by JIM KNIPFEL
June 16, 2019
My Bwain Hurts!
The last few times I saw him, my neurologist, Dr. Buckley, was cautiously optimistic. The Brooklyn hospital where he’d worked for the last fifteen years—a little hospital he had boosted tirelessly the whole time I’d been seeing him—was being taken over by a much larger, much more prestigious hospital with a lot more money and corporate backers.
I liked this neurologist. He was personable and curious and thorough. He’d uncovered a few conditions none of my other doctors had ever considered before, and was perceptive enough to know he could quote Monty Python during my appointments. You have to trust a doctor who cites the Pythons to make a medical point. This also allowed me to greet him whenever he stepped into the examination room by blurting a little too loudly, “ARE YOU . . . DA BWAIN SURGEON?”
“I think it could only be for the best,” he said of the ongoing takeover. “It means we’ll get more good doctors on board, which is always good, and we’ll get access to some state of the art facilities.”
When I asked if he was worried about the staff cuts that always seem to accompany takeovers of any kind, he said, “Well, I think I’ve brought in enough patients, people who come here specifically to see me, that they would never get rid of me. They did that, they know I’d take all those patients along.”
The last time I saw him in October of 2017, he was sounding a bit less optimistic in general. The larger, more prestigious hospital had insisted the little hospital they’d just gobbled up switch all their records over to a new computer system, and it wasn’t going very smoothly. The new system, which was becoming standard throughout the medical industry, simply didn’t work very well. My neurologist seemed a little frustrated and haggard. A month and a half later, I received a letter from the hospital informing me Dr. Buckley no longer worked there. They offered no further information that might help all his former patients follow him to wherever he might be working now.
Okay, now jump ahead to spring of 2019. My supply of anti-seizure pills was beginning to dwindle, but when I tried to get it refilled the pharmacist informed me that since the original prescribing physician was no longer at the hospital, I’d have to find another neurologist and have him write me a new prescription. That was no sweat, I figured. The last time I went to see Buckley, he’d asked me to consult with Dr. Jenkins, an epilepsy specialist in the same office. We’d spoken about the effectiveness of that seizure medication specifically, so he was clearly the one to tap. Jenkins was okay, too. Another curious and funny sort who told me I had “a very interesting brain.” I’d seen him twice, so figured I could just call and have them switch the name on the prescription and that would be that.
Well, no, of course it wasn’t that simple. In order to get the names on the prescription switched I’d have to come in for an appointment with Dr. Jenkins first. Why was I not terribly shocked to hear that? I grabbed the next open appointment, which was a month away. I’d have to ration out the pills so they could carry me that far, but it could be done. I’d done it before. What’s a few extra seizures?
A month later I got on the train at around ten in the morning and took it eight stops, walked an additional seven blocks to the office complex adjacent to the hospital, took the elevator to the fifth floor as usual, turned right and walked to the end of the hall to the neurology department. The office was much busier than I remembered it. After slowly picking my way through all the chairs and people, I found the front desk.
“Can I help you?” The woman at the desk asked.
“Um, yeah. I have an eleven-fifteen with Dr. Jenkins.”
“Dr. Jenkins is neurology.”
That seemed a strangely obvious thing to say. “Yes, he is,” I agreed.
“Why are they sending all the neurology patients up here today?”
I couldn’t tell if she was asking me, or someone sitting next to her, or if it was simply a rhetorical question. Maybe she wasn’t even the receptionist, but another patient with neurological problems. “So this isn’t neurology?” I asked.
“But it used to be neurology, right?”
“Well then, I guess that explains why neurology patients keep coming up here,” I offered. “So where is neurology now?”
“Fourth floor, suite A.”
“Um, okay,” I said, pausing a moment in the hopes she might offer a few more specifics, like where on the fourth floor Suite A might be found. Realizing no such information was forthcoming, I said, “Yes, well, I guess I’ll go look for it then.” I turned and again picked my way through the crowd to the door, which I found on the third try. Already I was getting a sense of how things had changed since the takeover. When it was just a little rinky-dink independent hospital, the staff had always been a bit more helpful and friendly, and I could always count on the neurology department being in the same damn place.
One floor down, and after taking a wild guess as to where I might find Suite A, I found myself in an equally crowded neurology department. The television was blaring some shrill celebrity gossip crap that always made my brain hurt a little. This time at least the woman at the front desk confirmed I was in the right place and found my appointment on her computer. Okay, then, things were looking up. Time was, all the women who worked the front desk used to know me by name, but considering the loud murmur of the brain-damaged and twitchy behind me, I guess it was too much to expect.
I handed her my insurance card. Now, here’s another difference. In the past whoever took the card would run to the back to photocopy it and slip the page into my file. Now the receptionist had a convenient mini scanner on the desk so she could simply scan the card quickly and easily, and the image file would then be dropped into my electronic record neat as a pin.
In theory, anyway, if the damn thing was working properly. After four or five tries she finally had something on the screen that sort of resembled my card, and so was satisfied with that. She handed the card back and told me to take a seat.
“Ummm,” I asked quite sincerely. “Where?”
Yeah, I was getting a whole different vibe from this place. Oddly, the one new addition since the takeover that bothered me the most was the introduction of one of those standard hospital intercoms which could be heard throughout the entire suite. Again, time was if one of the receptionists wanted to pass a message along to a doctor or co-worker, she’d just yell over her shoulder. Now the air was filled with an endless robotic patter of “Dr. Lesy, pick up line eight-four-two . . . Danielle to the front desk . . . Josephine pick up line three-nine-o . . . Calling Dr. Moe. Calling Dr. Larry . . .” It almost, but not quite, drowned out the shrieking of the live studio audience on the stupid television.
I will have to give the new corporate restructuring one thing, though. After checking in I could usually count on sitting in that waiting room an hour or more past my scheduled appointment time before anyone called me in, all the while my brain being damaged further by the shit pouring out of the TV. And I generally had to wait that long because the doctors were taking the time to sit down with their patients to discuss conditions, options, and occasionally act out a Monty Python sketch. That morning I hadn’t been in my seat for five minutes before a nurse called my name.
The nurse who called me explained she was going to run a few preliminary tests. This was to be expected, of course, but what it boiled down to was sitting me in a plastic chair in a bustling hallway, wrapping the cuff of an automatic blood pressure reader around my right arm, hitting a button, then leaving. The cuff expanded, then slowly deflated. Then it inflated and deflated again. Then it did it again. By the fifth go-round of having my blood pressure taken by a robot, I started to wonder if anyone was ever going to come back and turn the fucking thing off. Maybe that nurse went to lunch or to get a drink or something.
By the time the nurse eventually wandered past again and realized I was still sitting there, I’d lost count of how many times my blood pressure had been taken. She turned off the machine, checked the numbers, and told me my blood pressure was dangerously high.
“Can’t imagine why that would be,” I commented, trying to sound more genuinely confused than sarcastic.
She then zipped me into an examination room, telling me the doctor would be in shortly. Again I expected to be sitting there a good half hour as per usual, but a few short minutes later the door opened, and the doctor walked in. Or at least someone claiming to be a doctor. It wasn’t the one I’d made the appointment with, unless he’d had some radical experimental surgery since I last saw him.
The tiny woman said she was Dr. Jenkins’ intern, and she would be handling my case. She said her name was Dr. Circe, she had an indeterminate accent, spoke in the kind of baby voice that made me instinctively want to punch her, and If I had to guess I’d say she was about twelve. This was not going to end well.
“Now we’re talking about epilepsy?” she began. “So first of all I would like to get a complete history of your seizures? When did you have the last one?”
Oh, Jesus Christ how I hate the enthusiastic types. “Well,” I tried to explain calmly. “The only reason I’m here is because I’m running out of my seizure meds, Dr. Buckley wrote the last prescription, and my pharmacist won’t fill it until I get a new one from Dr. Jenkins. It’s a simple matter of switching the name over, then I’ll be out of your hair.”
“Yes, well, I’ll be putting my name on the prescription?” she told me. “But if you’re still having seizures? I’d like to see if maybe we should change the dosage or try a new medication? Our goal? Is to get rid of the seizures completely? Over time if you keep having seizures? It can lead to memory loss? And mood swings? And changes in personality and other sorts of brain damage?”
Oh, you don’t say.
“No, see, I’ve been through all this with Dr. Jenkins,” I tried to cut her off. “And he decided it’d be best to just keep me where I am with the meds I’ve been taking for the last thirty years. It’s working fine with no side effects, so there’s no reason to go mucking around with some new . . .”
None of it seemed to register. She simply began peppering me with questions I’ve answered a dozen times. And those answers should have been right there in the file she was looking at. I could feel my head start to tighten, which is never a good sign.
At one point the door opened and Dr. Jenkins stepped in. My vast relief was short-lived, however, when he just asked his pre-teen intern how things were going, then left again. This was the same doctor who, last time I saw him, told me to stop by any time just to chat if I’d like. He was very interested in learning more about blindness. Well so much for that.
“What I’d really like to do? Is a video study?” she said. “That’s the gold standard?”
(Later, Morgan told me that “the gold standard” is one of those meaningless corporate phrases that should always make you wary.)
“And what’s involved in this video study?” I already didn’t like the sound of it.
“Well, we’d check you into the hospital? For three to five days? We’d take you off your medication? Subject you to sleep deprivation and keep a video record of what happens?”
What the fuck? Is this how the feds were finally going to get me? By “the hospital” did she really mean “a CIA Black Site”? What the fuck was she thinking?
“Umm, no, we’re not going to do that.” I was getting fed up with all this and just wanted to get home. Just give me the fucking prescription and let me be on my way.
I guess I could have been more cooperative, but by then I wasn’t in the mood. In the end she put that five-day torture business on the back burner and instead set up another MRI, another extended EEG, and another bone density test.
“Fine, whatever,” I said. “But again I’d just like to get that prescription refilled before I run out. I’m leaving town in a few days.”
“Yes, yes, I’ll take care of that, too? But more importantly . . . ”
I stopped listening. “More importantly” she just wanted to sign me up for a series of very expensive, redundant and ultimately useless tests. That was another thing Buckley was good about. He’d suggest possible tests, but then shrug and tell me there was no real point. Well, so much for that sort of honesty when there’s money to be made, and with this little chippie anxious to prove what a good company girl she is.
After I finally escaped Little Miss Marker, but before I could hobble back to the subway, I was expected to take the elevator to the ground floor and get my blood drawn.
This, too, used to be a simple, low-stress operation. You’d step into the small waiting room off the main lobby, grab a ticket with a number the same way you would at a deli, then wait for your number to be called. The minute I stepped into the room, however, I sensed something was different, though I couldn’t tell what. I stood there a moment in the doorway and, hearing a few people fidgeting around me, I finally asked, “Is this the blood room?”
Someone grunted what I took to be affirmation. A moment later a young woman shoved something in my hand. It wasn’t a ticket. It was plastic and rectangular. About the size of a remote control but without any buttons. It was vibrating.
“Um,” I asked. “What’s this?”
“It activatin’” she said.
“Yes, but what is it?”
“For a number.”
“What? It’s vibrating. Is it going to explode?”
“Well okay then,” I said, concluding I wasn’t going to get much more by way of answers out of this whiz-kid. I found a chair and sat, stupidly holding this vibrating remote control, having no idea what the fuck was going on. And I wouldn’t know until I got back to Bay Ridge an hour later if that chirping little tween doctor had bothered to submit my prescription. I sat there wondering not only if this device was going to explode at any minute, but also how many other patients had already held it earlier that day, and what kind of diseases they were carrying.
Through the open door to the blood room, I heard one of the Jamaican nurses tell a patient, “No, no, we can’t do this test. It’s too late for this test.”
“What do you mean?” A middle-aged woman asked.
“It’s after twelve. We can’t do this test after twelve.”
“But I stopped taking my meds and I’ve been fasting since eight last night, just like they told me. I came in here from Staten Island.”
“I wish someone had told me you wouldn’t do this after noon. There should have been a note on the sheet or something.”
I checked my watch. It was two minutes after twelve.
“So what do I do now?” the woman asked, clearly frustrated but trying to sound reasonable.
“You can fast again and come back tomorrow morning. Or Monday.”
Yeah, in the end I guess I’ve been lucky, having made it halfway through 2019 before getting my first real taste of corporate medicine. No wonder we’re all royally fucked.
On my way back to the subway I removed the envelope containing all the prescriptions for the useless MRI, EEG, and bone scan and dropped them in a corner trash can.
Postscript: A month later, I received a $3,000 bill for the bloodwork alone, after the hospital billed it to an insurance company I hadn’t been connected with for three years. I called the hospital to get this resolved, and was passed around to four different departments. At each stop, I quickly explained the situation to whoever answered the phone, and in each case whoever I was talking to responded the same way: “Oh, no . . .” before passing me on to the next.
At last I ended up at the blood room responsible for the mis-billing. After the now familiar “Oh, no . . .” the woman told me this was my problem, and that I’d have to take it up with my former insurance company myself.
“But,” I argued. “This wasn’t my mistake—it was yours.”
“You have to call the number at the bottom of the bill. They’re going to want a lot of information, and you might have to mail them a photocopy of your card. Both sides.”
A photocopy? Where the fuck was I supposed to get a photocopy made these days? Do public Xerox machines even exist anymore?
“But again,” I tried patiently. “Your the ones who screwed up here. I call this insurance company, they’re gonna have no idea who I am, because I left three years ago.”
“Just call the number at the bottom of the bill,” she repeated before hanging up.
Thus began another long nightmare far too boring to recount.
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