Serving Time

by NotDownOrOut

The clock moves at the same speed every moment of every day, but the hours can pass so slowly when you long to be some other place. Today I met with Dr. H and heard that my blood tests showed no abnormalities. My platelets should be between 169 and about 380. They were 196. That’s fine.

On Friday I will meet Dr. Y for my first gynecological examination in a year. Nothing terrifies me more. The last time a doctor examined me I screamed in agony. I assume that a great deal more healing has taken place since surgery and twenty-five days of radiation. Nevertheless, even as I sit at my desk typing this entry, my shoulders are tense. My hands feel cold. There is that tiny quake inside my body that could become a tremor and maybe a shake if I let myself feel it. Instead, I am clenching my teeth. I am curling my fingers into my palms to keep my hands from shaking. It will probably turn out fine. Women go through this every day.

Maybe that’s why it is making me so nervous. It is supposed to be easy. Nothing has been easy for some time. I may have powered through it, but it was not easy.

According to Dr. H, if Dr. Y is satisfied, then I do not need to return for another appointment until August. I like the sound of that.

She and Dr. Z examined my “rash.” It has not gone away. In fact, it has spread. They studied the blood results, but could only speculate as to why the patches have faded, but the expanse covered has widened. Dr. H called for a dermatology consult. The Dermatology Clinic agreed to fit me in today at 12:30 p.m.

I had already been at the hospital since 6:00 a.m., but I agreed to wait around until 12:30.

That’s right. I was huddled in my car this morning in the parking garage at 6:00. The 34 degree winds were gusting up to 50 miles per hour. I was reluctant to go inside and wait in a long line for the elevators to open. I hunched down in my seat and waited until 7:00 a.m. By that time the public parking lot was filled and people were halting beside my car to ask if I was leaving because they wanted my space.

When I got to the elevator bank the line of people waiting for an elevator wound all the way to the front doors of the building and back around in a huge horseshoe shape. I stood behind a senior citizen in his wheelchair. He had his medical file resting on his knees.

Only one of the three elevators at the east side of the building was in service. The elevator would open and the police would direct people into it. Someone would press B when everyone else was headed to the second floor specialty clinics. Everyone would ride downstairs. The pack would part resentfully to let the “deviant” depart. Then folks rode back to the first floor. The waiting crowd would surge forward and then be forced to halt because there was no room in the elevator. The doors would close and the elevator would proceed to the second floor. On its return, it would head for the basement so we could repeat the exercise.

A woman in her seventies cut into the line beside me and started to pass me. She looked fit and capable of waiting. I could have objected, but I did not have the energy to squabble when we were likely to end up in the same elevator anyway. She then made a move to pass the man in the wheelchair. Big mistake. Don’t ever make the mistake of thinking that the disabled are incapable. They just have less of some abilities and more of different abilities. The man in the wheelchair saw her out of the corner of his eye and he turned the wheels of his chair just a bit faster. He avoided riding up on the heels of the couple in front of him, but he made it impossible for the woman to cut in front of him unless she hitched a ride in his lap. She lengthened her stride and drew up alongside him and did the racer’s lean. You know what I mean. Her chin came forward. Her shoulders followed. She tucked her medical file under one arm and thrust her handbag forward.

Her intention was clear. If the next elevator appeared crowded, she would edge out the man in the wheelchair and leave him to wait for the next empty car.

I may not have felt like starting a “rumble,” but the man in the wheelchair had no reservations. As we waited for the next empty elevator, he pointed at the woman and said, “This is a line, lady, and you can’t cut into it.”

“Lady” is such a polite term, but not when it is used as the man in the wheelchair used it. There was a wealth of sneering anger in that one word. I felt it like a punch in the gut. The man in the chair might have been at the county hospital for his care, but his khaki pants had a crisp pleat down the front of each leg. His plaid shirt had starch in the collar and cuffs. He may have been in a wheelchair, but his shoes had the super thick soles you see when men walk a beat or stand in formation. The file in his lap was Army green and had papers that were organized rather than assembled. He spoke with authority, but, as I said at the outset, there was something else. It was darker and a little menacing.

I looked at the woman. She was equally determined to succeed. There is an inscrutable manner that some recent immigrants project. It is partly language differences. They may or may not speak English. They may or may not understand our cultural norms. This woman looked like she was pretending not to understand. She made no eye contact. Her eyes were on the prize.

As the elevator doors started to slide open she made her move. She darted forward, cutting past the wheelchair and the couple ahead of us. As she reached the elevator’s threshold a police officer crossed in front of her.

“Are you cutting in line?” The police officer was very tall. His uniform was very blue. His eyes were very dark, like the night when the moon is a tiny sliver in the sky.

The woman betrayed no emotion. None. She evinced the steely determination that will likely see her through whatever health threat she must now overcome.

The policeman looked at me. “Did this woman cut in line?”

Now everyone looked at me. The man in the wheelchair was right. She was cutting. But, I swear, he was giving me the same scathing sneer of distaste that he had directed a moment earlier at the other woman.

I shrugged. “Officer, I’m not sure when she joined this line.”

The man beside me was fuming, but both of us waited as she forged past the policeman. There was room for the wheelchair but no room for me. As the door shut in my face, the woman smiled. It was not a pleasant smile. I know. She thought I was weak. The man in the wheelchair was pissed off. He thought I was a bitch. Maybe I was a little more of one than the other.

I am betting that he was the first one out of the elevator on the second floor. If he could have, then he probably ran over the woman’s foot. I was better off waiting for the next elevator.

When I got to Clinic H there were other bad portents. It was 7:30. That’s right. It took 30 minutes to wait for and ride an elevator down one level and up two. I took a seat because my appointment was not until 9:15 a.m., and it is bad form to try to check in more than an hour in advance. The receptionist summoned me to her desk then told me I was checking in too early. I went back to my seat and graded papers for my drafting class at the law school.

When the nurse came out to test my vital statistics she could not manage to get my blood pressure. We tried three different cuffs, put it on two different parts of my arm, and let the machine take readings at least a dozen times. We finally tried another machine. By that time my blood pressure was slightly elevated.

That was a long way of telling why I ended up with time to try to renew my charity status at the hospital. I returned to Room 1290. That’s where I went on October 26th when I was told that I could not apply for renewal of my charity status unless I owed the hospital money. At that time I had one day left of eligibility so owed the hospital nothing.

I discovered that Room 1290 is now County Care’s office. County Care is part of the Obama Care plan. It is health insurance for people who cannot afford health insurance. Of course, you also have to have an income less than $15,000. There is a tremendous tax hit as you cross over from poverty to low income. Why would a person making less than $15,000 work even one more hour if the first thing she lost was health insurance?

I work way too hard to qualify for County Care even on what universities pay to adjunct professors. The receptionist sent me to CareLink in Room 1690. I waited in line with about 20 people to get a number that entitled me to wait to see someone. When I last had an appointment with these folks I was told I would not need an appointment to renew my coverage. Everything has changed since then.

I got number 317 when the number being served was 298. I watched the clock. It was only 10:30 a.m. I had two hours before the dermatology appointment. At noon CareLink was serving number 307. I left for my dermatology appointment. I thought there was a good chance I could return before 317. No such luck.

In the Dermatology Clinic there was a full house waiting. I sat behind a man, who was sleeping in his chair, and his transgendered sister. She was at least six feet tall, had a full head of orange hair that matched her orange fake nails, wore a push-up bra and three additional pieces of lacy lingerie layered one over the other, and sported a noticeable Adam’s apple. I envied her amazingly long legs that went up to the sky in leopard print leggings. I am pretty sure that she studied the various exercises of the Brazilian Butt Lift because you had to see it to believe how high her buns of steel were. She was still working on her voice. It was tough. It was Kathleen Turner after the Super Bowl and a sip of whiskey.

There was a man with a hospital mask and a plastic “cowl” that covered him from his neck to just above his glasses. It was more than a little reminiscent of those collars they put on dogs to keep them from biting their own wounds. This man showed up every place I did today. Apparently he let the door to Clinic G shut in the woman’s face and then said to her, “Get your own door, lady.”

The woman was incensed. “Who are you calling, ‘lady’?” she asked. “Are you talking to me, dog breath? Because let me tell you that I have a bigger set than you do and mine were cut off three years ago.”

This exchange woke the brother. He sat up and watched for a minute. Then he pulled his cap down lower and let his head sink inside the collar of his pea coat.

The woman was not done yet. “In these shoes I could raise my leg and still piss on your head, you shrub.”

The man looked dazed. He scurried away. The woman sashayed back to her seat and announced to no one in particular, “If he wants to treat me like I’m a man, then I’m still twice the man he’ll ever be.”

I saw five dermatologists today. Actually, one person was a med student. She introduced herself and shook my hand. Then she took my patient history very competently. We studied my rash and she informed me that it covered my sides and back now. I had not noticed.

She brought Dr. G. Dr. G brought in two more doctors. They studied my legs where the pattern of red dots was extensive. Dots ran from my ankles to the tops of my legs. The doctors took out a magnifying glass and all took a gander at the red spots up close and under bright light. “Just like cayenne pepper,” one doctor declared. They got on the computer and looked at my blood test results. “It looks like a reaction to the bladder medicine except that such an allergy would have stopped at your legs and flanks.” Everyone studied the profusion of red dots on my arms. They were unlike any of the other swashes of red dots because they collected in patches. There was a pattern like a petaled flower at the inside bend of my left arm. On my right arm it looked more like bruising. They poked and remarked upon the lack of swelling, “heads,” and other awful signs of allergy.

They left to get “the boss.” Dr. S came in and everyone studied me yet again.

It is a teaching hospital. I became a class problem. The doctor thought it ironic that he had only seen a condition like mine in other teachers.

He speculated that I may have an allergic reaction to my bladder medication. However, he thinks it could be hypergammaglobulinemia. Discovered by Waldenstrom–who also discovered macroglobulinemia. One should be careful to NEVER confuse the two. The former is an immunoproliferative disorder. Basically, it is possible that I have too much gamma globulin because I have too little of another type of immunity (antibody) in my blood. The one type of immunity is a paraprotein that is in excessive supply–IgM. It could be that I am too low in another immunity–IgA, IgE, or IgG. I guess these other immunities are sometimes referred to as B cells, T cells, and Natural killers (NK). The doctors would need a paraprotein count, and the test is expensive so will not be done at County. However, he described it as a nuisance condition. The spots will stay or go and may return throughout my life. He suggested that I give it another month to disappear. If it lingers, then I should return to the walk-in clinic after 3 p.m. on one of the several days of the week that the clinic is open.

He did not even want to make a note to my file of the possible condition because it has not been confirmed and because the other condition that Waldenstrom identified is a blood cancer, a leukemia. It is a very serious disease, and he said that practitioners will hear Waldenstrom and the rest will sound like the teacher in a Charlie Brown cartoon, “Wah, wah, wah, wah.” They will never appreciate how much less dire my condition is.

I agreed that I could deal with the nuisance.

It was too late for me to renew my charitable status. By the time I made it back to Room 1690 it was 2:30 p.m. and the staff was working with number 327. I was 10 people too late and will have to start over on another day. Maybe I can stay after my gynecological exam on Friday to pursue the charity status.

As I drove home after 8.5 hours of waiting for about 30 minutes of time with doctors I was struck by the similarity between this potential explanation of my current spotted look and my encounters with people waiting for elevators, care, or charity. They just have less of some abilities and more of different abilities. The man in the wheelchair could not walk, but he was steely in ways that keep him from getting run over. The woman in the Dermatology clinic may not have had enough anatomy to qualify any longer as a man, but she had balls of steel when confronted by a man who thought to put her down. I am not poor. I have plenty of education. I work very hard. But I have a history of cancer and not enough income to pay for health insurance. I don’t have enough of some essential immunity, but I have so much of another that it’s splashing all over my body in its outrageous excessiveness.

Sometimes we come up short and find balance by having way too much of something else.  Today the thing I really had too much of was time, so I spent as much of it as I could learning very little of any use to me.