Wednesday, July 27, 2005

Ambulatory monitoring

For the past 24 hours, I've been wearing a heart monitor strapped around my waist, a little electronic device about the size of a pocket calculator, connected to various parts of my chest by five sticky electrodes. During the round-the-clock data collection, I carried my very own Patient Activity Diary, a remarkable piece of work in which the patient is instructed to record Actions - exercising, eating, drinking, urinating, intercourse, reading about the secret societies Supreme Court nominees belong to, that sort of thing - and Symptoms - feelings of fatigue, light-headedness, calm, excitement, nausea, revulsion, rage, whatever. The technicians will use this information to help interpret the reams of data in my readout. I can't wait to hear the results.

This was just a small part of the fun of my "new patient exam" at the family doctor I had never been to see before. One of the privileges of regular corporate employment, need I say it, is carrying the insurance card that is the ticket to what is widely known as "health care" but in fact is membership in the Consumer-Industrial Complex. Until yesterday I carried the card in my wallet but I wasn't yet a patient, but today I'm in the system, another consumer of health care, and therefore fair game for an array of lucrative health care products and services.

Since I am so new to this particular meat-processing industry, I can only begin to understand the experience in narrative form. You park in front of the impressive new building, show the all-important card, fork over the copay up-front, and fill out a couple of forms. The physician's assistant sees you first, weighs and measures the patient, takes its blood pressure, gives it the standard-issue humiliating multi-colored clown-gown, and hooks up 12 tape-on electrodes to record a quick electrocardiogram. More about that later. Minimal chit-chat, minimal explanation. Don't talk, just sit quietly and nobody gets hurt.

The doctor comes in, nice to meet you, how are the kids, gee they were in high school when she first saw them, that's just great. Some straightforward questions about family history, any special concerns, allergies, surgeries, joint problems, exercise habits, do you smoke, do you drink, and what does your wife want you to check out? I say my wife is more concerned about my mind. The doctor, who is a dead ringer for the actress Jeneane Garafalo, mutters audibly, "Is he being serious?"

The witty and personable doctor sees an atrial flutter she doesn't like in the EKG, so she has the assistant hook you up to the 24-hour heart monitor (remember the cardiac monitor? This is a story about the cardiac monitor) and send you on your way. But not before drawing a couple of vials of dark blood for liver, kidney, prostate, and cholesterol screenings; a Coloscreen kit for stool samples; directions to the radiologist for a chest X-ray; and the names of the gastroenterologists who will be calling soon to set up the colonoscopy. Any questions? Yes, am I free to go now? That at least got a smile out of the surly assistant.

Some part of my brain "knows" abstractly that none of these really simple medical procedures is news to anyone reading this, and to many of you, women in particular and women with children especially, THIS IS NOTHING compared to the poking and prodding and probing you've been through. It's been so easy for so long to keep my distance from doctors that it's a bit of a shock, and now that I'm in the system, I'm sure that trained professional army of health care providers will find plenty of things my over-50 carcass requires.

3 comments:

David said...

As you may know from reading one of my recent posts [me, Me, ME], I am no stranger to doctors and health care. Certainly my intestinal adventure this past spring reawakened me to the world of health care.

But, I try to avoid doctors when I can--much to the concern and disapproval of my wife.

Oh well. Doctors are only playing a waiting game with God anyway.

Man, I am in a fatalistic mood today.

Sven Golly said...

Burb is much too charitable. By my lights, doctors, hospitals, insurance companies, medical laboratories, medical equipment and supply companies, drug companies (shall I go on?) are playing a high-stakes game of chicken with all of us - I can't speak to the God game. Caveat emptor, and all that.

Sven Golly said...

And ironcially your fatalism is probably easier on your cardiovascular and other systems than my rage at the machine that profits when things go wrong.

There's a hospital in El Paso called the Hotel Dieu.