Archive for February, 2009

Adventures in Healthcare

Spent most of Wednesday in the hallway of Community Memorial Hospital.  No, they didn’t forget me on a gurney.  Sweetie was there for an angiogram.

For those who haven’t had the pleasure,  an angiogram is an x-ray that uses a special dye and camera to take pictures of the blood flow in the arteries near and dear to your heart.  A little puncture near your groin.  A teensy tube inserted in a blood vessel.  Noxious dye coursing through your body.  Medical exploration of your most private parts.  People who have really poopy x-rays sometimes have their chests split open for what is jocularly called triple or quadruple bypass.

Our arrival at the hospital was the end of a long journey that began one evening several months ago as we sat on the couch watching TV.  Sweetie suddenly straightened up, stiffened and complained about chest pains.  “They’ll go away, like every other discomfort”…we thought.  After ten minutes of feeling my blood pressure rise beyond the limits of my sphygmomanometer, I said “Put your shoes on, we’re going to the ER.”

Most people headed to an ER hop in the car and in less than five minutes arrive at that place of refuge.  But not if you live in the Upper Ojai.  You wind down Sulphur Mountain Road avoiding boulders that have fallen during the night,  get onto Highway 150 behind a hay truck driven by a myopic senior, crawl down the Dennison Grade, drive through Ojai’s stoplights…red of course, and eighteen minutes later arrive at Ojai Community Hospital.  It’s the longest eighteen minutes of your life.

After three hours of pokes, jabs, tubes, electronic invasion and fixation on the monitor attached to Sweetie, her condition was determined to be a muscle spasm.  Whew.  But alas, the EKG was inconclusive.   Doctor ER, in telephonic consultation with Doctor Cardio, determined that it would be prudent for Sweetie to pay a call on the heart guy.

A few days later, we visited Doctor Cardio.  ” Hmmm, he said.  Need more information.  How about a nuclear stress test?”  Again, for the uninitiated, a nuclear stress test involves injecting a nuclear isotope in your arm that makes you glow in the dark.  It helps the scanner to more clearly see what’s going on inside your cute little body.  So, being obedient patients, Sweetie glowed.

“Hmmm”, Dr. Cardio said after the atoms had done their work.  Looks like we need more information.   “Up for an angiogram?”  I was beginning to tire of “hmmms.”  The alternative was an impressive sounding 64 bit cat scan.  A recent development performed by a doctor who spent two months in Germany learning how to generate new revenue.  But the results might still be inconclusive.  “Hmmm” we said.  Off to angiogram heaven.

Bright-eyed at 4:30am, we rose and shone.  Had to be at the hospital in Ventura at 7 for a procedure that was to start at 9.  Musn’t be late or we’ll miss our spot in the angio line-up.  In the car before sun-up.  Merrily on our way.  Arriving before 7 we checked in with admitting.  Fortunately they knew us.  “Sit, please…it will only be a moment before one of our people leads you to the promised land.”

Wham!  Lights out.  Transformer blows.  Power gone.  Emergency lights on.  Surely they aren’t serious.  After all this and Edison conspires to cheat us of our long awaited appointment with the cath lab.  Thirty minutes in near darkness.  They’re going to send us home, I thought.  Bastards.  Do it all over again they’d say.  Not on your life I’d say.  We’re going to stay here even if it means sleeping on the floor.  I’m not going through this again, I selfishly thought.  We’re going to poke that hole in Sweetie even if I have to do it myself…in the dark.

Forty minutes since lights out.  But wait.  Coming towards us is an angel of mercy.  She must be an angel, I thought.  She appears to be at least 80 with a cute pink outfit.  “Come with me”, she intoned.  We went.   “Sit here.  I want to take your temperature.”  Good thing it wasn’t my blood pressure.  After trying twice to take Sweetie’s temperature, she muttered “hmmm” and left us alone…in the dark.  Not a good sign.

Finally, off to the prep area.  Blessedly the lights sprang to life.  A succession of lovely angels of mercy paraded through the room.  Major accomplishment was the delivery of a styrofoam cup of coffee…for me.  It wouldn’t have mattered if it was last week’s cold coffee.  I consumed it.

Two more hours in prep seemed designed to raise our expectations, our appreciation of the complexities of hospital procedures, and our stress levels.   But, relief was in store.  When our original ancient pink lady announced that our Dr. Cardio was also her mother’s cardio, Ila turned to me and said “her mother’s still living?”  I wet my pants.

The IV nurse showed.  “I am an excellent IV nurse.  It’s what I live for.  I don’t rummage around in your arm like those other neanderthals looking for the holy grail.  I look closely, explore with my eyes and then I stick you.  You won’t feel a thing.”  Know what?  She was right.  It pays to advertise.

Two hospital orderlies with biceps the size of both my thighs arrived.  All aboard the gurney, Sweetie.  You’re off for your long awaited tryst with Doctor Cardio and his merry band of explorers.  Kiss, kiss.  See you soon.  Have fun.  It will all be OK.  I promise.

A woman who looked strangely like Nurse Ratched said it would be an hour before Doctor Cardio would arrive with any news.  “Sit in the x-ray waiting room…you know, the one with the hard chairs, no reading material and a few hundred others who look like they’d rather be somewhere else.”

An hour.  Hmmm.  Must be a way to get a real cup of coffee in this institution full of revenue generating medical marvels.  The promise of sustenance lay in the basement.  A full cafeteria.  Home away from home.  But not at 10:45 in the morning.  It’s between meals.  No food.  But, wait.  There’s a coffee machine…undergoing an angiogram of its own.  Busted.  Won’t be up again for an hour.  Suffer, buster.  Might as well wait in x-ray’s Devil’s Island.  Sat there for fifteen minutes doing nothing.  The clock never moved.

The door where only angels are allowed to tread opened.  Dr. Cardio appeared.  “Rothenberg…are you here…stand and deliver.”  I got up, stared at him, waiting.  “Everything’s fine.  She has pristine arteries.  She’ll be in recovery for about three hours.”   Thank you, Doctor.  You are truly a god.  He left.  I stood there.

There is only one place in the hospital more uncomfortable than x-ray’s Devil’s Island.  It’s the little row of plastic chairs right outside the cath recovery room.  At the opposite end of the hall there’s an automatic door that seemingly opens and closes without any apparent human intervention.  And stays open long enough for a blast of icy air to chill you to the bone.  I figured that it must be how they keep us awake and upright.

Two and one-half hours repositioning my ass on that plastic chair allowed two things to happen.  First, it made me promise to never complain about the seats anywhere else.  Second, it let me observe the comings and goings of the endless throng of hospital visitors.  Short, tall, old, young.  And, above all, generally obese.  Tomorrow’s candidates for the cath lab and Doctor Cardio.

Hmmm, I’m sure my pink angel of mercy will still be there…taking their temperature.

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We were robbed!

Irv and Jeri are here, experiencing  below average temperatures and above average rainfall.  But if you come from the old country (Chicago), you take whatever you can get.

I’ve tried to ignore the political landscape while they’re here but find it a herculean task given the state we’re in.   The state of California, I mean.  The budget process goes on and on, we get frustrated, our bile rises, and we look around to see who’s to blame.  If you really want to know, just look in the mirror.

Proposition 13, the need for a two-thirds vote to increase taxes, and a similarly foolish rule about passing  budgets are requirements designed by us, the voters.  In a gleeful spree we happily made it so difficult to run this state that we are now enjoying the fruits of our labors.  So, dear fellow Californians, read ’em and weep.

But since you won’t take responsibility for the mess, let’s see who else we can blame.  The Governor?  No, I think he’s been an honest broker and keeps trying to be a mediator.  The Democrats?  Sure, they’re at fault for slashing expenditures, negotiating regressive tax increases and believing that those concessions would make the other guys come to their senses.

Three days ago after some nail biting negotiating between leaders of both parties, Assembly Speaker Karen Bass, a Democrat, said “I’m very confident the governor will have this budget on his desk tomorrow morning.”  It’s Tuesday evening and the Eagle hasn’t landed.  Republicans, with their 1/3 minority are holding out for Armageddon.  It isn’t enough that the Democrats with their 2/3 majority have agreed to…

—$8.6 billion dollars of reductions to education while California is already the 49th lowest spender per pupil in the country.

—$1.3 billion in reductions to human services including cuts to monthly checks for the aged, blind and disabled.

—$880 million in cuts to higher education including a 10% reduction for the UC systems.

—$208 million in reductions to health-care funding, including the elimination of dental coverage for Medi-Cal recipients.

As if the dollar cuts weren’t enough, the Republicans also got…

—A $770 million reduction to the taxes paid by multi-state corporations.

—Environmental concessions, including a delay in the implementation of new air pollution requirements on diesel engines (cough, choke.)

—A spate of tax increases that impact those least able to pay.

Not good enough, they said.  We don’t care what our leadership negotiated for in good faith.  We signed a pre-election pledge not to support tax increases…and you know how important our pledge is.  No, we want more cuts to balance the budget.  Screw the tax increases.  Take it from the school kids or the blind guys.  Close the DMV…who needs a driver’s license anyway.  And if that doesn’t balance the budget, take away our cars, our per diems and cut our salary by two-thirds (I thought of this final idea.)

In reality, the Republicans are afraid of losing their jobs.  Their constituents would surely vote them out of office…and elect other dedicated Republicans who think more of  their job security than what the people of this state need.  But next time let’s make their replacements wear masks.  No sense having to guess who’s trying to rob us.

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Premature emasculation

Sweetie and I just returned from eight days in Florida.  Lots of pale old guys with bermudas, dark socks and white tennies.  Lots of women with too short shorts, too much makeup, and too little sex.  But what the hell, it’s better than hanging around New York and Chicago where the temperature only serves to preserve the flesh.

After an exhaustive analysis of Florida snowbird habits, most folks wake up, eat, read the paper, eat, nap, eat, get ready to eat and then eat.  Even saw Jackie Mason in a Greek restaurant.  Good thing I was eating or I would’ve missed him.

Sandy and Nancy have been inviting us to Boca for years.  Living in California apparently didn’t provide enough incentive to us til now.  Glad we went.  Good people, great hosts.  Also visited Vic and Kathy across the state in Naples.  Wonderful seeing them again after much too long.  Went on a harbor cruise and saw multi-million dollar shacks where nobody lives, even in the winter.  Finally spotted a woman sunbathing in front of her castle…or maybe it was the help.

Got a chance to catch up with the cousins who own Florida condos that serve as escape pods from wintery Chicago.  They’re so cute and loving.  The older I get the more I enjoy spending time with them.  Maybe it’s because there’s so little of it left.  Used to be that we’d say “got a full schedule…see you next trip.”  No more.

Other than the absence of mountains, Florida has much in common with California.  Lots of talk about Obama, lots of unemployment, foreclosures, and unsold high-rise condos.  The air was filled with some uncertainty about our new president.  The sheen seemed to be wearing.  The rising of a new moon clouded by frustration.

The ubiquitous TV highlighted the negatives of the stimulus bill, the on-again, off-again cabinet appointments, Tim Geithner’s less than Emmy winning performance, and John McCain’s leadership of a pack of hyenas that smell fresh blood.  The honeymooon was suffering from unfulfilled expectations and premature emasculation.

After all, it’s been almost a month since Obama, Michelle and the kids moved in.  Surely the White House debris of the last eight years would have been swept away by now.  The functioning of the bureaucracy tuned to a fever pitch.  The banks shoveling money to needy borrowers by the carload.  Wall Street’s DOW rocketing back to 12,000 on the strength of increased peanut butter sales.  Democrats and Republicans marching arm in arm just like Clark Gable and Spencer Tracy did in the 1936 movie San Francisco.

Alas, it was not to be.  Instead, the purveyors of depression and doom continue their pronouncement of failure, to be followed by years of misery, debt and tainted peanut butter.   David Brooks  devoted a full column to his version of It’s a Wonderful Life…with evil Lionel Barrymore ending up in control of Bedford Falls.

The Republicans, with the exception of three stout-hearted women and men, decided to bail on the stimulus bill.  In brief, they figured no one would give them credit if it turned into the second coming and no one would blame them if it caused the black plague.  So, why not say no and just hang around the commissary?   During the debate, the Republican leader, Representative John Boehner of Ohio, angrily dropped the 1,073-page bill text to the floor with a thump, as he accused Democrats of failing to read the legislation.  A habit they must have learned from him during his eight years of obedient heeling to the wishes of his now departed leader.

I don’t claim to be a financial genius (my depleted portfolio bearing stark witness to this fact).  But $787 billion poured into the economy through a combination of tax cuts, and spending that the rest of us seem loathe to do, is likely to have some discernable impact.  This, in contrast to sitting on our hands moaning “woe is me”, is a reasonable plan put into action in less time than it takes me to respond to Sweetie’s exhortation to take out the garbage.

And while we are on the subject of accomplishments.  Obama’s early-administration deeds also include signing bills to expand children’s health insurance and employment non-discrimination, and issuing executive orders that roll back Bush administration policies on detention of suspected terrorists, labor policies and fuel efficiency.

But am I happy?  Not really.  I still want to see Clark and Spencer marching arm-in-arm.   The DOW at 15,000.  The Israelis and Arabs trading Valentine cards.  North Korea leading a gay pride parade.  And the Iranians attending Shabbat services at my synagogue.

So, my dear friends, be not of faint heart.  There’s always tomorrow.  And a cure for premature emasculation.

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