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More About May

5/30/2012

 

Patient Backlash

I've received a couple of great comments about my last post, “Tickety Tick Tick Tick,” and I’d like to share them with you.

My friend Val Komkov-Hill has this to say: “Can’t tell you how much I related to your doctor story. Mine is not as dire but at Christmas my PCP, let’s call her Dr. No Nonsense, said my lab tests had found hematuria (red blood cells in my urine) and set me up to see a urologist, who, of course I could not get in to see until two weeks ago. (four months later) Good thing I wasn’t, you know, dying. I had shifted my Yoga classes since I had to show up when they deigned or it would be another 3 month wait while I stewed about whether or not I had bladder cancer. The DAY before the appt. they called and said there was a problem because my Blue Cross insurance listed a different PCP, one I hadn’t seen in 20 years. I said no it did not and got my BXBS card out to read the correct PCP printed on it. They said I needed more proof, could my doctor refax insurance info, or they would have to reschedule. Heaven forbid they didn’t get their pound of flesh. Again, like you, calls to my PCP’s clinic that never got answered by a real person, and me finally driving over in a huff, much like you, to talk to a REAL person. Long story short, got problem solved, Bladdercam (ouch) showed pristine bladder. Kidneys singing happily. All well. Except, I got a call from the urologist two days ago. My sample I left for more testing was somehow leaked (translation: some fool dropped it or lost it) could I come back and pee again. Fine, let me drink a gallon of water and I’ll be on my way.” 


Hm. Val’s comment has that same buzz of rage beneath the surface that I felt while writing my post.

When I ask Val if I can quote her, she says, “Ha, I don’t mind if you use my name. I used to be so terribly shy and modest but after awhile, having been probed and x-rayed, and palpated, and poked, I kind of got over it.”

A person who wishes to remain anonymous shares the following: “Your story of dealing with doctor, nurse/receptionist, pharmacy, reminds me of experiences Jean Craig spoke of in her book Between Hello and Goodbye. It’s all so very frustrating."

Yes, yes, it is.

Crystal Bridges

On May 9th three of us drive to Crystal Bridges of American Art in Bentonville, Arkansas—it’s about an hour from Eureka Springs, where we are staying with friend and former Lubbock resident, Alice. This area of northwest Arkansas is now like a typical sprawling suburbia—replete with all the generic retail outlets one expects to see in such a setting—except that this megalopolis is not a satellite of any city. The nearly 500,000 people of northwest Arkansas live in a handful of burbs stretching from Bentonville in the north to south of Fayetteville, where the University of Arkansas is located—and all are serviced by I-540, which connects with I-40.
Keep this backdrop in mind as you picture Alice Walton’s Crystal Bridges (not to be confused with our friend Alice). As we go through the unassuming entrance, we drive along a wooded area on a smooth new asphalt road. The shoulders are abundant with what look like spring daisies—whites and yellows clumped together so tightly that there exists little space between them. We see that the outdoor parking is full so we investigate the indoor lot on the Lower Level. There is one disabled parking spot left, and so we take it. Alice uses the electrified system in the back of her van to lower her electrified wheelchair to the ground. Ken and I trot to keep up with Alice who zooms ahead. Inside Ken “checks in” (one only has to pay $5 for the special showing of The Hudson River School Exhibit). Otherwise, entry to Crystal Bridges is virtually free to anyone. It is our plan to eat lunch in the museum’s restaurant, Eleven.  Unlike some museums it is designed to handle large groups. Even though Eleven is apparently full, we have no problem securing a table for three. The cuisine and service are great, and we leave fortified to begin our trek through the museum.

I first became aware of Crystal Bridges on CBS Sunday Morning—a piece that emphasized the visual and architectural aesthetics of the museum itself. On our visit the museum is teeming with people—families, school children, and seniors, people with all kinds of accents—not just the locals. Alice says that when she visited in the winter, the place was empty. It is now overloaded with friendly and polite docents, because the rules must be enforced: no flash photography (none at all for The Hudson River School Exhibit); no drinks or food, no gum, no pens; no pointing at a painting. And you can get no closer than eighteen inches to a work. If you must read the identifying information, lean in directly in front of the sign, not the painting.

Crystal Bridges is constructed of a series of halls or pods that lead easily from one to the next. Each is large in length, width, and height. Very few paintings take full advantage of the latter—which portends well for artists of the future—whose works may indeed aspire to great heights. The halls move through more than two hundred years of American art (Colonial, 19th Century, Modern) until finally you end up in the Contemporary Gallery, which includes Abstract Expressionism—a breath of fresh air, if you will, after traveling through the past. Here you see square inside square, squiggles, solid colors, all of them providing a visual relief from two centuries of more figurative works. This pleasant progression seems a tribute to the museum staff’s layout of the paintings.
After four and a half hours I decide to go outside. Even though it is 68 degrees in the sun, the air is cooler than inside what could well be the most modern museum in the country. I photograph the patio/amphitheater area and take exterior shots all of the halls or pods. Crystal Bridges is landscaped beautifully and contains a substantive sculpture garden. Unfortunately, this visit we do not have time to investigate it.
Ms. Alice Walton, daughter of Sam Walton, has been reviled by some for having the audacity to snatch up what are considered to be very important paintings that some feel should never have left their former homes (yet usually paying handsomely for each piece), but after seeing what Ms. Walton has created here, one certainly cannot fault her with not having a great sense of philanthropy. We can complain all we want about Wal-Mart’s faults, foibles, and failings, but Ms. Walton has amassed a world-class collection of art and installed it in a world-class facility—one that virtually anyone in the world can walk in and see . . . enjoy . . . appreciate . . . savor. If she has provided the proper endowment—and one must assume she has—this initial collection is something that can only grow and last well into the future. And maybe, just maybe, Wal-Mart will mend its ways (or is that a political matter of applying more pressure?).  We can always hope.

Our day ends with a quick trip south on I-540 for an early dinner at P.F. Chang’s located in a shopping area that in Alice’s opinion outclasses the mall in Fayetteville. On the way back to Eureka Springs, just past dusk, we cross over the (yikes) one-lane Beaver Bridge that we used earlier in the day when the sky was bright, and it makes me feel as if I’ve passed from one world to another—back from the flat, sprawling megalopolis of Northwest Arkansas to the bucolic life of rocks and rills that seem as timeless as art itself.


See more pictures of our trip by going to Photos, "2010 To Present."

Artfully Repurposing Our Trash Collectibles

PictureRepurposing Keys Project
If any of you have received the May/June issue of Sierra, you know of the column "Repurpose | Trash Into Treasure." This time the page demonstrates to the reader how to take old keys (and we all have a million of 'em, particularly since so many aspects of our lives have gone keyless). You can go to the Sierra Club Web site to locate step-by-step directions. Sierra Club based their project on one by Nicholas Torretta at viraroque.blogspot.com. Let me know of your own such projects.

I myself have begun to re-purpose non-recyclable items if I can. Remember the blue rubber rings that come around the necks of my pharmaceutical bottles? The plastic bread bag clips? Lids, lids, and more lids? I packaged up all those items featured in my "Item's That Won't Recycle" posts (see Archives) and sent them to artist friend Aidan Grey in Denver CO. Click on his name to read a review of his recent exhibition at Denver's Edge Gallery. In an e-mail, Aidan told me,"My next show is going to be 'trashGod,' making icons of the gods of trash and waste, to open at the end of July." I believe the show will probably be at the Edge. Check out their "Schedule" page, and I'll keep you posted in case you live in the Denver area or will be visiting during the time the show is open. I can't wait to see how Aidan re-purposes America's trash.

My Book World

Picture
Donald W. Richards, my mother’s first cousin, has published a novel entitled Call Me Elmer. Set in the late 1930s, this novel begins when a family traveling to a new life in the West accidentally leaves their eighteen year-old son behind during a rest break. He does wander away from the car, so, in a way it’s his own fault—but the reader has to wonder why a family would leave a member behind and not return to the scene. The young man, Mathew Russell, has no choice but to keep on walking and finds a job working for Middleton Farms somewhere, I’m guessing, in the Southwest (Richards never tells the exact location that Mathew comes from, nor the one where he winds up, giving the narrative an "Everyman" feel to it). Mathew makes quite an impression on the owners of the farm, not to mention their granddaughter, Kathy, and works his way up in the organization. He is not afraid to speak his mind and actually helps the Middleton Farm make some significant changes. Mr. Middleton, because he had lost a son named Elmer (Kathy’s father), re-names Mathew, and Mathew eventually adopts Elmer as his middle name. Taking the name is significant because “Mathew” seems to represent his old life and “Elmer” his new life with the Middletons. Accepting both near the novel’s end brings an integration to his life he doesn’t have at the beginning.

World War II interrupts Mathew Elmer’s relationship with Kathy and the Middletons, not to mention his university life and career aspirations. He plays a significant part in the war effort, recruited precisely because of his agricultural expertise. While in England Mathew encounters a man whom he identifies as his brother. The man, however, denies any knowledge of having ever known Mathew. This event could confuse the reader; it's sort of an emotional slap in the face. Is the brother angry that Mathew never tries to find his family? Is Mathew afraid to confront his brother with the question as to why the family never returns for him? At war’s end Mathew returns to Middleton Farms, and he and Kathy practically marry on the spot in 1945.
Overall, the novel is quite enjoyable, and Richards’s elegant prose contributes to a fine reading experience. It’s a pleasure to read someone who has a strong command of the English language and can communicate his thoughts clearly. I wish Don well with Call Me Elmer as well as his next book, which he’s told me he’s close to completing.

Call Me Elmer is published by Ghost River Images, and you can probably purchase a copy by contacting the author at <[email protected]>.


Something About April

5/17/2012

 

Thanks

As I make my ninth posting since September 2011, I want to say I'm grateful to you for viewing/reading my blog. On the days that I’ve announced my posting, I’ve had as many as 150 page visits (according to the stats provided by my server). When friends or relatives tell me personally that they’ve enjoyed a certain portion of the blog, I’m very gratified to hear it. I hope you will forward each posting to others you think might enjoy reading it.

I want to apologize to anyone who, in the last seven months, has attempted to download copies of my Published Stories and been unable to do so. A friend of mine recently brought the malfunction to my attention, and I immediately logged on to the server to create a link where you can download a PDF file of each story listed under the heading of Print Journals. My baddy bad bad.

In this posting I’m experimenting with font color/size to make it easier to read. Let me know if the changes are effective . . . or not. I shall continue to tinker with both until they seem satisfying to all. Is that even possible?

A Writing Retreat

PictureIs This Where the Bad Guys Hide?
On April 27-29, several friends and I drive to Fort Davis, Texas, to be a part of the Texas Mountain Trail Writers annual retreat. For Marilyn and me (members of Ad Hoc writing group here in Lubbock) this is our second time. The weekend is a compressed but stimulating time of listening to several authors address our group of forty. The retreat is held at the Davis Mountain Education Center (Mountain Trails Lodge) one mile south of Fort Davis. As it is located between two cemeteries—the Pioneer with a number of graves from the mid-1800s until 1940, and the other, St. Joseph’s, from 1940 until the present—the weekend takes on a particular flavor.

The weekend’s speakers include Suzy Spencer, memoirist and journalist, and best-selling author of Wasted. Her new book, Secret Sex Lives, is anticipated by all of her fans, and will be released by Penguin/Berkley Trade on October 2, 2012 for $16.00. It is available for pre-order from Barnes & Noble. She shares much with us about the eight years it took her to complete this book, but not enough to keep us from buying a copy!

Other speakers:

PictureChantelle Osman Uses Teaching Aids
Chantelle Aimée Osman is an author of flash fiction and mysteries.

PictureMIke Blakely Sings One of His Songs
Mike Blakely is author of seventeen western novels and is also fine musician and composer of Western music.

Like superior writers of any genre, all three speakers transcend the subject to take the reader places s/he has never been before—and with great panache and style. All three are generous with their expertise and advice.

The weekend concludes with volunteers reading 500-word pieces they’ve written especially for the reading. This year’s topics include “Love in the Cemetery,” “Wanderings,” and “Spirit(s) of the West.” I include photos of fellow writers who also shared. Each reader’s mouth is open (of course), but each face includes a certain animation, an excitement that accompanies the act of reading one’s words aloud to a group. I've left out at least one reader because I had to leave the audience for a minute. My apologies, and I hope Kip Piper will have the gentleman's picture when she posts these on the TMTW's Web site. Also, I've not tagged the pictures in order to keep search engines from picking you up.

Yours truly spent a month writing a sestina for the first time in his life, a poem about the two cemeteries, and shares it with the group:

Matt Hall and Marie Townsend

Matt Hall was buried up at St. Joseph’s.
His love Marie across the way at Pioneer.
It was quite a tale about a longneck tenor
Who returned to haunt her as a ghost.
When Matt was dead, Marie proclaimed, “My goodness,
Must we keep closed that dad-blasted gate?”

Yes, we must keep closed that dad-blasted gate
All because dear Matt resides up at St. Joseph’s.
His short life was filled with nothing but goodness,
And daft, daft Marie at the Pioneer—
Was she, too, but a contentious old ghostie
Who on moonlit nights feigned singing tenor?

Yes, on moonlit nights, feigned singing tenor
Her ghost, that’s who, stationed near that dad-blasted gate.
And of course one had to say, “Ghost, I saw no ghost,”
All across the way from the St. Joseph’s
To where one saw Marie at the Pioneer,
Was her life ne’er filled with light and goodness?

‘Deed, her life was ne’er filled with light and goodness,
Marie Townsend had married the handsome tenor
Matt Hall on tall tawny grass at the Pioneer.
She’d tricked him into it at the black gate
And hurried on horses over to St. Joseph’s,
T’was all their trouble, to see an old ghost?

For all their trouble, to see an old ghost,
And should we have announced: Auras of goodness
Surrounded them aplenty up at St. Joseph’s?
T’was the mighty Matt Hall crooning tenor,
Serenading daft Marie Townsend at the gate.
Yet, a death yonder at the Pioneer?

Yes, a death yonder at the Pioneer,
Where all the night Marie fought off Matt’s teasing ghost
Near the gate, yes, yes, near the grave’s wrought iron gate.
He often pining after her goodness,
Ha, the dark, tall, handsome and talented tenor
Who wound up dead, buried at St. Joseph’s?

Yes, Matt wound up at St. Josephs, Marie at the Pioneer
He a fine tenor, and she, like him, a ghostie—
A shared goodness eluding them both at that dad-blasted gate.           

©Richard Jespers 2012


Thanks to TMTW leaders Reba Cross Seals, Jackie Siglin, Donna Greene, Elaine Davenport, Kip Piper, and many others for their countless hours of work and preparation, not to mention their flair for pulling off a great weekend year after year (this marks their 20th annual retreat, I believe).

Tickety Tick Tick Tick

I didn’t intend to use this forum to air difficulties about my medical problems, but something that happened recently has made me reconsider. Mostly, when this sort of event is over, I wish to forget about it. But I made myself write down the details as they occurred because this tale may augur problems yet to come for all of us.

In August 2006 my physician (let’s call him Dr. Smartz), an electrophysiologist, began prescribing the antiarrhythmic drug Tikosyn to treat my atrial fibrillation (irregular heartbeat). Used in Europe for many years with great success, Tikosyn was relatively new to the U.S. at the time and was put on the market with certain restrictions. Manufactured by Pfizer, Tikosyn is considered so toxic that I had to spend the first seventy-two hours in the hospital so that my bodily functions could be monitored—kidneys are the main concern. Mine did fine and continue to function well almost six years later. By and large the drug does what it should; I seldom have one of the jarring episodes during which my heart speeds up to 150-300 beats per minute, and if I do experience such an episode it is usually over in less than a half an hour. Tikosyn works in conjunction with two other drugs, Digoxin and Metoprolol, to keep my old ticker ticking (without a pacemaker), and I’ve become very grateful for that small favor. Tickety tick tick tick.

The office of Dr. Smartz, whose expertise deals with the electrical impulses of the heart, contacts me on Wednesday, April 18th, and his assistant whom I shall call Aida leaves a message asking me to contact her. By the time I check my phone, it is after hours so I call her the next day, April 19th, but only the service answers—all day long. On Friday, April 20th, I forget to call. On Monday April 23rd, Aida does answer the phone and informs me that because my insurance drug plan (Caremark by way of TRS-Aetna) is now requiring an additional test (before they will renew my Tikosyn) I must drop everything and come in for an exam and lab work to test my blood for toxic levels. Prior to this demand, a one-year follow-up and lab test were all that was required; now Caremark wants me to have the full-range blood test taken every three months. Why? One can only guess. Perhaps before the Affordable Care Act (which limits charges insurance companies can make) fully takes effect, the companies are going to gouge us for all they are worth.

Tickety tick tick tick.

I tell Aida that I have plans to leave town on May 2nd and will run out of medicine on May 7th before I get back. “Can’t Dr. Smartz give me an emergency extension, and then I’ll be glad to come in for the tests after I return?”

In a word, she says NO. To complicate matters, Dr. Smartz himself will be out of the office until the following Monday, April 30th—two days before I am to leave town. Aida, a very capable and caring woman, says she will call me on that Monday. But she does NOT. I call the doctor’s number, but Aida has placed the phone on service, meaning I can only leave a message. I do NOT. Instead, I drive three miles to Dr. Smartz’s office (unshaven and in a dirty T-shirt and jeans), and Aida, a robust woman in flowery scrubs, greets me with glee, as if she’s just been trying to call me. I assure you she has NOT.

“Mr. Jespers, I’m so glad you came in. If you’d be willing to have the lab work done now, Dr. Smartz will see you even though this is not a clinic day (i.e. he is not seeing patients), and we can get you fixed up.”

“I would have showered,” I say. Tickety tick tick tick.

The sequence of events that follows occurs in such a whirly whirl whirl that said events are now difficult to keep in order, but I must try.

Does Aida really write me an order with STAT at the top (from the Latin statim meaning “immediately”)—and do I really drive three blocks to the lab where my blood is withdrawn?

Do I say to the nurse, “And you will send the results to Dr. Smartz right away?”

Does she answer saucily, “That’s what the order says”?

Do I really drive back to Dr. Smartz’s office only to have Aida confront me with a three-page questionnaire? Do I really fill out the form, the same one I fill out every time I come in? Has it really been copied and photocopied so many times that the text is barely legible, the print akilter with the rest of the page? Must I say that I hate, really hate this kind of form, one that screams I could care less about what you write down here? Let’s see if I can recall at least a few of the questions on the form. “Does your heart skip beats?” “Does your heart race?” “Do you cough up blood?”

Tickety tick tick tick and whirly whirl whirl.

Does Dr. Smartz’s nurse really give me an EKG?

Does Dr. Smartz really have the gall to give me his sob story about Medicare?

While he’s holding the stethoscope to my chest, Dr. Smartz says, “What your drug plan is doing is illegal.”

Do I really say, “For asking to have these tests run?”

“No,” he says, glancing over his shoulder at me as if I’m a moron. “For practicing medicine without a license.”

Do I really giggle, then act sheepishly when I see he isn’t joking?

“We’re headed for socialized medicine. Do you realize that my Medicare payments have been cut by thirty percent?”

Do I really say “Yes”? “Aida told me already. It’s awful. Awful.”

But is it? I wonder. Isn’t this what Congress is so insistent upon, cutting Medicare costs? Dr. Smartz may not be guilty of doing so, but haven’t we read study after study about doctors overcharging or running tests or doing procedures that are totally unnecessary, just to gouge the government (a government that doctors claim they hate even though it is a government that makes up the shortfall the elderly can’t pay)? I’m sure Dr. Smartz is still quite well off. Across the top of a shelf in his outer office are located little plastic models of contemporary cruise ships. Methinks that is why he was out of town the week before; I can still see the salt encrusted on the newest ship that sailed the Caribbean perhaps.

Tickety tick tick tick and whirly whirl whirl.

I now recall the cardiologist who in 2006 ordered a pacemaker for my father when he had less than two months to live (though, at the time, none of us knew that). But was that expensive operation really necessary for an eighty-seven year old man with congestive heart failure and imminent renal failure? Was that cardiologist (Dr. Grabzitall) just picking up an extra buck at the government’s expense because he could?

When I check out at the desk, Dr. Smartz seems pleased with my EKG, my three-page questionnaire, my blood work (which has now come in over the phone). Do I really not have to come in for an exam for another year?

“Do I really need to have one of these blood tests done every three months?”

“Yes,” Aida tells me.

“It’s okay,” I say, “as long as we schedule them in advance.” Aida hands me an order to have it tested in July and says she's faxing my prescription for Tikosyn.

Do I really ask, “Wouldn’t it be faster if I walked my prescription to the pharmacist myself?”

Does Aida really say, “Ah, no”? “I’m faxing it right now.” Do I really leave the office before I can see her place the document in her fax machine?

Tickety tick tick tick and whirly whirl whirl.

On Tuesday May 1st, must I really call Fred my pharmacist three times, only to find out each time that he has NOT received a fax from Dr. Smartz’s office? Must I really say to him, “Can you give Dr. Smartz a poke”? He says he will. By 2:00 p.m. when I’ve heard nothing from anyone, must I really drive for the second time in two days to Dr. Smartz’s office? Why? you ask. Because the frigging office isn’t answering the frigging phone again!

Tickety tick tick tick.

I’m wondering, Am I really going to get out of town in the next 24 hours?

When I walk in the office, does Aida really act alarmed as if I might be carrying a gun?

Do I really have to tell her that Fred my pharmacist has told me three times that he has NOT received a fax from their office?

Does Aida really proclaim that she DID send the fax?

Do I then say, “Really?” Tickety tick tick tick.

Does she then say, “Yep, faxed it last thing before I left yesterday. But I’ll fax another order right now.”

Do I really sit for another fifteen minutes while Aida kibitzes with a drug representative and while she fiddles with a foot-high stack of paperwork? 

Does Aida finally call me over to the window and show me the confirmations from Fred my pharmacist? Does she hear me curse under my breath? Tickety tick tick tick.

Does Aida really say, “We don’t usually do this, but I’m going to call your pharmacist.” Does she really pick up the receiver and dial? “Yes, this is Aida calling for Doctor Smartz. Have you received our faxes for Richard Jespers’s Tikosyn? Really. Well, I’m holding the confirmation you just sent me. Wait, let me read you the number (about 10 to twelve digits).” She fiddles with papers while she waits. Then she looks up at me and winks. “May I ask how soon you can have this ready for Mr. Jespers? Five o’clock? Is that all right with you, Mr. Jespers?”

Do I really nod? Can I really say anything else but Yes? I mean, I think to myself, Will I now actually get my Tikosyn?

Do I really grin at Aida and say, “You should run for president”?

In the car I call Fred my pharmacist, a young man I really like and who is usually quite efficient, and ask if he can move that pick-up time to four o’clock? “I’m already out of the house and it would make it easier for me to drop by soon.” He says yes.

I drive the 4.6 miles, and Fred my pharmacist offers no apology or explanation as to what has happened to the faxes it is obvious that my doctor’s office sent. Do I actually apologize for bothering him so many times throughout the day? Yes, I’m afraid I do, but I grab my meds, check to see that the pills look right, and run for the parking lot. We will leave town in less than 24 hours. Tickety tick tick tick.

By this time I’ve spent perhaps five or six hours over a period of three days just to solve this ONE small problem. Is this what we’re all in for as we pass into our senior years? What happens when I no longer have the physical stamina or mental capacity to keep up with faulty fax machines and/or their faulty operators?

No, don’t tell me; I think I know the answer. Tickety tick tick tick.

If you feel so inclined, tell of your tickety tick tick tick nightmare of a medical story by leaving a comment below, but keep it short.

Next Posting

I had so much to write about this month that I will save my account of our trip to Crystal Bridges until my next posting—probably in the next few days. Tickety tick tick tick.
    AUTHOR
    Richard Jespers is a writer living in Lubbock, Texas, USA.

    See my profile at Author Central:
    http://amazon.com/author/rjespers


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