Just Another Day in American Medicine

I.

It's been seventy minutes while we sit here waiting for a covid test in a room where we were told the wait was ten minutes and we get to wait in the car. The waiting room is a crossection of the northwest Baltimore public. An African American father who can't get his four year old daughter to keep her mask on. A sixty fivish quiet ultra-orthodox man reading a volume of Talmud with his fortyish daughter with a loud voice wearing a shaytl. She is at the front desk yelling at the secretaries and one secretary literally calls her insane as she storms off and they laugh at her. An African-American teenager who's grown his hair out waits in a chair against the wall. A tall white woman stands in the corner. An African American mother with two well behaved elementary school age girls sit near us. Mom is a young seventy, and me, an old forty. Mom is playing sidoku, I stew in rage. Gradually the room thins out until it's the Rabbinical guy without his daughter, the teenager, us, and the secretaries; along with someone hanging out at the desk, whom I can only suppose is another secretary. We didn't see anybody get called. I suppose it's possible everybody else just left. Literally the only people in the room wearing an N-95 are us and the white woman.

A half hour in, I ask the secretary how long it's gonna take before they call us, she says right away. That was forty minutes ago. Twenty minutes after that I irritatedly say to my mother 'we could be here till ten.' She irritatedly responds says 'you can go, I'm staying.' Comsidering we came in the same car, that option seems impractical. Finally my mom goes up and with a politeness grown over a lifetime to melt the hardest bureaucrat she asks how much longer.

Without looking up the secretary says without even looking up 'you guys are next.' Both the secretaries are not wearing their masks over their noses. As is the custom in hospital waiting rooms around America, the TV plays loud enough to drown out the patients' thoughts, presumably so we can't hear our own fear and anger, but I don't know how the secretaries haven't gone crazy, let alone the rest of us.

It's just another day in the 2020s, when the world's patina of functionality has come off and we are left with the world as it's always been, a mixture of chaos and luck. All of us live in a lottery where the wheel of fortune calls our number and we are called to learn if we get lucky. As the game moves from round to round, the good plates on the wheel get fewer and fewer and we all fear we're going to be called up for a round of sudden death.

We try to remember what there is to go on for and that there's more to all this than just fearing worse and worrying that the mere attempt to solve our problems may cause more problems than it ever solves.

We are all set in our habits. We sign up for a test, and damnit, we're staying to get thay test even if it tells us we're negative only for the wait to give us covid and we are here again next week, potentially worse than we ever were.

America is accustomed to working out. We don't remember bread lines, we never experienced the Soviet Union where people existed to serve the bureaucracy and questioning it would get you sent to Siberia. We're here, we expect things to function, and even if it doesnt work out, our lower brain keeps us in line. Why? Because this is what America always was, and as Americans, this is what we do.

All we want is to live a life that's sometimes free from fear. Once upon a time, we had it and we tell ourselves that this is just a temporary nightmare. We wait for that day to come again, and we wait, and we wait. Was that the real world, or is this?

II.

75 minutes. Our names are finally called. We go into the waiting room. The realization gradually dawns on us that even in the examination room, the wait continues, and the wait this time is another half-hour. Healthcare is about waiting. Jerry Seinfeld has a bit on it in standup and more bits about it on nearly every season of his show.

Every Jew is raised to think there is one god, and His name is Doctor. Jews and everybody else just take it on faith that doctors are doing everything they can for us at what they do better than anyone else on the planet. We see them as perpetually overworked, overtaxed, and we take it on faith that they're not overpaid. Every doctor has their horror stories about patients, and every patient has their horror stories about doctors. If the patient dies, it's not their fault, but it might be the patients' fault for how they lived. If a nurse or lab tech screwed up, well,... good help is so hard to come by....

And if it's the front desk's fault?

Well... it's the nature of class prejudice, but people when they're frustrated say uncomfortable truths out loud which are inadvisable to declare in any polite company, particularly people with enough privilege to have no serious ramifications for saying what they think:

Even if we don't consciously think it, every person in America operates in a medical office as though whoever's working the front-desk is a person of mediocre intelligence and mediocre ethics; and that and who can doubt that presupposition conditions medical secretaries to spitefully act the part of the person we already think they are? Every day, a dozen or six people wait on the phone, speaking to them through gritted sinuses while they fight the urge to break their cell against the wall,, and every day, a crazy person with an entitled streak can't take it any more and melts down on them. And in their minds, every day a doctor either browbeats them or treats them with condescension. The medical front desk a job that virtually conditions its occupants to take their revenge on the patients with an encyclopedia of passive aggressive techniques. If a patient dies, it's obviously the doctor's fault, not theirs. The medical front desk is a job with nearly as much power over life and death as the doctors themselves, and the entire class struggle is virtually built in.

After 30 minutes, the nurse comes in. Takes notes on our symptoms, swabs our noses, tells us it will be ten minutes.

30 more minutes until a nurse-practitioner comes. I was a little hard on my mother. She was still feeling sick, so she wanted me to drive her, and enthusiastically told me that I should book a test too because according to my brother the whole thing only took ten to fifteen minutes and we could wait entirely in the car.

We had already gotten a long covid test whose results will arrive either tomorrow or Friday, but we got this test because she didn't want to cancel her physical therapy appointment tomorrow or her dentist Friday. The only problem is... it's supposed to snow tomorrow and my parents live up a driveway on a hill, so she might have to cancel both appointments anyway. Furthermore, we literally drove to my brother's house to pick up a home test, but she wanted this appointment, not the home test, because "I don't want to waste it."

It is a cliche when any Jew says 'This country gave us everything.' But so far through American history, it really did, and there is no greater American than my mother. Whatever her political views, if she ran for President, she'd get 100% of the vote and be our greatest President since Hillary Clinton.

After 20 minutes my mother goes into the hallway and I hear her ask the first nurse she finds how much longer it will be. She's using that 'appease the bureaucrat' voice again. Any bureaucrat whose heart can't melt at the sight of Mom has a heart of stone. The nurse says 'It'll be just another few minutes.'

Ten more minutes. Not as bad as I feared, but we got there at 7:15, we got our results at 9:45.

Negative, both of us.

Sigh of relief I guess.... but then I ask:

"How likely is it that we were contaminated by the waiting room?"

The NP looks at me like a crazy person.

"There's no likelihood at all. You can't catch covid from people waiting in a car."

"But we weren't waiting in a car. We were waiting in the waiting room."

(A look of shock and blame.)

"Why would you possibly do a thing like that?"

"It's what the receptionists told us to do."

(The shock intensifies.)

"Nobody's supposed to wait in the waiting room."

"Well over the time we were there there were well over a dozen people in the waiting room. Possibly a dozen and a half."

(Shock turns to panic.)

"How long were you there?"

"Thirty five minutes." My mom says.

"It was over an hour." I correct her.

"That is absolutely not supposed to happen."(No apology.)

"Your chart says you had symptoms. Here. Let me take your vitals."

She takes our vitals and says she will write a prescription for imodium. She leaves before we have time to tell her we already have imodium at home, and like good Americans, we're conditioned to wait. We wait another fifteen minutes.

She gives us the prescription, and is on her way out the door. I summon my male authority voice with the deepest gravitas I can find, when she immediately turns, I switch mid-sentence to demure nasal mode.

"IF WE WERE WAITING in the lobby what is the likelihood we caught anything."

"Oh, there's no likelihood you caught anything. To catch covid you would have to be in the lobby for more than fifteen minutes."

(Did she already forget?)

Mom responds: "We were there for forty five minutes."

"Over an hour." I correct her.

"Oh. Well... if you end up having symptoms you should get tested."

"But what about our symptoms?"

"Well, it's possible you may still have covid but not enough of a viral load for the test to pick it up."

We're out, it's nearly ten.

Some people are built for situations like this. Your faithful facebook correspondent is not one of them, and halfway through the drive home, we switched and my mother became the driver. Scenarios flash through my head of all the various ways this could avalanche to horror.

One day, the paranoid delusions of bad Americans like me will be proven right, and oh how happy we 'll be.