One of my favorite movies is Four Weddings and a Funeral and the title inspired that of this post. Happily, no one was in any particular danger during the medical procedures described in this essay.
These all new, all true stories were ripped, if not exactly from national headlines, then straight from the lives of three ordinary American families as they made their way in recent weeks through the mystery-shrouded realm that is modern medicine, as defined by insurance companies and HMOs.
Case 1
A young male not long into puberty experienced pain in his knee after engaging in rough play with other males his own size and age. After letting the injury go untreated for several weeks, he was taken to a doctor for an examination.
The appointment was a standard one, meaning there was a lot of excess waiting and not much face-time with the doctor who, it should be said, did make a correct diagnosis.
The responsible party was advised to receive an x-ray as a precautionary measure and the patient was sent to an adjacent facility to have this done. Once there he was admitted as a hospital patient, had the x-ray taken, and was discharged immediately thereafter.
The x-ray revealed, as the doctor predicted, that there was no permanent injury or indication that surgery was needed.
Later, the bill for the x-ray alone turned out to be in excess of $600.
Case 2
A mother of two went in for a minimally invasive procedure to remove several cysts from her liver. The surgery was performed without incident and she was sent home that day as planned.
Although there were no unexpected complications whatsoever, she was unable to walk or even stand unaided and could not use the bathroom or get a glass of water for herself for the first two days after surgery.
Five days later she began to resume, carefully, some normal activities such as walking around her home and eating meals with her family and relatives. She did have to forego many other simple activities, such as carrying her young, for a longer period, however.
The patient recovered well and has had no ill-effects from the surgery.
Case 3
An adult female went in for a minimally invasive procedure to correct a reproductive health issue after having dealt with pain and discomfort for several years.
(Prior to being scheduled, this surgery had required significant research to find the right doctor and technique. Also, the patient endured an extended period of waiting for the operation to be covered by an insurance plan before proceeding.)
Unfortunately, during her surgery a complication arose and the procedure suddenly became more significant. Ultimately this issue was resolved successfully and the rest of the surgery was completed as planned.
In the recovery room, however, the patient was not provided with appropriate pain medication and was allowed to lie there in agony for well over an hour before a person who’d been waiting for word about her the entire time went to demand to know what was happening. The staff apparently did not know what had transpired.
Like the patient in the second case this patient was sent home the day of her surgery in a condition that made caring for herself impossible. For several days the pain was quite intense and performing day-to-day tasks was impossible for her. Luckily caregivers were available to stay with her while she was alone at home during the day.
She is expected to recover fully from the operation.
Case 4
A young mother went in for surgery to have her tubes tied as no additional offspring were desired. The operation was performed as scheduled and the patient was retained at the medical center overnight for observation in small but private quarters.
No ill effects made themselves known and she was discharged the next day, as scheduled, upon the promise to return for a follow-up visit in one week.
The patient was instructed to rest and avoid unnecessary physical activity during this period, a prescription that was generally followed, save when the boredom of her surroundings became to much to bear.
The patient recovered well and has had no ill-effects from the surgery.
Case 5
Another pubescent male experienced a traumatic blow to his lower leg during play with his peers and was seen to be limping badly the next morning. He was taken to see the doctor and was treated more or less promptly.
During the examination the doctor was given a description of the injury and proceeded to perform her examination, concentrating on the knee area. Finding nothing wrong she asked for clarification about the injury was was told again that it occurred to the lower leg region.
During the further examination, which was conducted efficiently and, to the uneducated eye, thoroughly, the doctor received and accepted a cell phone call and had a brief but animated conversation in a beautifully expressive Romance language before returning to the task at hand and explaining that her son was in town.
As in the first case, the patient was sent for x-rays as a precaution against misdiagnosis. But unlike the previous patient he was sent across town to a less expensive clinic where the x-ray was performed in a matter of a few minutes and without paperwork of any kind.
The x-ray showed no fracture, confirming the doctor’s diagnosis.
Quiz
The questions are these:
- Which of the patients is a Siamese cat?
- What makes you say that?
- What does this say about America’s (human) medical system?