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?

Post-Halloween "treat"

I’m not looking forward to this holiday season at my current place of employment.

Here’s what I found between the color & black-&-white printers this morning, obviously left over from some Halloween party yesterday afternoon:

Leaving aside the fact that I find even fresh pumpkin pie repugnant, isn’t leaving a custard-based dessert substance out overnight a health hazard?

Scary season

Since we’re still in the cusp-of-eternity period (it being el Día de los Muertos), I figure it’s okay to report that in Saint Louis, if you want to get treats you have to tell a joke.

It would be hard to make that work around here, because the treat-giver would need to be able to take in jokes in Farsi, Hindi, Urdu, Spanish, Mandarin and Vietnamese.

But it’s a nice idea.

Christmas in October

Ugh—it’s 1744 on Halloween & I’ve just seen my first Christmas TV commercial.

No, not for a salad shooter, so not completely official. But it was a Chex Mix with red & green bits, & had that dingy-dongy “Carol of the Bells” music in the background.

Not primordial ooze. Maybe

All Souls. Día de los muertos. Samhain. Halloween. All Saints.

The hours from 31 October through 2 November are just chock full of us looking over our shoulders at mortality, whistling in the dark, building bonfires to push back the night, dressing up as someone or something we aren’t, communing with the departed & generally displaying our defiance at the Last Unknown.

Night is taking over day & we have to convince ourselves that we’re somehow going to trick the Almighty into bringing back the light or even into skipping over us when sending the Angel of Death on his appointed rounds.

But this is also a time for, well, for just plain being weird. & for concocting strange—really strange things—with pumpkins.

For example:

Love & crime in Colorado

File this under the heading of “you just can’t make this stuff up”: A Colorado Springs man (& I use the adult-male designator loosely) sought help from the police when his online & offline love lives collided at oh-dark-thirty Wednesday night.

His wife got home earlier than he’d expected & when his Craigslist conquest showed up for their assignation, Kevin Gaylor, 24, resolved his dilemma by calling 911 & reporting the girlfriend as an armed intruder.

Once the cops figured out what was happening, they charged Gaylor with misdemeanor false reporting of a crime. & I hope they advised the incipient paramour to Google anyone she meets on Craigslist to see if there's a spouse lurking about. 

There are a couple of things that bother me about this story:

The unnamed college student who appeared for an 0300 date (& what’s up with that, I wonder?) was reportedly driven there by some guy. & evidently he wasn’t her father.

Uh, has dating changed so thoroughly that you have a male friend drive you to your hookups? Or is it the whole Craigslist I-could-be-meeting-up-with-a-serial-killer thing?

& has the concept of meeting someone for coffee for the first date not made it to Colorado Springs?

The other thing that is a serious concern is this: is this Gaylor bloke procreating? If so, God help us.

Sweet & spicy

As I mentioned yesterday, Diwali involves—among other things—sweets.

(According to one of my colleagues, in general Indians are really big on sweets. He should know; he’s from India. But that’s also borne out by the number of Indian fast food places around here that have “sweets and snacks” in the name.)

Anyhow, that being the case, I made a batch of garam masala-spiced pecans and left little packets of them on the desks of a couple of colleagues who could specifically use a little sweetness in their lives, given the kind of tsuris they’re getting from the job.

Well, I had to get them out of the house, didn’t I? Turns out that they go way too well with Prosecco.

Holiday sweetness

The festival of Diwali is upon us again. I have to say that I can get behind any holiday that celebrates the triumph of good over evil, light over darkness.

But this year I’ve learned another reason to set candles ablaze and leave the doors and windows open for Lakshmi to enter and bring with her prosperity for the new year (in the Hindu calendar).

It turns out that sweets form a major component of the festivities. How did that escape me last year?

I mean, seriously: righteousness whomps wickedness, candles invite prosperity in through the window and you’re authorized to indulge in desserts?

O happy Diwali!

Skipping & slogging

The WSJ recently ran a frisnic on reading styles—in depth vs. skimming. (Or, as Cynthis Crossen clarifies, skipping.)

When I was being paid to read books and scripts for film and TV companies in Hollywood, it was clear to me from the “coverage” (basically, book reports) of other story analysts that many of them flew through the “properties”, barely touching down every six chapters or so to pick something up.

I, on the other hand, slogged through just about every single thing. Except for the one historical romance that was so long (more than 600 pages) and so ghastly (I’m not even going to start, but it was more than 20 years ago and the thing is still seared into my memory) that I eventually had to just scrape the surface like I was skimming fat off the bottom of a roasting pan.

(And I actually met the, erm, author a couple of years later, at a screenwriting class taught by a producer I used to work for at Chuck Fries Productions. She was everything you’d have expected from reading that oeuvre.)

These days I don’t usually bother scanning a book—either I read it or I dump it after a few pages. Although I occasionally flip through the James Fennimore Cooper descriptive passages to get to some actual, you know, action.

(Many, many years ago my father described Cooper’s writing style as being, “One Indian comes up to another and says, ‘How.' Then there are six pages of description of the weather, the woods, the wildlife and the beads they were wearing that came from Woolworth’s, and then the other Indian says, ‘How.’” I did not agree with my old man about much of anything, but when I finally picked up The Last of the Mohicans, I had to confess that he was right about that.

(I still read the whole damned thing.)

But then, I’m what Crossen refers to as a “fast reader”. Back in the day, I could read a feature film script (typically 120 pages) in an hour, and most novels in three to five. (In that day, I was being paid $50 per script and minimum of $75 per book.) My former roommate tried covering a couple of properties and reckoned that between the reading, analysis and writing the report, she was making about $5 per hour.

These days I sometimes drift off and then have to return for reinforcement (one reason why I can’t deal with an audio book—a sentence, a concept, a phrase will set me off on a tangent and if the book is on a CD I can’t rewind and find where I went astray), so I’m a little slower, but I still go through a few books a week.

Well, Bodyguard of Lies took me a hair under three weeks. And I did skip maybe about the equivalent of 50 pages. But in a 900-page book of considerable density, that’s not completely dishonorable.

Generally I stick with it, because I mostly read non-fiction, and if you skip chunks, you miss more than a plot point or two. The writer doesn’t care whether I ingest every word in the book or not, as long as someone’s paid for the privilege of me opening it. But I’m reading it to learn, and to skim would be cheating myself out of that knowledge.

Where I do skip shamelessly is TV, with my DVR. It's not just fast forwarding through the commercials; or even whizzing past the segments of a movie I've seen before that I know to be lest than enthralling.

The other night I hit FF4 through considerable parts of Eat Pray Love. The blah-blah ones, where Liz is reliving her disintegrating relationships, and then where the scars of those breakups threaten True Lasting Love (and would change the movie title to Eat Pray Bromo.)

That cut about 50 minutes out of the 2:30 total run time and made it almost tolerable.

Diagnostics

I can’t believe I’d ever hear these words coming out of my mouth, but Friday I had my annual mammogram and the experience took up entirely too little time.

(If you’re apprehensive of TMI, you may want to leave this post now.)

I got to the Valley Radiologists Imaging facility early, on account of having to fill out that poxy paperwork. And I wasn’t heartened by the fact that some of their magazines were five years old, or that there was one guy who spent about 15 minutes while I was there asking the reception staff when they’d have his paperwork so he could go. (Eventually, after he’d been there more than an hour, they got it to him; seems the delay was…because he was paying cash. Which seems counterintuitive; cash ought to be simpler and shorter than anything else.)


But five minutes before my actual appointment time, the mammographer called me and took me straight to the mammography room, hauled out one of those mini-gowns (you leave on the lower part of your clothes, so why have a gown that goes beyond your navel?), told me to put it on and left.

Now, for the Y-chromosome set out there who may not have heard about this, normally you’re sent to a dressing room to make this change, usually a cluster of them around some central waiting area, with magazines; because the procedure is for the tech to make the images and have them checked by a radiologist for clarity of image before sending you away. If there’s any question, you go back for more shots.

So I thought this rather odd. But it got stranger.

With hardly any adjusting at all, she took four shots and told me I was done. That was a total of ten minutes; I timed it.

Now—again, TMI alert—I have A History. Not of cancer, but of cysts, which typically set off all kinds of red flags and alarm bells. I’ve actually had surgery because of this. (There’s nothing like going into your junior year of college and having your doctor find A Lump and referring you to a surgeon. That kind of wakes you up in the whole exam area for the rest of your life.)

Indeed, my last three mammograms (two in Washington, one in Virginia) triggered not only more shots, but also ultrasound before the radiologist in each case diagnosed cysts & sent me on my way.

(BTW—every time I’ve gone through this, I have been sent away “clean”. But the past is only indicative, and every time you get that, “Uh, we need some more pictures” call, you think, “Is this the time it turns out to be Something?”)

And the imaging centers always allocated an hour just for the ordinary screening—what with messing you about on the instrument of torture, taking a few extra views because she can see that there’s something going on and then having you wait for the radiologist to scan the images. They don’t want you leaving the place until the radiologist has verified that they have pictures that can be interpreted. If the first round doesn’t do it, you need to rinse and repeat.

(Although in the Reston Hospital radiology center that factors in at least 35 minutes for waiting because they over-book patients, and then for being told that they can’t find your previous films and that you must have taken them the last time you were in. And turning out that they were done at a different facility since at that time they had no mammographer so they sent you to their Sterling site and had never bothered to send the films back to the main center.)

Longer if they want to squeeze you in, so to speak, the ultrasound schedule.

So, I’m somewhat concerned about this latest experience. Every woman who’s ever had a mammogram will tell you it’s akin to root canal (but without the anaesthesia): you do it because you have to; but when you have to, you want it to serve a purpose and be done right. I find it hard to believe that this facility’s equipment is so far superior to anything that’s ever been used on me that four quickly-placed shots will provide the physicians enough information to give me the clean bill of health I’ve always mostly had.

Which means that they’ll either be calling me back for the usual rigmarole, or they’re just going to pass it off and I’ll be wondering if this time there’s Something that they just can’t be bothered to find.


Actually, what I really wonder is whether they can only collect some limited amount from my insurance company and they want to put forward the minimum amount of effort because of that? Although adding in the ultrasound would enable another charge to Blue Cross, they probably get paid the same sum of money whether they take four or 14 mammogram films.

(Having taken a shot at our medical delivery and compensation system, let me add that it could be worse. When I first visited my GP in England—the physician at the surgery to which I was assigned by the National Health Service by virtue of my postal code—I said I wanted to get a mammogram. She asked why. “Because it’s been a year since my last one.” Blank look. “In Britain we only do them every five years, because of the cost and because only one woman in ten is at risk.” Didn’t matter that, with my history, I might be one of the ones, she wasn’t going to refer me to a lab. And you’ll notice that they’re okay with double-digit breast-cancer roulette. Even our insurance companies have figured out that it’s cheaper to detect and treat cancer earlier than later, even if they only care about the cost and not the lives.)