Because You Never Asked

(2/04)

     Although I might be considered fairly well preserved, I've achieved a level of longevity that the human body begins to waiver under. My latest run-in with America's lack of a decent health system had an element of the picturesque, but is more relevant as a further examination of how this country deals with sickness.

     If you are not one of the approximately 6 billion people who are unfamiliar with these essays, you might already know that I, like more than 40 million of my compatriots, am uninsured. This, in spite of the fact that I work full time, I provide a useful service, I pay my bills, I pay taxes, I've never been a ward of the state, I'm a useful, serviceable human being contributing to the proper function of our society . and yet, I cannot afford to pay some corporate hustler enough money every month so that my occasional bouts with sickness do not cost me substantial amounts of money.

     I am not worthy.

     For the last year or so, I've been suffering a certain degree of burning in a part of the anatomy that should be more a source of great joy than physical pain. In its worst manifestations, this burning would be accompanied by an inability to pee, creating an excruciating several hours that could only be relieved by drinking tons of water in short periods of time. The routine repetition of this course of action eventually became unacceptable, leading to the unavoidable use of our society's medical professionals.

     My first step in what's turned out to be a long journey still lacking a definitive cure, was a walk-in clinic where three general practitioners occupy the front lines in the war on disease. As the reader will see a bit further on, this essay's purpose is not to denigrate the quality of the medical services rendered. This clinic and its staff provide a noble service, at a reasonable price, to those with few options.

     Upon having explained the symptoms and adventures associated with whatever was ailing me, the doctor began asking what seemed to be the proper questions: what I might eat, do I drink, smoke, my sexual habits (my sexual habits are a problem, but more for their absence than their health risks), how often does this, how severe is that, when does it come, how does it go . hey, this guy has obviously been to medical school. He then began tapping here, there, around the horn, with a deft wrist action I've only seen from our medical professionals. Does it hurt? Any pain? Good. Drop your pants. Various fondles in forbidden places, cough please, good. He saved the best for last when he stuck his rubber-gloved finger up my ass. Oof! Good.

     As I was recapturing my dignity, he explained quite confidently that I was most likely suffering a not too serious condition men my age frequently fall prey to. He named it with 3 initials I can't remember. It had something to do with years of accumulation in the deepest folds of my discharge system, causing an infection whose swelling qualities hinder the passage of what has to be eliminated. No fun. He prescribed an antibiotic (quite expensive) and sent me merrily on my way.

     No problem.

     No problem turned into 3 more visits to the clinic. Each appearance resulted in a different attempt at a prescription remedy. It was time for a higher form of wisdom.

     The "urologist".

     I had to suffer a month more before I could get to see one of the two men in my town that have the most expertise in these fetid urinary expulsions. His life is an off beat one spent poking in and around anatomical parts that are usually off limits for anyone other than one's most intimate acquaintances (or guests on the Howard Stern Show). He and his young nurse (more on that later) handle penises with the same casual routine one might use in choosing a good piece of fruit.

     My first trip to the urologist was not much different than those previously made to the clinic. His external examination was a bit more thorough; he asked a few more questions. He then prescribed a really expensive antibiotic. Three days later, I had a bloody rectal discharge, as if I'd just crapped an order of stewed tomatoes.

     I don't know about you, but I was alarmed.

     It was the weekend. I called the doctor's emergency number and spoke to the other urologist in town, who was covering for my doctor at the hospital. He called in a prescription, one that included something called "Pyridium", which relieves burning sensations you know where. This one little pill --- whose side effects, other than to make one pee red, are nil --- made my life bearable for the almost one month more I had to wait in order to have an embarrassing procedure known as a "cysto" performed on me.

     (Before getting to that, I have to wonder why it took almost a year of on and off suffering before anyone prescribed this Pyridium to me? I almost fainted when I heard the 20 pills prescribed cost only $7.85. They're these little red things that look like M&M's, and, considering their economy, I thought I might sprinkle them on ice cream and ingest them like that. Could their almost negligible cost have something to do with their lack of use?)

     Having now exhausted all other avenues of combat, it was time to get serious. A "cysto" is a procedure where the doctor inserts a narrow, hose-like thing in one's penis in order to have a look around where the sun don't shine. One is reminded of a U-boat commander peering through his periscope as the doctor scans one's innards in search of clues. Obviously, if one is to survive such an act without going stark raving mad with pain, some further medical arts are necessary.

     This is where the young nurse comes in, such being a reasonably attractive, 25-ish brunette, who was somewhat plump for most men's taste, including mine. Having said this, after decades of erotic adventure, I've also found that such borderline sexual allure can become quite stimulating when the possessor of such decides your dick is the one she wants to play with.

      Upon arrival that morning, the young lady in question led me to the room where the dirty deed would be done. She informed me that she was going to "prepare me". She then ordered me to take off everything but my tee shirt and lie down on the metal table so disposed. This having been done, she spread a large gauze-like material across my privates in what turned out to be a ludicrous attempt at some form of prudish dignity. She then began to delicately sponge in and around my whole "package", gently lifting my "fella" to the left, right, all around the town, cleansing the area with deft precision. With this phase completed, she held my member straight up and, with the use of a device she gently inserted in its opening, began squeezing a thick liquid substance up the urinary passage in much the same way a baker might squeeze decorative icing on a cake. As a result, though the "cysto" proved to be an uncomfortable experience, there was no great pain to bear. I was now  "prepared".

     One having gone through such an experience quite logically begins to ask oneself why not even the hint of an erotic feeling intruded on these moments. My first impulse was to attribute such to my advancing age, a difficult thing to admit, but one also lacking evidence in real life. Corroborating this fact is a similar event I suffered almost 20 years ago when my hormonal powers could not be called into doubt. I had spent 5 weeks that summer partying on the Greek isle of Paros. As I was getting ready to head north to England, a young lady with whom I'd shared some intimacy suggested I get checked for one of those "dirty" diseases. Upon arrival in England, I went to a hospital and was examined by an attractive female doctor from Ceylon. Very exotic. She took my "willy" (that's what the girls call it in England) between her thumb and forefinger, stood it up straight, informed me that this would not be nice, and took a scraping out of my urinary passage. I can assure you, the erotic qualities of this experience were about the equivalent of getting frostbite. Through such a happening, one learns just how important mood and feelings are to the sexual impulse. I had more of an erotic feeling writing about these events than actually living them. The hard core reality of a medical environment --- the harsh, Antarctic-like lighting; the goose-pimply coolness; the hard edged, purely practical furnishings of polished steel and plastic; the all business attitude --- are about as sexy as an incontinent fart, regardless of who is handling your penis.

     The rest of the procedure proved to be distasteful, degrading, uncomfortable physically, but uneventful. The doctor took a good look around . bladders, urethras, God knows what else. Over the course of the past year it had been fairly well established that my symptoms showed no signs of stones or prostate problems. Under such circumstances, there is always the fear of something cancerous; a tumor, growth, whatever. All clear there. The doctor decided to "dilate my urethra"; a procedure whereby the urinary channel is widened and flushed out with water. As I write, 2 weeks later, I am cautiously optimistic. Time will tell.

     And that gets me to the real message of this essay. This whole past year of intermittent suffering has exposed yet another contradiction in the privatized, market health care being so brazenly rammed up our asses by special interests in the Disney States of America. (Somehow, for this essay, that seemed to be the proper phraseology).

     At this point, it is pertinent to talk about the medical professionals I've dealt with in my time. My bitch with American medicine is not with the doctors. I've generally found them to be well prepared, articulate and intelligent, as we'd expect. They seem to know what they are supposed to know, which --- and no one wants to admit this --- means there is a lot they don't know too. The human body is a complex organism and they don't always get it right. They are not Gods, even if our system forces them to act like ones. But that doesn't mean they are bad doctors. What's bad is the system they have to work in and how they are compensated.

     It must be obvious to some of you out there that dealing with sickness does not lend itself well to a free market, business environment. In a properly functioning market system, better work is compensated with more money. Home made, bakery cookies are more expensive than a pack of Oreos; a Lexus is worth more than a Chevrolet, etc. But the reverse system of reward is evident in our corporate, profit motivated health system. Each time the doctor gets it wrong, the patient ends up paying substantially more. The worse he or she does, the more the "consumer" (what a horrible euphemism for a sick person) pays, the more the doctor makes.

     If the treatment of sickness were to be rescued from the "market" and made a part of the "social contract", as it so rightly is almost everywhere else, this contradiction would be minimized. When I say the "social contract", I mean the citizenry pooling their resources as a nation to provide medical services to all, administered by the one institution that directly represents and is directly answerable to the citizenry: the government. As I write these words, I am amazed to think how discredited such an idea has been made by the socio-political propaganda in America, controlled by business interests lusting after your money. (Even though this is far from being a "radical" concept, in fact, making health care a purely business gambit, as it is done in America, is truly the radical concept). These business interests are solely responsible to themselves, and the correlation between the citizenry's well being and their own well being does not always match up. My God, how much more proof do we need before we do something about it?!

     In such a "social contract" system, the doctor can more easily say, "hey, I'm not sure, we'll have to do this or that, take more tests ." etc., without putting an additional financial burden on the patient, or without avoiding a perhaps necessary procedure the corporate insurer doesn't want to pay for . and without having to act like the omnipotent God he is not. Yes, each time the doctor does not get it right, it costs more, but in a "social contract" system such cost is assumed by the massive wealth of the entire nation born financially by all. In addition, such a system could eliminate a tremendous amount of waste in duplicate services, excess paperwork and public relations expenses, which the private sector spends gobs on.

     And now, I wait to see if I've been freed from urinary hell. If the doctor still hasn't gotten it right, how much more do I have to pay for a more mediocre service?