On December 21, 2013, I decided to get some extra exercise because I was attending a holiday party that evening. I figured I should burn some extra calories before eating 10 beers and 5 pounds of food. So I went to the local tennis center to attend their morning drop-in clinic which features some cardio-intensive drills.
During one such footwork drill I fell backwards (because I have terrible footwork) and put my right hand out to brace my fall.
As soon as I landed I knew I broke my wrist. I tried to hit a few more balls and it was impossible. The wrist was almost locked in place. I realized this could have serious long-term repercussions and that I needed immediate medical attention so I went home, showered, and was in front of a doctor in the ER within 90 minutes of the injury. Here's what happened next:
The doctor in the ER was very young. Older than Doogie Howser but probably not far removed from his 30th birthday. He ordered an x-ray and walked through it with me. He noted that my scaphoid bone was broken into two pieces, but when he poked me in that region of my hand I had no pain.
He concluded "I can't tell if this is an old break or a new one. If it's an old break they you just have a sprained wrist. You need to see a hand specialist." Within two hours of arriving at the ER I left with a hand splint, the name of a hand specialist, and no diagnosis.
Oh, and the flu--I left the hospital with a flu-like virus which reared its head a week later and lingered for 14 days.
I was able to see the hand specialist on December 24. He did not get a copy of the x-ray from the hospital nor did he take one himself. In fact he did not even have an x-ray apparatus in his office. This surprised me, but I figured it might be hard to get a license for devices that use radiation in an office building. He poked my hand in various places and said "You tore the muscle that connects your thumb to your palm as well as a bunch of ligaments in the back of your hand. Wear the splint, take Advil, and ice the wrist for 10 minutes every hour. If it doesn't get better in a couple of weeks come back." Then I paid $150 because he doesn't accept insurance (although they oddly made a copy of my insurance card).
After a couple of weeks the swelling went down but I still had pain and limited range of motion. So I called the hand specialist and got an appointment for the next week. I slogged through a massive snow storm (griping about Audi's shitty windshield wipers the whole way) and when I arrived the doctor said "This is bad! You need an MRI. I'll refer you to my buddy who is a wrist specialist." So he wrote me a prescription for an MRI and told me to call an imaging center to get it done, and my head almost exploded at the idea that my hand specialist doesn't know about wrists. And that he uses the word "buddy." Then he banged me for another $100 for the office visit.
I called the imaging center. Turns out I needed pre-approval from my insurance company. I called the insurance company and they said that the doctor has to call for approval. So I called the hand specialist's office and his receptionist said "Oh, right. We have your insurance information. We'll call them." Eventually I had an MRI appointment scheduled for the next week.
The MRI took about 30 minutes and they gave me a CD with the images, which I FedEx'ed to my hand specialist the next morning. I was told that the report would be ready the next day. But the doctor didn't get it the next day, so I called the MRI center and they said "He'll get it tomorrow." So the day after that I called the MRI center and they said that the report was ready. They said that I could pick it up in person or they could mail it to me. I asked that they mail it to me and called the hand specialist. No one answered the phone (and I called repeatedly) or returned my voicemail so I went to the imaging center to get the report.
The battleaxe of a woman at the imaging center refused to give me the report because it had only been two days. "The doctors typically prefer to see the report first so we usually don't give the report to the patient until 6 or 7 days after the exam." So I explained that I called ahead and was told that I could pick up the report. She replied "Who told you that?!" I said "I don't know, I didn't think I needed to get a name." She said "I don't care what they told you on the phone, you need to wait 6 to 7 days."
Much like Danny Duberstein I am good at two things but math isn't one of them.
Those of you who knew me when I was 18-25 know that in situations like this I am superhumanly adept at dismantling bad logic while demoralizing my victim. I can be mean, I can be an asshole, and I am better at outsmarting people on my feet while simultaneously being a mean asshole than anyone I know. It is not pretty to watch and I am not proud of this skill. But it came in handy sometimes.
A few sharp replies flew to the forefront of my brain: What's the point of having a phone if you don't care what people here say through it to your clients? Are you really telling me that I'm not allowed to review the diagnostic report from my radiologist for almost a week? You know I paid for it, right? You know the radiologist is my doctor, right? You know that disclosing confidential patient information to the patient is entirely permitted under HIPAA, right? Oh wait, you haven't read HIPAA, have you?
But now I'm older and calmer and simply too tired to fight. Instead I said "Look, I hurt my wrist about 6 weeks ago and I want to get it fixed. I left work early to get here before you close and it was a hideous pain in the neck with all the traffic. I just want to know what's wrong with my wrist."
She balled up her face as if I was holding her at gunpoint and making her eat dog shit. Then she asked for my name, date of birth, and printed out the report. I thanked her and as I turned to leave she yelled "I don't care what they told you on the phone, you normally need to wait 6 to 7 days!" It was a "Now go home and get your fucking shinebox" moment.
But I did not call her a mutt or pistol-whip her or tie her up and put her in the trunk of a Pontiac Grand Prix. Instead I walked off a few paces and read the report.
I broke two bones in my wrist. After six weeks and about two thousand dollars in medical costs, I learned that I have a broken wrist.
Pissed but relieved to know the real deal, I called the hand specialist the next day. Multiple times. It was busy, then no one answered, then no one returned my voicemail. At 3:00 the office closed (it was Friday) and I got the answering service.
At this point I was ripshit. I pulled my copy of Castle Connolly off the shelf and found a wrist surgery specialist 2.4 miles from my office. On Monday, in a torrential snow storm, I got an appointment, went over, showed him the MRI report, had an exam that included an x-ray right there in the office, and learned that my scaphoid fracture was indeed a new break. He even explained how you can tell and said that they guy in the ER should have known this. As a result my lunate bone is pointing 45 degrees the wrong way and the scaphoid is healing incorrectly.
So I need surgery. He sent me for a CT scan, the results of which are sitting in a giant envelope on my dining room table (preposterously, CT scan results are only available in hard copy). He also noted that the "hand specialist" the hospital sent me to is a COSMETIC hand specialist, not an orthopedic type.
Before I went for the CT scan the cosmetic clown called me back. He said "You have two broken bones but I'm not worried about them, they'll heal on their own. I'm more concerned with the ligament tear." Note that the MRI report says "Mild DISI but no definite ligamentous tear currently seen." He again mentioned his buddy the wrist specialist, this time by name. I told him that I went to see someone else who is an actual orthopedist specializing in hand, wrist, and arm injuries. He said "Ok great, give me his name and I'll send him the MRI report." I don't know if he did, or if he still has the CD with my wrist MRI pictures. I doubt it.
The point of this rant? My wrist is a metaphor for the healthcare delivery system--both are broken.
I went to the hospital and said "I have a broken wrist." It took six weeks, at least five doctors, and close to two thousand dollars to confirm that yes, I do indeed have a broken wrist. Which I knew the moment I broke it.
This is preposterous. I live in the most technologically advanced country in the history of our planet. I went to a hospital ranked #10 in NJ and #25 in the NY metro area by US News. I have health insurance. I make enough money to pay for these services even without health insurance. I'm well educated--I have two advanced degrees including a degree in public health!! I worked in orthopedic research which required me to take x-ray films and review CT results!! I know how to navigate the healthcare system, I understand what bones are and how they fit together, I know how to interpret radiographic results. So I understand what happened to my wrist and I understand whatever technical jargon the doctors are using, and I can afford to pay for treatment either with insurance or cash. I even own a copy of Castle Connolly's guide to top doctors. And I still got fucked.
How the hell did this happen?