Bones Scanned

At 8:30 am this morning Nick, a kind nuclear med technician at Littleton Adventist, swabbed the crook of my elbow and took a needle from a lead-lined box. It contained radioactive isotopes of calcium. Makes sense for a bone scan. With a quick, painless insertion he sent the isotopes into my blood stream. Took thirty seconds.

“Come back at noon. Drink 32 ounces of water. Be sure to use the bathroom before you return.” I did that.

Kate and I left at 7:20 am. There was a heavy fog on Hwy 285 going downhill. It struck me as an apt metaphor. This time between the discovery of my rising PSA and getting data about the cancer puts me in, as I said yesterday, a cloud of unknowing. Today we traveled through it, paying attention, careful attention to brake lights, possible crashes.

The bone scan will lift a bit of the fog, make the path from here a bit more clear. But. The CT scan was not approved yet. Ironically, I stopped at the Post Office on the way home to pick up a certified letter. It was the denial of coverage from New West physicians for the axumin scan. Out of the fog into the fog.

Nick had me remove my belt, all the metal from my pants, my glasses. I could leave my shoes on. Hearing aid? No, the machine won’t bother it. I laid down on the slide, a curved piece of metal. Would you like a warm blanket? Yes. (This would prove to be a mistake.)

We velcro your arms to your sides. That way you don’t block the scan. Oh. The straight jacket like cover went over the warm blanket. Are you claustrophobic? Yes. Hmmm.

This was the mistake with the warm blanket. Since as near as I can discern, my claustrophobia came into existence during time spent in an iron lung as a toddler, heat makes it worse. The claustrophobia comes when the box like device with the screen attached comes down within an inch or so of the nose.

It’ll be there for about four or five minutes. OK. I’ll close my eyes.

A bone scan. Not me.

So here’s a very human anomaly. That scanner scared me more in those five minutes than that which it sought to find. Cancer. Weird. I held it together, but there were moments when my muscles tightened and my stomach clenched. Also, I had this urge, a strong urge, to open my eyes. Which I did a couple of times. And quickly closed them.

After the seventeen minutes in which the scan covered my body, Nick said he’d go see the radiologist. He might need other shots. He didn’t.

I thanked Nick for his kindness. Well, we try. The folks that come to see us are not having a good time. I’m not. And your kindness made this part easier. I didn’t say, but I could have, I’m driving through heavy fog right now.

Nick assured me that the radiologist would read the scan right away and that it would be ready by late afternoon. That’s in time to inform our appointment with Dr. Gilroy tomorrow. At least we’ll have some data.

Sigh

Leave in an hour for the mythical imaging services of Littleton Adventist. I’ll begin to believe in them when they put me on the slide and move me into the magnets. An unhappy yesterday. It had me reaching for distractions, not from the cancer, but from the American health care system.

I know it’s a cliche and I know the comparison is overblown, but I’m going to say it anyway. One of the three young women from Centura Health benefits said, when I asked to pay what my insurance company would have paid: “I don’t make the policy, I just abide by it.” Cindy and Vanessa, too. All of those I talked to except Amanda. I’m just following orders.

A fascinating book on the Holocaust dispelled the myth that the Germans who served as its agents were psychopaths or ideologues. No, they were just ordinary people who chose, over and over again, to do what they’d been told. These agents of denial are all following the arcane and often invisible dictats of bureaucracies built to serve themselves. In the case of United Health Care it’s about the bottom line. In the case of Medicare it’s about the rules. In both instances the clerks, the phone callers and phone answerers, the case managers, (I find myself wanting to put quotation marks around a lot of these words.), the administrators all sleep because they don’t make the policy, they just abide by it.

In neither case is the patient’s health the prime objective. The prime objective is what sustains the organization. You may say, what’s the alternative? I would say single payer health care. Why? Because in that situation it is the patient’s health that drives the system, it is the rule. Would it be perfect, without self-serving bureaucracy? No. Certainly not. But it would have as its raison d’etre the health of the country’s populace. That would make these frustrations much, much different. At least to me.

In the meantime we have a system that, not all the time, but frequently enough, puts people like me, desperate for some answers, in between dollars and health care. It also serves to dehumanize its agents who must again and again say, no, that’s not been approved. No, sorry, I don’t make policy, I just abide by it.