Newspoem 13 September 2007

The Hypocritic Oath

I was born into a criminal empire that today has drawn up plans to take over another neighborhood. There is a cancer spreading in this community.

Rushed to the Carle emergency room, Cristy is administered EKGs and a battery of tests. The two doctors tentatively conclude that the reason she fainted in the park that July afternoon was probably dehydration. I clear my throat, and ask if she can have a glass of water. They hadn't thought of that. It has been almost two hours since she fainted and she has had nothing to drink. $600.

Health plan, the emergency number on your website is not open on weekends. The other numbers are disconnected.

When I call Carle Clinic to inquire about a bill, I am transferred back and forth from department to department, given no answer, and finally transferred to the cafeteria.

The cancer grows.

Dr. Elephant, a malignant grin metastasizes across your face and your demented eyes grow wide as you describe my impending surgery to me. "We're going to make a WIDE cut,” you leer, staring through the diamond-shaped hole made by your fingertips. You grab my belly's flesh and pull, wondering if I have enough skin for you to cut as deep as you desire.  “If it were melanoma,” you say with drooling earnestness, "we’d go WIDE and DEEP.” “It’s not melanoma,” I hasten to assure you, wondering why you would even suggest it. Instead of asking me to sit up, you grab me and upend me roughly, a slab of meat in your callused hands. This consultation lasts ten minutes. You have the bedside manner of an actor in a low-budget horror movie. $250.

Dr. Good, you have someone weigh me, though I have been weighed twice this month already. Glancing at my record on your computer screen, you say: "You're basically healthy, right?" I answer yes. $120. Am I doing all the work?

The lash of my contempt is for you, Chris, in insurance. All these appointments are because I am to have surgery to have a suspicious mole removed—a  trivial unobtrusive procedure. You are to get me to agree to an estimate of what it might cost. Staring inscrutably through mascara-raccooned eyes you push at me a form to sign. After reading through it I push it back.

With complete reason, I explain: “It seems the purpose of this form is for me to acknowledge that I have been given an estimate of what my operation will cost. But I don’t feel comfortable signing it because the space for the amount has been left blank.” You are surprised that I would be so difficult. You will make some calls, you say.

This is to be my first surgery. I am nervous and vulnerable. Fresh meat.

I go to meet with an anesthesiologist who thinks he will render me unconscious for several hours, and feed air through a tube fed down my throat as a precaution in case I stop breathing. It will take me a day or two to recover. But in fact I am only supposed to be put into a borderline state called “twilight,” according to what I have been told. When, in fact, as I later discover, only local anaesthetic is appropriate for a mole removal. You, Dr. Anaesthetic, are doubly wrong, but it is your job to use your vast medical training to contrive the most expensive possible option, even if it is more dangerous. $100.

Before I can leave, a nurse stops me and again I am placed at a table opposite you, Chris. Now the form you push at me says my surgery will cost $13,000-46,000, an estimate is astonishing in both its magnitude and lack of precision—e ven the lowest end of its $33,000 range is far more than I would expect. The wide range, you shrugs, is because they aren’t sure whether it is impatient or outpatient surgery. Nobody in this hospital is sure what they are going to do to me, I realize, except for you, who are going to get me to agree to any expense. It is, I say, outpatient surgery. I persuade you to cross off the high end of the range before I will sign it, but, unwilling to imply a possible limit to what I might be charged, you write, in a childish scrawl, “a little more than” before the $13,000. That is ridiculous. Even with my insurance,  it will take me a year to pay for the removal of a mole that is not even cancerous. And I have dozens of moles.

If Dr. Elephant is the knife man, you, Chris, are the hatchet man. It is your job to get unsuspecting people to sign blank estimates so your criminal bosses can write in obscene figures later. You are a health care fraud professional. Your excessive eyemakeup must belie that you cry yourself to sleep at night.

If I, a man with perfect health and insurance, must go into debt for the removal of a benign mole, what do real people, with families and working-class jobs, needing real surgery, do?

After making twelve phone calls, I discover I can have the mole removed by a dermatologist for a few hundred dollars. One quarter the number of personnel, one tenth the time, one hundreth the cost.

Carle Hospital, you are infected with malice, incompetence, and greed. Your mission is to end the lives of sick people by burying them in permanent debt.

I walk in your doors with a minor cut, and your staff circle me, rapt, thrashing, deadly earnest, sharks gone mad with hunger at the smell of my blood.