Thursday, March 25, 2010

More Close Encounters of the "Bob" Kind

Has enough time passed since the jubilant signing of the Health Care Reform Bill and its necessity of 20 pens that we can settle down and speak the truth?

Like... what a terrible disappointment it is that the public option was sacrificed, when it alone would have made this true reform?

Like... how despicable conservative obstructionists have been? How heartless, and cruel? How manipulative and disrespectful of their own followers, that they have, essentially, abused free speech by inciting to riot, by screaming "fire, fire, fire" in the cramped and dark theatre that is the U.S.A.?

Like... how uninformed and illogical many citizens are, and how driven by out-of-control emotion -- fuming, frustrated anger that has all the hallmarks of a two-year-old's temper tantrum, except that two-year-olds don't usually wield the weapons of bigotry?

And (having taken a quick look at today's news headlines) like... how if the Democrats could adopt just a tiny bit of right-wing anality, the bill would not be subject to a re-vote on the basis of parliamentary mistakes? Just because you have succeeded in doing, in a marginal way, what is minimally moral, does not mean that you should fail at following the rules for governance. Yes, I am a nerd, and often a wonk. Yes, I am frequently appointed to be the Ball Buster Rule Diviner -- often seen as a curse, due to the thankless nature of the work, but that role is necessary to success. I haven't yet scoped out who the House Parliamentarian is... but 30 lashes with a limp noodle might be appropriate.

So I ran across this Emperor Bob person/persona on Twitter, then briefly visited his blog, Emperors Rants and Observations, where he can be found addressing the Various Issues of the Day, from campaign finance reform and climate change to the health care reform initiative and Alaskan politics. He's keen.

Oh, Faithful Readers:
I am so tired this morning.

My internist and I, recognizing an infection flaring in my left shoulder, decided that I should return to my poor orthopedic surgeon. Um, poor in the sense that the man has operated on me eight times since 2005, replacing shoulders, removing shoulders, putting in antibiotic spacers, taking them out, and so on, but has not managed to get any of the bacterial specimens to grow in the laboratory environment. Without identifying the offending bug, the correct antibiotics cannot be applied to the situation.

And now the pain is getting worse on the right side, and... {whisperofdenial} my left hip. Both of those joints have "hardware" implanted, thus making them attractive breeding grounds for germs. But we won't think about that today.

So, Fred loaded me and my super-duper powerchair into Ruby, the Honda CR-V, and we sped off to see said surgeon.

You are a fool if you believe that being without health insurance does not affect the standard of the care you receive, even in the form of advice.

ShoulderMan opined that he wanted another "aspiration under fluoroscopy," which would be the fifth or sixth time we tried that particular trick. It is painful, not particularly dangerous, and expensive. But, for me, the overriding factor was that it has never produced a piece of useful data.

If samples of purulent pus taken directly from my humerus during surgery and rushed to the awaiting petri dishes in a sophisticated hospital lab also cannot produce the identification of the offending organism, why do we keep pretending that these painful and expensive aspirations are in any way superior?

I reminded ShoulderMan that since I had last seen him, I had been priced out of my health insurance -- my Faithful Readers know well that I just could not swing $1513 a month for premiums, plus the $5000 more in deductible, and all of that on top of the thousands not covered. I live on private disability insurance due to the combined effects of CRPS in all my limbs (and now, face), avascular necrosis, lupus, Addison's disease, aortic insufficiency and so on, ad infinitem, ad nauseum.

Believe me, I tried to stay insured. It took the help of my state's Insurance Commissioner for me to have coverage to begin with, once COBRA expired. But BCBS eventually was demanding 97% of my income... and I dare you to criticize me for folding, at that point.

ShoulderMan said: "I don't get it. You ought to have MEDICARE."

{we have had this exact conversation already several times over and over again, not to be repetitive or fall into a déjà-vu sort of iterative redundancy}

Moi: "Yes, Dear ShoulderMan, I ought to. {actually, i tried to pull off an oughtn't i? but couldn't spit it out.} However, I fail to qualify because most of my working years were spent in university systems that did not pay into Social Security but rather into poorly funded and criminally operated pension funds. I lack ONE work credit, in the amount of $830, toward eligibility."

ShoulderMan replied, with a fair amount of dripping condemnation in his voice: "Well, why don't you do some work for a week, maybe tutor some local college kids, and turn that in?"

Moi: "Hmm, wow, I never thought of that." Okay, that's a lie. What I really said was:

"I have been informed by my Disability Insurer that to do so would mean the loss of my disability income, and it would be well over two years before any substantive replacement from governmental sources would kick in."

ShoulderMan muttered: "Oh, well... Okay. So I think we need to get this aspiration done and consult with a new Infectious Disease doctor, maybe over at Charity Hospital. This is the kind of thing that cannot be ignored..."

And he promptly exited, stage left.

His minion, PA Bob, then did something that reduced me to tears. Yep, here I go again, even crying into my laptop.

He came over to me, handed me the official pink and yellow copies of codes for the visit, so that I could check out and pay (which I obviously was prepared to do). As he walked into the crowded hallway, he said, loudly:

"Why, wasn't that nice of Dr. ShoulderMan. Look, he marked the box for 'No Charge' so that you don't have to pay for this consult."

Dr. ShoulderMan, who moves at roughly the speed of light, was long gone and already ensconced in the next exam room, so Bob was not making points with him... Leaving me, once again, to wonder why Bobs, in particular, are so intent on confusing me! For a succinct treatment of my history with Bobs, read this.

I've never engaged in a political dialogue with either PA Bob or his boss, having intimated from various remarks that they are both ultra-conservative and that ShoulderMan may, in fact, be an Evangelical (I intend that to reference the Conservative Evangelical Movement, à la George W. Bush).

Aside: Here is one of the fairest succinct explanations of Evangelicalism that I've run across. It comes from an address by conservative EPPC Senior Fellow Wilfred McClay* entitled American Culture and the Presidency, delivered either in Fall 2004 or early 2005.

As a faith that revolves around the experience of individual transformation, it inevitably exists in tension with settled ways, established social hierarchies, customary usages, and entrenched institutional forms. Because evangelicalism places such powerful emphasis upon the individual act of conversion, and insists upon the individual's ability to have a personal and unmediated relationship to the Deity and to the Holy Scriptures, it fits well with the American tendency to treat all existing institutions, even the church itself, as if their existence and authority were provisional and subordinate, merely serving as a vehicle for the proclamation of the Gospel and the achievement of a richer and more vibrant individual faith.

Anyway, there is nothing abstract in the nature of how being an uninsured (and uninsurable) citizen impacts my life. It truly may contribute to my death, as I have spent the first few working hours of this day on the phone with the aforementioned Charity Hospital -- and the helpful pickings are, let's say, slim. The clinic system there may eventually help me, but there are no appointments to be had anytime soon.

Unbelievably, three times (like Peter's crowing cocks), I was told to go to the Emergency Room!

I have avoided a close rereading of what Obama signed, and what Congress is continuing to work through, precisely because I am not yet convinced of the permanence of any change -- but clearly, I am going to have to dedicate time to it today.

Because if there is no fairly immediate help for me in the legislation, I am close to abandoning all hope. I cannot continue with daily fevers up to 101, the attendant sweats, chills, and pain -- on top of my usual severe pain from CRPS and AVN -- I cannot sit in waiting rooms for hours, especially now that my left hip may have joined with the Infected Skeletal Alliance.

Oh, boo-hoo! What a sob fest this post has turned into! But I am going to leave it as is, if only for its potential to serve as a shaming mirror the next time I decide to whine.

The saving grace here is this YouTube video from Emperor Bob, an amazingly calm rant to which I will return with frequency... Thanks, Bob! [Correction -- a correction which blows the whole Bob Phenomenon to hell, but maybe you won't notice -- that is not Bob on the video. No, the star of that show is one "old fart rants," who has quite the head of steam built up over on YouTube!]






*Wilfred McClay is the 2009-2010 William E. Simon Distinguished Visiting Professor at the School of Public Policy. He is the SunTrust Bank Chair of Excellence in Humanities at the University of Tennessee at Chattanooga, where he is also professor of history, since 1999. He is Senior Scholar at the Woodrow Wilson International Center for Scholars in Washington, DC, Senior Fellow at the Ethics and Public Policy Center, and has served since 2002 on the National Council on the Humanities.

Major sigh, and where is the ibuprofen? "The SunTrust Bank Chair of Excellence in Humanities"?

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