 4, promising he would call her at home in a few days to check in on her), he came back in the room with a glossy brochure. “You have Reformania Exhausticitis…it’s a new disease…but I’m seeing a lot of it these days. It’s nothing to worry about, there’s a very harmless new drug you can take that will clear it right up.”

“What is it?” I asked.

“It’s called Complacencia,” he said as he handed me some literature, and I suddenly felt like I was in one of those awkward TV commercials that plays during the six o’clock news.

“Can’t I just have an antibiotic? Or is there something else I can do without having to take another pill?” I pressed.

“No,” he retaliated, and handed me his scribbled prescription on a piece of paper. “Here, I’ll give you some samples to get started. And I’ll call you next week just to see how it is going.”

Ah, free samples. Music to my ears. I felt like I had won the Pharmacological Lottery. I embraced my swag, reading the pretty, glossy font: “Complacencia: That Little Something to Restore Your Satisfaction with the Status Quo.” It went on to explain how the medication could help me stabilize my reform moods, fend off my cravings for real progress and change, and better manage my tolerance for mediocrity.

Clutching my prize, I took the first two pills right then and there, and by the time I reached the parking lot, I was ready to get back into the trenches of healthcare reform…hungry for more of the same. Once again, the miracle of modern medicine had shown me its awesome power.

Notice: Complacencia is not for everyone—use only as directed by a physician. May cause drowsiness or excitability, especially in adults who act like children. Some patients report dry mouth, wet mouth, constipation, diarrhea, sadness, happiness, the urge to gamble, the urge to stop gambling, and a propensity to want to just sit around and watch television. Do not use Complacencia if you are an activist, reformist, concerned citizen, or employed in a job where you need to be highly motivated. Ask your doctor about taking Complacencia if you are already taking optimism-reducing medications such as Headlinea, Partisinia, Prodeficitia, or C-spania. Extreme liberals and conservatives should not take Complacencia for more than 30 days without consulting your doctor. Moderates should not take Complacencia, as it can cause an overdose of complacency that can be fatal. Have a nice day.

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NOTE:  ERIC DISHMAN'S 'HOME BLOG' PAGE HAS MOVED TO:  blogs.intel.com/healthcare.