They Didn't Mind The Quack Quack Quack

Kaiser Permanente is a highly regarded health maintenance organization, and I like them well enough. Certainly I do not count myself among all those whiners you hear complaining about how they took off the wrong leg and stuff, like they're so perfect. I mean, they can do that only once at most, and then it's problem solved.

They've never offered to take anything off of me. I had a fatty deposit on my eyeball once that they figured could stay put. Got something they call fibroid tumors growing inside me and something else hanging out of my urethra like a damn pee deflector, and their surgeons won't get out of bed for any of those, either. They won't even slice off the mole where my eyebrow used to be. Sucker is big enough to throw shade but the only C-word they keep using is "cosmetic." During my colonoscopy, everything looked so good that they not only didn't nip anything out, but they didn't even need to clean the itty bitty camera afterwards. All they ever do when I point out potentially fatal conditions is offer to keep an eye on things.

That's the real problem with Kaiser. They never find anything wrong with me. I've explained to anyone who still listens that there's something wrong with my heart. It skips and flutters and doesn't kick in on a hike until I've gone a quarter mile or so, when it finally says oh fine and starts working again, and sure, then it gets me up a mountain and back, but you can't tell me people don't die in the first quarter mile. They do.

The doctors humor me. They've stuck electrodes on me and put me on a treadmill and hooked me up to machines and did a lung function test and most anything I've asked them to do, and everything always comes out just fine. They're quacks.

Take the other day. My crustacean tubes have been clogged up since I got the flu in February, so I consulted the Ear Nose and Throat contingency. They gave me a hearing test. They stuck doo-dads in my ears and disappeared into a different room and had me push a button when I heard things. Well, evidently, they haven't seen such a good hearing test on an old lady in ages. They couldn't stop gushing about it. Evidently, I could track whales from fifty miles inland. But heck. They stuck the sounds right in my ears. I'd like to see them try it from a few yards away, behind the crustacean tubes' backs.

That's what the nurse-lady did when I was taking my physical exam for postal work back in the '70s. She got at one end of the hall and asked me to repeat what she said, getting softer all the time. "Pancake," she said. "Pancake," I said back. "What?" she said.

That's how you conduct a hearing test. Well, it was silly anyway. Letter carriers never listen to anyone. They had us lift a seventy-pound sack, which was at least germane to the job. For the rest, they could have just dispensed with the physical and issued us bullet-proof vests, and we'd have been fine for anything that was likely to come up in the station.

So the ENT doctor came in and said more nice things about my hearing test and looked in my throat, where he claims he saw my crustacean tubes winking at him and looking tip-top, and then he looked in my ears and told me, breathlessly, that I had beautiful ear drums, and wrote me a prescription for Flonase just for the hell of it and called it a day. They're all about the flattery, Kaiser. Apparently I am a pink paragon of perfection.

Basically, they don't think I'm ever going to die of anything, and that's just medically incompetent. They have no credibility. I'm not buying any of it until someone peers down my throat and up my butt and between my toes and tells me it looks like I have a touch of being about to be hit by a bus.

And they're going to want to keep an eye on that.

Giving Kaiser The Finger

Dave's middle finger just blew up. It had always been knobby since the day he mishandled a line drive and smashed the last knuckle to bits. But although that injury ended any career he might have had as a pianist, his finger has more or less behaved itself through the years. Until a few weeks ago. That's when, for no reason, it started to swell up. It got huge and round and pink on the end. It looked like--well, it looked like he might be able to make a good living with it in the, uh, personal services field.

And it hurt. I could tell only because after the third day or so he casually mentioned that he was going to walk over to the emergency room with it. That means Kaiser.

We have Kaiser insurance because that's what I had all those years and I liked it. Dave was always on Blue Cross and thought the world of it, but after we retired I had the better deal. It would cost significantly more to keep the Blue Cross. And all that stuff about Kaiser taking out the wrong kidney or sawing off the wrong leg, well, that hardly ever happened.

But Dave doesn't like Kaiser. He doesn't like how it takes a while to get an appointment (although that only applies to routine appointments, and urgent matters are handled expeditiously). He doesn't like that you have to go through a gatekeeper to get anything done. He doesn't think you should have to see your internist to be referred to Dermatology when lichens are growing on your face. He thinks you should just be able to walk into Dermatology and point at yourself.

Basically, Dave is pissy about Kaiser. And there's no reason to be. They've always done right by him, unless you count that time he had to get a big cyst drilled out of his testicle and they did an excavation and then he had to sit on an ice block for like three months and pop Vicodin like Tic-Tacs to keep from blacking out and finally he went back and said he really thought he should be feeling better by now, and could someone take a look? And someone did, and said everything looked just fine, implying he was a big whiner, except for that big cyst in his testicle, and maybe he should think about having it drilled out. So they drilled it out again, and did a thorougher job of it, and he was only out the two co-pays and a lost half-year  of happiness, or so, but still he brings it up.

Kaiser emergency is only about six miles from home so he walked over there and went through the door, finger first, so as to get the most attention. The first person to attend to it was concerned. She handed him the Pain Scale sheet, with its Graduated Grimace illustration of pain levels, from a slight wince to a rictus of agony. "On this scale of one to ten, how do you rate your pain?" Bad question to ask Dave. If Dave had posed for the illustrations on the one-to-ten scale of pain, the face would have looked exactly the same for all ten levels, and then in number eleven there would be big X's over his eyes. Dave drew a breath and delivered a treatise about the subjectivity of the perception of pain and the impossibility of determining anything useful from such an exercise when there was such a wide range in the abilities of people to withstand discomfort, and what is a pain threshold, anyway, is it something empirically measurable or does it reflect a level of stoicism or--let's be honest--strength of character that has become sadly lacking in this pampered modern world wherein happiness is considered an entitlement?

She told him that maybe he could go home and take a couple of Tylenol and see how it goes.

After several days on antibiotics...

"Nine," Dave said.

So then stuff started happening right away. He was diagnosed with cellulitis, an infection so dangerous that there was a possibility of gangrene, brain fever, unsightliness, and several versions of death, and he had antibiotics introduced intravenously and someone lanced a tub of pus out of it and he was sent home with more antibiotics and Vicodin. Took one of them, too.

It's looking a lot better now, not that it will fit between the black keys. I'm proud of him for going in, and I'm proud of Kaiser for doing such a good job, not that you'll hear that from Dave. He's the perfect man for me. I need a man with a high tolerance for pain. I hope the swelling doesn't go down too much.

Happy birthday, big guy. You'll always be my old man.