Surgical strike

Some time tomorrow, I’ll be in a surgical centre, having arthroscopy to repair torn menisci on both knees.

Imagine my joy. I live in a third-floor walk-up.

But it has to be done, and as long as that’s the case, better get them both fixed at once to minimize the time spent hors de combat. Also—better to have the procedure while I’m still covered by the best health insurance I’ve ever had. It’s about an hour of actual cutting time and then the sharp pain I’ve been having for the last few months goes away. (Okay—after a weekend of icing and six weeks of physical therapy.)

But I have a few observations about the process.

First of all—what is it about surgeons that sends them off the scale of arrogance? You don’t find rheumatologists, obstetricians or endocrinologists swanning around with quite the air of godhood that surgeons exude. I mean, we’re talking the same aggressive egos you find in cops. I’ve come up against around ten surgeons (in their professional capacity) in my time. Two were actually decent human beings; the rest were either complete or borderline jerks.

This one, Arrogant Jerk, M.D., is one of the worst. Here’s what I mean:

I wasn’t all that impressed with his interpersonal skills on my first visit, but I did get the sense that he knows his orthopedic onions. Plus, he’s part of a sports medicine practice that treats players from the major professional teams around here, and those guys have real bone and joint problems that need to be fixed. The way you’d fix a racehorse, on account of it’s got to be in the best shape possible and a lot of money is at stake.

But their surgical centre is in Burlingame, about 30 miles up US 101 and I balked at trying to find someone who could schlep me up there and back. So at our second meeting, when we went through the options, I asked him who he would have do the procedure if it had to be done in the South Bay, since I didn’t have anyone who could drive me up to their facility so far away.

He visibly stepped back—what? I wasn’t going to automatically sign up with him? WTF? He professed to know of no one, but then asked if I could make it to Palo Alto…because he has privileges other places… Well, yes, okay, I could do that. Alright, then—he’d make a special exception and perform my surgery there and then scoot up to Milbrae (he lied about where the centre is to make it seem less onerous to me) to open up the factory line.

Only when I finally reached his surgical coordinator, she said AJ, MD, already was scheduled for that time in Burlingame and “he can’t be in two places at once”. Well, if he’s the god he thinks he is, I don’t see why he couldn’t manage that, but never mind.

(Also never mind the fact that they tell you in person and on their web site that you won’t know when your procedure is actually scheduled until 24 hours before, so I’m not understanding how he could already have that precise time blocked more than a month away.)

However—and here you could hear the sound of something sour in her mouth and something sharp up her butt—the centre will send…a car to pick me up and take me home. She said it wonderingly, as though she couldn’t believe this was happening. AJ, MD, had decided he didn’t want to do the surgery at Stanford, he wanted to do it at their centre, so they’ll supply a car service.

Now, ordinarily medical professionals won’t let you go home alone after any procedure that involves anesthesia because they want to think that there’s someone around you in case you suddenly get sick or a blood clot or something. They don’t look too closely at who it is who’s carting you about, but this is unusual enough that when I mentioned it to the surgical nurse last week, she couldn’t believe it.

(And here’s where I wonder what’s up with this? I mean, I understand that AJ, MD, gets a cut out of the surgery centre’s exorbitant fees, which he’d miss if he did the arthroscopy at another facility. So that’s maybe $10K-15K for the centre on top of his $3K-5K fee. And in the face of that, $200 for a car service is like a couple of extra aspirins tacked on to the bill. But why would he be so focused on not losing my little procedure? Does he have some kind of quota to fill—no Bas Bleu knees = no quarterly bonus? With all the 49ers and Giants and what not—does he really need my insurance company’s $20K total?)

The other thing I’ve pushed hard for is for him to do it under local anesthesia. I hate general anesthesia, it always makes me sick. And redheads need more of it than other people on account of we’ve got some wild-ass enzyme that makes us more sensitive to pain and that just leads to me being even more nauseated after it’s all over.

AJ, MD, was fine with that (although I believe I heard him warn me that being awake didn’t mean I could supervise), but his surgical nurse said that I’d have to get the final word on that from the anesthesiologist when he calls me tonight to discuss the whole thing.

Both the surgeon and nurse were fairly confident that I’ll be back on my feet by Monday. (Although I didn’t mention to him that my car has a manual transmission. I’ll just have to see how that goes.) AJ, MD, actually said this isn’t as difficult a procedure as repairing a torn rotator cuff, which I’ve already had done. (But of course, you generally aren’t walking around on your arms after shoulder surgery, so I’m not sure how the weight-bearing thing will affect me.) The nurse just thought I might still be kind of tired on Monday.

I’ve been stockpiling ice to use over the weekend, I have a stack of library books & a bunch of videos queued up in the DVR. As for the surgery, I’ll be interested to see if they find any matchbox cars or maybe Jimmy Hoffa in there.

Now, my one concern is: should I wash down the post-op painkillers with red or white wine? The tablets are white, if that has any bearing. Perhaps a crisp Pinot Grigio?