The Holidays and Bronchitis

What is the special connection between Christmas time in South Carolina, my lungs, and the bronchitis bacteria? It would seem that every year there is some form of reunion between these three entities.

(NOTE: I typed this entry on my laptop in December of 2008, and have just now posted it to my blog. I had forgotten it was on my hard drive!)

I wonder if more study was put toward discovering the real connection if I could not prevent this reunion in the future. The irony this season is the fact that all over Thanksgiving my two children and my wife were all throwing up with some form of a stomach flu. Six bottles of Purel later, and I avoided that one! Maybe the 8 years of school teaching allowed my system to build up an immunity to the Rotavirus, I don't know.

Then, three days into the first fully non-sick Simpson-House in four months, I come down with Bronchitis. Fever, chills, Nyquil, the whole bit.

As I type this very entry, I am sitting in my family physician's waiting room, across from a handicapped teenager scrunching his hands together in circles, rocking back and forth. [And based on the sound of his dozen or so coughs (thus far) he obviously has the same infection I do.]

TIME 3:13pm (3 Minutes after arriving.)

Why would I be blogging in my doctor's waiting room?

Well, because I have a real job you know? Anytime my family doctor works me into a sick-visit, I am always in the waiting room, and then even more infuriatingly in the little patient room, for what seems like, hours on end. Therefore, I brought along the laptop.

One weird thing is the unknown policy dealing with the order which one is seen by the doctor. The unknown of whether it's first come first serve or if it is strictly by appointment time. You know what I mean? My appointment was for 3:00 p.m. I always wait a minimum of 45 minutes, so I was in no rush to get there on time. But after I arrived at 3:10 and signed in, four other folks arrived, signed in, and were summoned to the back to start the next phase of waiting inside the patient room.

I wonder when their appointment times were? Maybe they were dreadfully late for their 2:30 appointments and it actually is based on the appointment times. Or maybe they were on time for their 3:15 appointments and the nurses were sticking it to me for being late. I think if they were to make their policies public and post them on the wall in the waiting room that it would drastically change the behavior of us all.

Since they won't, I sit, prepared with my laptop, external firewire drive, extension chords, and surge protectors in case there is no open power outlet close by. I am sure the children playing with the electronic train didn't mind the 30 seconds that their power went out while I unplugged their power and plugged in my surge protector and then replugged in their train. The adults around them gave me a mean look while this was happening, but as they began to say something, I simply called upon the inner depths of my lungs where the latest round of bacteria had been brewing for twenty minutes or so, and then coughed. And after the adults had waited for my coughing to die down, they looked as if they may try and speak again, so I started coughing again. They then remained silent.

"Mr. Simpson . . . " the nurse says. So I quickly pack up my gear and head back to Phase 2 of my waiting! You know, the part where the nurse pretends to take important vital signs, and patients lament over deciding to not bring the most recent People Magazine with them back to this second phase. (For some reason folks always forget that Phase 2 waiting is just as long as Phase 1 waiting!)

TIME Now: 3:52 p.m. (42 Minutes after arriving.)

Currently in Phase-2 of waiting now. I am back in the patient's room. This is where the doctor sees me. I really have to urinate, but I am holding it in case they need a sample. This has caused mild irritability.

There is always a momentary lapse of judgement or a fleeting glimpse of optimism, I am not sure which, that overwhelms us as our name is called by the waiting room nurse. We leap up like we are going to go right back and start talking with the doctor. We start rolling our sleeves up to prepare for the blood work. We take our shoes off twenty feet before the scale as if we are being graded on how well we know the drill.

Then, reality sinks in. We get our blood pressure taken, our temperature taken, and then . . . "Dr. So-and-So will be with you shortly."

It's right about then when I wonder why every healthcare provider in America believes that "shortly" means 35 minutes. I think the real definition of "shortly" when it is referencing anything related to healthcare, is simply, whenever the most educated person in the mix feels like it.

So I help participate in defining this term, shortly , for the healthcare industry. Here is my explanation. You see, I understand that I may be part of the problem with the healthcare system in America for holding this opinion, but I cannot change the inner-most convictions of my heart. I truly believe it is our duty and honor to pay our medical bills only after a small dwarf has shown up at our house with a battle axe and threatened to kill our family pet if we don't pay the balance right then.

I just think turn about is fair play. I wait 2 hours for an appointment. I sit in an M.R.I. scanning booth for an hour. A radiologist, that's not in my network, takes five minutes to read the scan and scribble something in my chart, my doctor's nurse calls the radiologist's nurse to get the results, those results are dictated into my chart for reading over the phone, and then my nurse gets those dictated results to my family physician for my follow-up appointment six weeks from that original M.R.I. scan. When I get to the follow-up appointment, I wait another two hours to hear that everything is fine. I figured if their system, that should take five minutes to get me my information, actually takes six to eight weeks, then this provides the ratio by which I establish the timing of my payment. The reason I say five minutes is because the technician on site administering the test always tells me something like, "everything looks fine, but wait till your doctor calls... "

So, I take the 5 minute to 8 week ratio and work from there.

• There are 1,440 minutes in a day.
• There are 10,800 minutes in a week.
• There are 80,640 minutes in 8 weeks.
• So the ratio to work with here is 5 to 80,640.

The proper time it should take to pay my doctor's bill is 30 days. I believe that every doctor would be satisfied to receive every bill payment 30 days after delivering service, don't you?

So, in the ratio above, the 5 minutes becomes 30 days. Therefore, it is prudent and fair to pay this bill, based on the above ratio, 2,419,200 days later instead. OR, in years, 6,627.9 years later this bill should be paid.

Or in other words . . . shortly .

TIME 4:15pm (65 minutes after arriving.)

Still in Phase-2 of waiting. No peep from doctor. Don't even hear him next door. I feel like Burgess Meredith in that Twighlight Zone episode where the world ends outside and he goes out there to discover he is the only human left on earth. Lucky for me I don't wear glasses. In the similar episode that stars ME as the main character, instead of my glasses breaking so I cannot read (like in the real episode) it would somehow end with no electricity to charge laptop batteries.

[Cut To: Shawshankesque Crane Shot from above of me holding my Apple Laptop Power Plug (you know the white box with the thin chord to plug-in) standing in front of a power outlet with it plugged in and yelling,

"NNNNNOOOOOOOOOOOOOOOOOOOO0000oooooo!!!!!! ]

This is always when I ponder moving to Canada, but even the air conditioning in this Phase-2 room is cold, so I probably wouldn't do well in Canada. Did you know my friend that lives in Canada just had a baby, and the national health plan allows for 70 percent of her salary for ONE year as maternity leave? The cold must really get to politician's brains too!

The beauty of all this is, I am a web developer, so if my doctor had the extra 54 dollars a year to invest in a wireless router, I would be forced to feel guilty for working on my personal blog instead of on my customers' websites. As it stands, my family doctor doesn't plan on getting a WIFI network installed until the iPhone has teleporting capabilities, which according to Steve Jobs is in late 2010. The ironic thing there is once I can teleport to the doctor's office when they call for me, WHY will I need WIFI in the waiting room? Turns out the real sufferers in the equation are my customers!

TIME : 4:29pm (89 minutes after arriving.)

I just heard the sounds of chairs scraping. Evidence of human life in the next room is always good. However, this could have easily been a raccoon going through the garbage cans in the connecting hallways, I am not sure.

Just think, I will have been out of my work day from 2:30 p.m. until (return here and put the proper time). I bill my clients anywhere from 100-200 dollars an hour depending on what I am doing for them. I feel like I should bill the doctor for the lost time. THAT would make healthcare affordable.

I predict I will spend less than ten minutes discussing anything with the doctor. However, that will not make me NOT try my latest tactic. You see, we have met our abnormally large deductible for the fifth year in a row. My son is a faller. Yes, a faller. My six year old son, Walt, has been to the E.R. in four different cities! Thanks to the adventurous climbing nature combined with the lack of coordination to stick the landings, my family has met the 5,650 dollar deductible for five straight years!

We have a low premium (relative term) high deductible (universal term) healthcare plan. Everything from this point forward in the year is paid in full, so long as it's medically necessary.

When the doctor does come in, I am going to attempt to get him to combine into this one visit all of the following things:

• a prescription for Zithromax for my bronchitis
• a referral to a spinal surgeon specialist for my minimally invasive back surgery so I can have ANOTHER MRI this calendar year fully covered
• my follow up visit to my recent colonoscopy that he ordered that is technically scheduled for two weeks from now
• AND my yearly visit for Narcolepsy.

We'll see how this goes.

I don't want the Doctor to do anything unethical, nor do I want him to get paid less than he deserves for delivering all of this treatment, I just don't want to have to BE HERE for it.

You see the problem is if he does all this in one visit, he can only bill for the one visit, but if I come back in a few weeks, and then again in a few more weeks, he gets three times the money. I need all those visits medically, and he can ethically bill for those visits without cheating the insurance companies, I just want them all to be done today!

I propose that this visit can do all of the above and take 8 total minutes. Here is my eight minute visit broken down into two minute increments.

First 2 Minutes ::
I say, "Hey Doc, (BIG COUGH.)" Stethoscope, rumble in my breathing....Doc says, "Wow, here you go with a Z-pack."

Second 2 Minutes ::
I say, "Hey Doc, remember my ongoing back problems I have had for 20 years...well I cannot have an MRI covered by my insurance unless you refer me to a specialist. I need that called in ASAP so I can get the actual MRI before Dec. 31st."

Doc says, "No problem...we'll do that on your way out."

Third 2 Minutes ::
Doc says, "How was your colonoscopy?"

I say, "Everything is clear, no issues. He prescribed me Aciphex, yes ASS-Effects (for my irritable bowel syndrome.)"

Yes...Aciphex, for my Irritable Bowel Syndrome but that's another blog-entry all together, but the medicine didn't really change anything. Bowel Doc says to stop eating late at night, and quit eating chocolate. Based on that assessment, my bowel will remain irritable until I am around ninety years old. (Assuming a steady diet of Raw Cookie-Dough 10 p.m. every night is the magic ticket to age 90!)

Fourth 2 Minutes ::
I say, "Hey Doc, you know I have that Narcolepsy blood work in two weeks,? Is there anyway I can draw blood today and not come back that day? But keep my appointment on the books, just do the blood work on that appointment time so I don't have to come back in ok?"

8 minutes -- botta-boom--botta-bing!

I think I am dreaming...but I am going to try anyway!

TIME : 4:40pm (90 minutes after my arrival.)

Still no sign of life in the office. I am pondering on whether to step outside and peek. I feel like I lose the "sympathy leverage" if I do that and they ACTUALLY DID forget about me though...So, I wait. Part of me thinks if they did forget about me I would somehow get a free set of steak knives or something of equal irrelevance. BUT, if I peek, with an irritated mannerism, then I lose my steak-knives!

All of this just makes me want to get the contract for the Doctor's website. Have him make an appointment for a meeting with my company downtown. Then when he starts cussing at me for making him wait an hour and a half in my lobby, I will say, "I am so sorry, man, come on back."

And then, walk him into the in-between room. The room between the waiting room and my office, and leave him there for another 45 minutes. Then come into that room and say, "You know what, we do these websites all the time, I know exactly what you need, so you can just head on, just make sure to email me any changes in content from your current site to this one..ok? Bye now...But oh yeah, don't forget our follow up meeting in a week to discuss the colors I will use on your website..."

And then make him wait to pay in front of a desk where no one sits for another 20 minutes.

TIME : 4:51pm (90 minutes after my arrival.)

Still have to pee like a friggin' race horse but I am still holding in case they need a sample. (Which makes me ponder how bad a race actually has to pee?)

TIME : 5:13pm (123 minutes after my arrival.)

I FINALLY see the doctor!! And to my disbelief, he does check me out for all my issues. AND he is super cool about the whole deal. So, I guess I did win a prize! 2 hours of total visit time. 7 minutes in front of the doctor! All is well in America!

TIME : 5:18pm (128 minutes after my arrival.)

So when I check out, the check-out lady asks, "So you have a balance of 184 dollars from other visits, would you like to clear your balance today?"

I just smile as I back out the swinging exit door and say,

"I will take care of that . . . shortly."