Adventures in Health Care-Part 3

The door opened and a young man in a white smock entered the room.  He had a folder of papers in his right hand.  Papers that contained the results of Steven’s biopsies.

We started this odyssey in September when son Steven went for a general physical from his newly assigned primary care doc.  “I’ve got this thing on my back.  It gets irritated by my guitar strap.  And sometimes it bleeds.”  Off to the dermatologist.  “Hmmm, we should remove that mole and have it biopsied.”  It came back “melanoma.”  An advanced one, stage 4.  The internet screamed the dire possibilities.

Steven gets his health care through the Healthy San Francisco  program.  A program for the uninsured.  Only for those who live in San Francisco.  All services to be provided in San Francisco through an array of clinics.  Get sick in Oakland and you’re out of  luck. The bulk of hospital services are provided by San Francisco General Hospital, a county facility.  Visions of Martin Luther King Hospital flashed through my head.  An ER without compassion.  Patients left for dead.  Or worse.

Sweetie and I accompanied Steven to the hospital in mid-October to meet the surgeon who would, we hoped, remove all trace of the invader melanoma.  We found the last space at the top of a six-story parking structure, stowed the car and crossed 23rd street to the main hospital building.  Maybe forty people in line at the first floor pharmacy window.  Waiting for their free meds.  Not a good sign.  We wandered about the third floor searching for the registration desk.  Found it and took our seats in the waiting room.  The walls were lined with notices in multiple languages.  The only one I could read offered the services of a wide array of interpreters.  A good sign.

“Steven Rothenberg” the voice shouted from somewhere down the hall.  Afraid of immediate loss of our appointment if we didn’t respond instantly, we all leaped to our feet and were greeted by a small, friendly faced female.  “Come with me.”  We obeyed.  And we waited in one of those small, windowless examining rooms that after ten minutes makes you believe that you have been forgotten…forever.  But we weren’t.

Dr. Horn became our new, best friend.  A surgeon with a terrific bedside manner.  An oxymoron, but true.  He patiently explained what needed to be done.  Not displaying the pressure of a large patient load, he slowly answered my questions about his background and experience.  A salaried physician on the teaching staff at UCSF.  “I seem to get all the melanoma patients.”  A very good sign.  “You’re lucky”, a nurse told us after Dr. Horn left the room.  “He’s a wonderful surgeon.”  A very good sign.

The surgery wouldn’t be performed for several weeks.  Discomforting because of the popular understanding of the rapid spreading nature of the evil melanoma.  Discomforting because of the time we would have to wait, the uncertainty and the fears.

We returned in early November for the surgery.  Arrived at SF General at 7am.  No parking problems.  Steven checked in and had his body autographed with Sharpie pens delineating the surgery sites.  More suspicious moles were to be removed in addition to the original offender.  Then off on the shuttle bus to UCSF hospital for a nuclear tracer that would identify the lymph nodes that were also to be removed and inspected.  We caught the shuttle back to SF General.  Steven was ushered into the ambulatory surgery suite at noon for the procedures, including general anesthesia, that were scheduled for 1:30.

Five hours had passed since our early morning arrival.  We took our seats in the windowless waiting area.  A TV set hoisted out of reach of adjustment played an array of stuff that I would normally have not watched other than under the threat of bodily harm.  By 4pm I had read all of the magazines we had shlepped with us and half of a 400 page, small print book.  A friendly nurse appeared.  “Would you like to come into the ambulatory suite to see your son?”  Well can you beat that, I thought.  Not bad.  Only 4pm and they’re done.

Only one person at a time is allowed in the surgery suite.  I elected myself as the first visitor while Sweetie waited her turn.  As we walked to the door I asked “How is he doing?”  Nurse Ratched responded oddly.  “He’s not a happy man.”  I entered and found Steven, blue hair bonnet in place, lying on a gurney in the hallway.  “Well you look pretty good after a bout of general anesthesia and multiple stab wounds.”  He was, indeed, not happy.  “I’ve been laying on this gurney for four hours.  I haven’t seen a knife yet.”   I left and relinquished the pole position to his mother.

Five hours later he was recovering from the stab wounds inflicted by Dr. Horn and the twenty-four metal staples that now held his wounds in place.  The good doctor had removed a large chunk of flesh surrounding the melanoma, an assortment of lymph nodes and two more suspicious moles.  Fresh as a daisy at 9pm, Dr. Horn displayed a positive attitude and announced that things had gone well.  “We should get the biopsy results in about five days.”  Following an hour in recovery, we bundled Steven into the car and got home around midnight.  It was a long day.  Longer days and weeks were around the corner.

Three days later, after the usual two-hour wait, we watched Dr. Horn remove the dressing that covered the staples.  “No results yet.”  Five days passed.  Then two weeks.  Then four weeks.  An assortment of horror stories passed through our heads.  We spoke almost daily with Steven.  His disposition was a lot better than ours.  Last Wednesday we loaded ourselves into the car, drove to San Francisco and anxiously awaited the scheduled Thursday visit with Dr. Horn.

Usual routine.  Drive to SF General, find one of the last parking spaces, enter the main hospital building, and wave to our new druggie friends in line at the meds window.  Plunk ourselves down in the waiting room three minutes before our 10:45 appointment.  At 1pm we were still on the wait list.  Kindly nurse Ratched appeared.  “Follow me.”  You bet.

Ila took the little wheeled backless stool normally reserved for a doctor.  After 15 minutes of sitting stoically, she began to wheel about the room.  After 20 minutes she wheeled to the open door of the exam room, stuck her cute head into the hall, and spotted Dr. Horn as he moved from room to room.  “Yoo hoo, we’re here Dr. Horn.”  This movie replayed itself every five minutes.  Until the young man in the white smock with a sheaf of papers entered the room.  The papers announcing the biopsy results.

What seemed like an hour passed while Doctor-To-Be Alekko, a fine-looking boy, told us that he was a third year medical student at UCSF.  Finishing his resume and displaying a yet to be developed bedside manner, he mechanically intoned,  “Steven is fine.  The old melanoma is gone and the margins are clear.”  He went on.  “No evidence of any cancer in the lymph nodes.”  And, blessedly, “The other moles were non-cancerous.”  We showered our relief and gratitude on him.  Somewhat embarrassed, Doctor-To-Be Alekko said “Dr. Horn will be here soon.”  Alekko left and Ila resumed her imitation of a roller derby queen.

Dr. Horn arrived and repeated the biopsy results, but in a way that made you feel that he really believed them, that they weren’t just words on a piece of paper.  “By the way”, he said.   “The reason they took so long was that one of the moles was a bit of an enigma.  We had to send it to the University for another opinion.”  I thought “they must have turned it into a case study for the entire medical school, written a book, and made it into a movie.”

We thanked Dr. Horn for his work and, I hope, made his day.  A funny feeling was shared by the three of us as we left the hospital, crossed to the parking lot, found the car and drove home.  No elation.  Just sort of like air exiting a balloon.  It reminded me of when I watched the election results and the moment that Obama was declared the winner.  After what seemed like years of hoping, we had been rewarded.  Thankful for a wonderful result but no excitement.  Happy that things had turned out as we hoped they would, but no dancing in the streets.  A feeling of comfort after a long journey.

23 Responses to “Adventures in Health Care-Part 3”


  1. 1 Michael December 14, 2009 at 7:26 pm

    Freddy-

    I read this holding my breath for the news which I’m very happy for all was good. Next time tell your readers the good news first and then the story. I’m dizzy from lack of air!

    Love to all!

    Mikey

    Like

  2. 2 robert December 14, 2009 at 7:31 pm

    im glad to hear steven is ok…im sooo bad i have meant to call him since i talked to you guys..i will do it! happy hannukah to all and hope to see ya soon

    Like

  3. 3 bbojai December 14, 2009 at 7:40 pm

    You kept me in suspense all the way through. So glad for the happy ending.

    Like

  4. 4 Anne Shrage December 14, 2009 at 8:01 pm

    So happy to hear the great results….
    Happy Holidays to you and your family…..

    Like

  5. 5 Harry Dyner December 14, 2009 at 8:24 pm

    Fred/Ila:
    I am glad that everythingg turned out fine for Steven. I hope that Steven, you and Ila can now enjoy Channukah and the New Year.
    Harry

    Like

  6. 6 Aryna December 14, 2009 at 8:53 pm

    I am so happy for you all that things turned out well. Happy Chanukah and Happy New Year! Thank you for sharing your story.

    Like

  7. 7 Sharon December 14, 2009 at 9:36 pm

    I, too, kept reading, hoping that the end result was going to turn out fine. Thankfully Steven is well and all of you can now take a deep breath and enjoy the holidays.

    Like

  8. 8 steven December 14, 2009 at 10:09 pm

    I’m glad someone was taking notes…..Thanks Dad.

    the only part you left out was the yelling & swearing exhibition I gave all the nurses & doctors after lying on the gurney for 4 hours waiting for my turn to finally come. We’ll save that for the R-rated version.

    Love,
    Steven

    i’ve still got the staples if anyone wants to see ’em. And the big long scar, too.

    Like

  9. 9 judie December 15, 2009 at 6:12 am

    I read the long story because I did not know the particulars. Thankfully I knew the outcome from an earlier email. Again, enjoy the holiday and a continued healthy and happy New Year to you all!!!

    Like

  10. 10 myrna December 15, 2009 at 6:51 am

    thinking continued well wishes for you son steven

    tanti baci

    myrna

    Like

  11. 11 Gary December 15, 2009 at 7:32 am

    Fred & Ila
    Alice and I are very happy that things turned out so well for Steve and the family

    We miss you guys!

    Love

    Gary and Alice

    Like

    • 12 Molly December 15, 2009 at 9:18 am

      Thanks for sharing Fred. It means a lot to me to know what’s going on with you and Ila. Love and healing thoughts to you and Steven…and a big sigh of relief! Molly

      Like

  12. 13 leo December 15, 2009 at 9:07 am

    Thank you for sharing .
    Very best wishes Fredila.

    Like

  13. 14 karen evenden December 15, 2009 at 9:55 am

    I was relieved to find a happy ending…our very best wishes to you all.

    Like

  14. 15 Alice December 15, 2009 at 11:06 am

    Been there ..done that..6 years ago this week! I also had melanoma…the scar will heal and I tell folks it was a shark bite.

    Miss you both.

    Love,

    Alice and Gary

    Like

  15. 16 Sally December 15, 2009 at 11:36 am

    Love the way you write, Fred. Glad for the happy ending, but wish for better treatment and healthcare options for everyone so this sort of thing is less traumatic. Steven — I’m sure your younger Minnesota cousins (not their parents) would love to hear your version. Come visit — our lake isn’t even frozen…yet.
    Love, Gene and Sally

    Like

  16. 17 Jason December 15, 2009 at 11:41 am

    Fred:

    I’m so glad I added your blog to my RSS reader–otherwise I would not have heard about Steven. Very glad and relieved for the good news, after only reading the bad news a few paragraphs before.

    Greetings from Los Angeles and Happy Hanukkah.

    Jason

    Like

  17. 18 Trudy and Peter December 15, 2009 at 12:16 pm

    Dear Ila, Fred and Steven,

    L’chaim to all of you! The news is terrificand we know you will celebrate this holiday season with lots of joy. All our wishes for a wonderful 2010.

    Love,
    Trudy and Peter

    Like

  18. 19 Susan December 15, 2009 at 1:03 pm

    I had forgotten how much I enjoy they way you write. I am so glad there was a positive outcome for Steven. Makes you remember and appreciate all the times we have with our loved ones.

    I wish you all have a terrific holiday.

    Susan

    Like

  19. 20 Maureen December 15, 2009 at 6:39 pm

    A scary, yet ultimately uplifting story, I am glad to hear that Steven has gotten through a very tough time of life. Having his parents there to support him through his trials must have meant so very much to him. Wishing you all good health in the future.

    And please continue your interesting insights into daily life in Ojai during this trying time of our country’s existence.

    Like

  20. 21 Rima December 19, 2009 at 9:14 am

    Dear Fred and Ila,
    It is great to know that Steven is well and hopefully will heal fast. I wish you never to experience again the pain of your child or grandchild having serious health issues.
    Wishing your family many healthy and happy years !
    Have a great 2010!
    Love Rima

    Like

  21. 22 Kay December 26, 2009 at 7:20 am

    What a story and boy can I relate what with my experience with you know who. My book, of course which I won’t write is, “Why don’t you listen?”

    Happy to know the results were positive. Isn’t it a shame the time we must wait whether for an appointment, treatment or results. What is the answer?

    Too bad people who make these executive decisions don’t read this. Maybe, just maybe something might get done.

    Our best to you and your family.

    Like

  22. 23 Shari Guilfoyle December 29, 2009 at 1:49 pm

    I am so glad that your son is doing well.

    Like


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