Along the Tracks

Wednesday, August 20, 2003


Ever have one of those vacations where you come back ... with an edge? One of those keep-expectations-low-but-stay-positive-and-hopeful-that-fun-will-be-had-only-to-get-stressed-out-all-over-again-on-the-way-home kind of vacations?

That’s what I just had. And then the first day at work was a !@$#%@&!*@! to really top things off.

Anyway, I’ve got an attitude going, so don't be surprised to see bushels of sarcasm heaped on several metric tons of pent up rage in my posts, columns, articles, McDonald’s orders, etc.

Even so ...

It’s not as if the vacation itself was a disaster. We spent two days plus on Long Beach Island, New Jersey, and while it was a bit crowded (Surf City), there was plenty of room for lyin’ in the sun, taking a swim, drinking a beer and watching the tide roll in and out. I even got up early Friday to watch the sunrise - spectacular - and got the bonus of seeing a couple smallish whales swim leisurely along the shore. Later that day, we spotted a group of dolphins about a hundred yards off shore, hopping along in the lukewarm waters. We picked up about a ton of shells for Miah and Clair (I missed both terribly), got nice tans (without burning!) and in general had a good, relaxed time.

One of the “stressers” on that trip home was a major (I assume) accident on the Pennsylvania Turnpike which had traffic backed up for miles at almost a complete standstill - it took us an hour to get from a rest stop where the jam began to an exit two miles away. We took the exit and found an alternate route to another interchange past the accident. The new path, Route 30, wound its way over and through the mountains, and views were great. As it so happened, we also were brought within a couple miles of the crash site of Flight 93, so we decided to visit. That was quite an experience - if ever there was an “American” memorial, this was it. The plaques, posts, slabs and other remembrances, some done with exquisite professionalism, some exuding simple, heartfelt emotion, seem to emerge from the very soil. It is a planting. The care given the site by residents of Shanksville, Pa., is plain to any visitor, like a well-kept garden. The United States loves grand memorials, as the World Trade Center design competition attests, but I hope the Flight 93 families, the people of Shanksville, and all Americans agree to allow this site to remain a “people’s memorial,” created and maintained by folks who care - who do it not to be paid, but because the site means something to them.

Doing okay

My mom, that is. Apparently there is a new medical intervention system, which I will call “lightning surgery.” It works like this: You beg and plead and cajole and demand a surgical procedure which you believe you need (and perhaps your doctor also believes you need), going through all the hoops of insurance, government, specialists, hospitals, etc. After a year or so of this, with no apparent hope on the horizon, you move on with other things requiring attention, and put the surgery on the back burner.

Then “KUH-RAAAACK!!!” - lightning strikes. The surgeon with whom you’ve discussed the procedure says he’ll do it, damn the torpedoes (insurance, government, etc.). He’s open for Wednesday, does that work?

That’s right, from back burner to full-fledged boil-over on the kitchen floor. Now everything else must be shoved aside so that surgery can happen approximately “now.” Have a job? Call in sick for the next month. Family? They’ll fend. Other important, long-scheduled events, medical treatments, financial commitments, etc., on the agenda? Not anymore!

Don’t get me wrong: I certainly don’t blame my mom. After all, what choice did she have? Get it now or get it maybe never, basically. The surgery she needed was a gastric bypass, which is still considered somewhat experimental and, alternatively, cosmetic rather than medical. Trust me, this was medical. And while our family was concerned about the procedure itself, we all certainly understood the need for Mom, whose health has been shaky at best in the past few years, to lose the excess weight and all the bone, muscle and joint problems which come with it. She has tried, really tried, many times to diet, to exercise, but nothing seemed to help. I would tend to agree with those who say there is a willpower factor involved here, but pointing to it doesn’t answer the problem (and in fact she has tried a number of “mental conditioning” methods of weight loss, to no avail). While we may not have been entirely comfortable with this particular surgical technique, we all fully agreed some form of intervention was urgent.

So, WHAM-BAM-BOOM and Mom’s scheduled for the gastric bypass - on the day we leave for Jersey. This is where the “lightning surgery” becomes problematic. Yes, Mom was going to get it done no matter what, but she - and her family - should have had an opportunity to plan for it, to get things in order. It’s not like a doctor suddenly said, “Woah, you need this stat!” The doctors were in basic agreement she needed this at least six months ago. The problem was all the bureaucratic paperwork necessary to make it happen. Insurance, Medicare, hospital requirements, doctors' requirements, etc. ad nauseum. When it looked like all the avenues had been exhausted, and the surgery was not going to happen for the foreseeable future, Mom dove back into her job, scheduled some shoulder surgery she needed after a dislocation last winter, helped dad plan for roof work on the house this summer - you know, pretty typical stuff. Then BOOM! Life-altering but non-emergency surgery in two days.

What kind of a screwed up system is this, anyway?

Mom’s home as of yesterday, and doing pretty well. Dad’s handling the caregiver duties with no problems. And with a little luck, the procedure will prove to have been effective and the “inconvenience” of short-notice surgery will be happily dismissed. Yet even now, Mom is uncertain what her share of the surgery and hospital cost will be, what specific regimen she will be following during recovery, what other costs, and even procedures, may be required in the coming months and how they will be split between insurance, Medicare and her own bank account. Again, this was elective, not emergency, and it seems ridiculous that the doctor, insurance companies and government are incapable of offering a clear-cut procedure to such monumental decisions that allows some lead time to prepare before surgery.

It could be worse, of course - no surgery at all, or surgery after waiting for four years. But the reason we Americans have generally enjoyed top-notch health care (if not health care “system,” something entirely different) is that we demand it. Cutting slack because others perform even more poorly only guarantees our eventual slide into mediocrity.

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