It Hurts When I Do This

It Hurts When I Do This


Cognitive Dissonance


“Well, then don’t do that” is the proper response any competently trained physician would answer to a statement like that. Or at least that’s the well known joke passed around my household when I was a kid. Don’t do ‘that’ and you won’t have pain there.

It was actually a double entendre for us because we were too poor to simply run down to the local doctor for a proper diagnoses any time something hurt or went wrong. And this was during a time when medical care in general, while still expensive on a relative basis, cost much less as a percentage of our total income than it is today.

But I’m not here to discuss the cost of modern medical care, at least not directly. As promised a week ago, I wanted to write regarding my recent foray back into the medical establishment after an eight year absence. I’m not counting the two annual trips to the walk-in clinic to receive treatment (meaning Prednisone) for massive cases of poison ivy.

Did I mention I’m allergic to poison ivy and I’ll catch it if the wind is blowing my way? That’s my story and I’m sticking to it.

While I will not discuss, at least not at this time, what has prompted me to seek guidance from the medical priests and witch-doctors, I still wanted to post my observations, particularly because we have relocated to a rural area since my last significant medical encounter(s) and I wanted to discuss the differences and similarities.

They say all politics is local. It makes sense, because to the average Jane and Joe that pothole in the street is more likely to affect their lives, at least at that precise moment, than the latest geopolitical earthquake in the Middle East or Europe. It stands to reason everything that happens in the world is always distilled through our own personal how-does-that-affect-me rose colored glasses.

The same thinking applies to health care. While I am somewhat interested in the latest medical breakthrough or diagnostic procedure pioneered at Johns Hopkins Hospital, I’m (much) more interested in knowing why it hurts here when I do that.

The last time I submitted myself to the ‘sickcare’ industry I was living in the suburbs of Washington DC, the global center of loose government money, substantial salaries, statism worship and an enormously enlarged entitlement mentality. While I left the area before the ACA (aka Obamacare) was enacted, it was right around the corner and the industry was already preparing for the inevitable.

Back then, while each individual caregiver I encountered appeared to be competent and concerned, they were all clearly overworked and always in a rush. The waiting rooms were packed, the front office staff rude, the doctors and nurses preoccupied and harried and the assembly line was always running at 11 on a speed scale of 1 to 10.

I was first and foremost a common run-of-the-mill commodity with medical insurance and a credit card that was leaking fluids, had medium to high mileage and was making expensive noises under the hood. Judging from the payments the insurance company made during those nine years I was captured by the system, I was paying the office rent for the three different doctors I was seeing….and quite possibly several dozen payments on any outstanding student loans.

I even joked about it on several occasions to two of the younger doctors, both of whom absent mindedly nodded their heads in the affirmative while they poked, prodded and pinched. This doesn’t even take into account what I paid out of pocket each year. Suffice to say I hit my significantly high maximum out-of-pocket expenses each year on top of the steep monthly insurance premiums.

With a heaping helping of gallows humor, I considered myself the old oil well that was still profitably pumping crude for the sickcare industry. Every time I walked out of their offices I swore to God I heard the cash register ring. They claimed it was just my Tinitious, but they couldn’t fool this old fool.

I deeply resented being listened to, but not being heard. Most people don’t understand that doctors are trained to listen to the patient, but assume the patient is not of clear mind because of any number of reasons. From drug seeking behavior to hypochondriac complaints, many doctors are trained to be somewhat skeptical and suspicious of their patients.

This is the primary reason everyone should bring someone with them directly into the exam room to act as their advocate. Just as children will listen closer to adults other than their parents, so too will doctors listen more carefully to the advocate rather than the patient. Sadly, back then I did not follow this excellent advice primarily because I was living alone and far from family.

Eight years later, and with Mrs. Cog now in my life, I have re-entered the white coat house of worship to deal with some lingering, and new, medical issues. Remember, I walked away nearly a decade ago and have not received treatment of any sort since then.

Ultimately I am better off for doing so since my quality of life improved immeasurably, even though my primary chronic illness was still taking its toll. When you get to the point where you are taking drugs to counter the side effects of drugs you take to counter the side effects of the primary drugs you are taking, and they want to add a fourth level of drugs, it’s time to either go big or go home.

I went home.

As it so happens, there is a modern medical care facility within 10 miles of our home up here on the mountain. This surprisingly well equipped medical center is set up to deal with emergencies, routine medical care and the treatment of certain chronic issues. It also has a separate fully stocked pharmacy on site. While I was told of the place by some friends several years ago, we only recently investigated when the decision was made to take my first tentative steps back in.

This isn’t surrender, but rather a resource grab. Many years ago we made a decision to take personal responsibility for our own health and have been on a steep learning curve ever since. Unfortunately the sickcare industry has a strangle hold on all aspects of the discipline and it is nearly impossible to do certain things and obtain specific resources without the priest’s consent.

Blood tests, prescriptions, medical tests/equipment and diagnostic procedures are all locked away from the public and only accessible through your local certified priest’s practice. You simply cannot walk up to the counter at your local CVS and have them draw blood for some ‘routine’ blood work, which can reveal a wealth of information about what’s going on within.

While there are many alternatives available to achieve the health results we want, sometimes we need to understand specifically what’s wrong in order to make it right, particularly when multiple issues are interacting at the same time.

With all this in mind, after consulting my health insurance policy, then checking it twice, I made a new patient appointment with a specific doctor in the group (from a choice of two, he just felt ‘right’ from afar…not even going to try and explain) and showed up the next week 20 minutes early to fill out all the forms.

Previously I had contacted my old Rheumatologist and obtained a significant portion of my medical records so I could hand carry them with me when visiting the new practice. No sense trying to explain the medical history when I can hand the new doctor 50+ pages to speed read.

I will get into some specific impressions in my next article on this subject. For now I would like to speak generally. The county I live in down here in Southwestern VA has a population equal to about a square mile of any DC suburb. Life is much slower around here with everyone operating on Mountain Time, a pace slightly faster than South Pacific Tropical Island time.

It gets done when it gets done and not a moment sooner or later. That’s fine with me, but I feared the waiting room would operate on the same glacial pace. To my extremely pleasant surprise the medical center, as well as two specialists offices I visited the week after, all called me in within 5 minutes of my appointed time.


In all three cases, everyone from the front desk to the nurses and doctors were all pleasant, attentive, listened carefully when I spoke and responded directly to my, at times, very specific questions whenever possible. I actually felt like someone of value to them, and by value I do not mean monetary.

This was somewhat unexpected, but is very likely a product of small town USA rising to the surface. For very practical reasons, small town folk tend to be nicer since they probably either know you or your family if you grew up in the area. At the least, the odds are relatively high the people in that office will run into you somewhere at some point in the future. Being rude now might come back to bite them in the future.

There definitely is a sort of ‘we are all in this together’ mentality among those who live, work and play here. When visiting doctors’ offices in the DC suburbs, the chance of seeing anyone in the office anywhere other than in that office was essentially zero. Being rude to the patient has few, if any, social consequences to deal with.

In addition, the office work pace locally was clearly somewhat slower and more relaxed, leaving everyone with some time to actually acknowledge the person in front of them as more than just ambulatory meat.

I will continue these observations in a few weeks. Thank you for taking the time to read my musings.



Cognitive Dissonance

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