Saturday, September 8, 2007

on sickness and health

i'm a bit of a hypochondriac. i'm not ashamed to admit it. sometime i will post on the many reasons in my personal history why i am.

but this week, after visiting my primary care physician (pcp) and taking a blood test, a breath test and a fluroscopy, i have been thinking about the relationship between art, health, and capitalist society.

where to start? let's start at the end. today, i found myself sleeping an obscene amount, and not in that lazy, let's enjoy saturday because we can, way. i feel my body just refusing to wake up, as if held down by an enormous weight. i've decided to blame the prilosec, which i took for the first time yesterday morning.

i have a cough that hasn't gone away for about two months. it's one of those intense coughs that makes me double over sometimes in fits. it interrupts conversations, it keeps me awake, it makes my partner look at me with those very concerned doe-eyes. for the first three weeks, i thought it was just a bacterial bronchitis and that it would go away. but finally, i decided to go see my pcp. she listened to my chest, looked at my throat, and very patiently and thoroughly asked about my symptoms and diagnosed it as allergic bronchitis--a cough brought on by the post-nasal drip caused by allergies. this made sense. for anyone who lives in central texas, you know that allergies afflict everyone for at least a few months a year. pollen, mold, and various animal allergies are almost always abound. so doc prescribed a generic antihistamine (which cost less than the generic claritin i've been taking) and a generic nasal spray (which has an awful taste and burns my nose).

two weeks later, although my symptoms were okay during the day, i would still have coughing fits at night. i went back to my doc on thursday. she shook her head a little and after asking whether i've been consistently taking my meds, she said, "i think it is probably acid reflux, but i'm gonna have you take some tests to make sure. once you're done with those tests, immediately start on prilosec."

so i went in to the lab, after getting my blood drawn to check my cholesterol (which is yet another problem i have, i believe it is genetic), i breathed into a bag, drank a nasty drink, and then breathed into another bag. then yesterday, i scheduled a fluroscopy. it involves not eating, drinking, smoking, or chewing gum (i remember saying to the person who scheduled my appointment, "not even water?!") from the night before. then, they made me drink this fizzy drink that "inflated my stomach" and then i had to drink barium. if you've never had barium, it's basically liquid chalk. she took still pictures of the barium going down my throat and into my stomach. it was kinda neat seeing my own stomach on the screen in front of me. she took pictures of me swallowing barium while standing up, while lying on my stomach, and then she took "different pictures" of me on my back. then she told me to be on the lookout for constipation. wonderful.

but this whole ordeal has made me very thankful that i have insurance. at least for now. i enrolled in COBRA when i left UT. this is a way for me to keep the same insurance i had as an employee at the same rate UT had been paying. it sounds like a deal, but it still costs me over $300 a month. but with my monthly medications, office visits, and therapy, i usually end up breaking even. the thing about COBRA is i'm only eligible for 18 months, so it will eventually run out.

the real rub is the fact that UT doesn't recognize domestic partnerships. if my partner and i were married, i'd have free insurance and it would only run out when my partner left her job. whenever i think about that, it becomes acutely real and material how homophobia affects my life. it will cost me $4000 in health care to be queer this year.

but after briefly taking a tantrum about heterosexism, i begin to hate the state. ever since that time in a london hospital when i hypothesized having HIV to a doctor and her saying, "we'll take you on--for free." i have been ashamed of the U.S. health care system. we live in one of the only first world countries where poor people (and even middle class people) are not allowed to be sick. when we/they are "allowed" (though local grants and non-profits) to be sick, we/they must accept that the care we/they receive is inferior to that of upper-middle class patients. it becomes painfully clear that the lives of the poor and uninsured are less important than others.

i have had a strange relationship with my health. it just happens that i seem to develop ailments that are not usually diagnosable with the textbook symptoms. the cough mentioned above is just one example. it took me many years of uneven periods with different nurses and doctors before i was finally diagnosed with poly-cystic ovaries. it took going to one of the best gynos in the city to come up with a treatment plan that didn't involve birth control pills that i did not want or need to take. it took that diagnosis process to reveal i was clinically depressed and at risk for diabetes.

none of these revelations would have happened if i had been going to an hmo or medicare. the doctors just wouldn't have had the time, patience, or resources to figure the whole thing out. and these doctors were available to me because i had/have one of the best insurance programs in the state.

almost all of my friends who are artists full-time are uninsured. some are in heterosexual marriages that allow them insurance, but those friends are few. almost all the dykes i know who don't work for UT or IBM are uninsured or under-insured, even if they do make an okay living. everybody i work with, including my boss, is uninsured. i have a good friend who will be paying off a $200k hospital bill for the rest of her life. sure, she only pays $20 a month now, but if she were to come into any money or assets, she would basically have to give it up right away.

a lot of political analysts seem to think the 2008 presidential election will be decided on health care. i doubt it. lobbyists are too invested in for-profit health care. and for-profit health care is here to stay. whereas before, places tried to keep it under wraps that they were curing people for money, now it is becoming more obvious. i heard that a lot of hospitals in the area are beginning to call patients "customers" complete with the "customer is always right" mentality. and hospital and pharmaceutical boardrooms are filling more and more with business tycoons and accountants rather than doctors and researchers. many doctors, who feel it defies the hippocratic oath, grumble, even start their own clinics. my old-school physician father in-law said, "it's not about doctoring anymore, it's about getting the patient out of the facility as soon as possible." the pensive look on his face said a lot.

i don't look forward to losing my insurance in less than a year's time. in all likelihood, i will end up joining some type of health plan, no doubt much inferior to my current plan, but something that will let me sleep at night.

it's just i feel that along with equality, choice, and speech, the right to become ill and have access to the best care is a fundamental human right. doesn't that fall under the "pursuit of happiness" that our country was founded?

when i hit the lotto, i think i'll just buy a group insurance program and just allow anyone who wants to join it. especially those dykes and artists. they'll be first to get on.


Carole said...

i totally understand your pain on the health insurance. i am unemployed right choice. however, not having insurance and my refusal to pay for COBRA is giving me grief. Why do lab tests have to cost like $500?

i thought about moving to Canada where they have their "universal health plan"...but i hear that is pretty shitty as well.

feel better kt.

k. terumi shorb said...

yes, i hear people complain about state-run plans, from canada to england to japan. i think i would still prefer that to having no safety net and the possibility of running up bills that would be more than i could earn in my life time, unless i win the lotto, of course.