Hypochondriacs beware!

Nursing Homes, August, 2006 by Gary Tetz

From time to time, I think about my health. Sometimes I do this like a casual, detached observer performing a semiannual audit. Sometimes I approach it with the frenzy of one snatching mementos from the jaws of a house fire. But either way, it's much on my mind.

Some--and they know who they are (1)--even accuse me of habitual hypochondria, and to them I say, stop disturbing me while I'm googling "discomfort, abdomen, pain, death."

The truth is, I'm no hypochondriac. I know this because I've looked up the definition (2): "Abnormal anxiety about one's health, esp. an unwarranted fear that one has a serious disease."

I simply don't meet that standard. For one thing, who among us are qualified to determine what may or may not be normal? (3) Is it normal to periodically conduct a thorough body inventory of all moles and skin anomalies? Of course it is. Is it normal to keep a pin with a tiny flag stuck in each nevus and nodule for tracking purposes? Perhaps not. But I think we'd all agree, it's a fine line.

Another loophole is the phrase "unwarranted fear." Scientists now believe that the human body contains one or more essential organs, each under relentless attack by a network of ruthless and evil-doing microorganisms called the "Axis of Illness." These tiny critters hate freedom and are constantly trying to kill us.

Often, they succeed. Almost always, in fact. Except for a few highly debated exceptions, (4) human life itself has been proven to be entirely fatal. So is my fear in any way unwarranted? The evidence suggests otherwise. Whatever anxiety I feel for my health is in quite reasonable proportion to the statistically documented futility of my quest for survival.

So I'm not a hypochondriac. What a relief.

That said, it was a perfectly normal, though pointless, obsession with continued existence that propelled me recently to a local clinic and hospital for a series of diagnostic tests. I'll spare you the details, except to say they were certain to be (a) painful, (b) expensive, and (c) painfully expensive. Instead of merely writing about it, I was poised to experience our healthcare system personally, one might say even endoscopically--from deep inside.

Things started off poorly enough. It must have been "HIPAA Violation Week," (5) because my confidentiality was threatened at every step. The sign at the clinic check-in read, "For the privacy of our patients, please wait here to be called forward," but it was placed only a few feet from the counter, and the receptionist's piercing voice echoed through the tile vestibule. "Hello, William Harold, are you still at 1066 Hastings Drive?" (6) she asked the victim ahead of me at a volume usually reserved for relaying burger orders to grill workers.

[ILLUSTRATION OMITTED]

It didn't get better when it was my turn. "What are we here for today?" she asked, and I leaned forward, answering truthfully and discreetly. "Did you say chest pain and reflux?" she repeated loudly, reminding me of the supermarket checker who grabs the microphone and bellows, "Bob, can you get me a price check on hemorrhoid cream?"

I soon ran out of fingers and toes to count the HIPAA infractions. Open charts sitting in plain view. Phone calls I could easily overhear, complete with full patient names and procedure information. Careless conversations between coworkers. I hadn't heard HIPAA enforcement was now being handled by the Department of Homeland Security, but the alert level for possible privacy violations was yellow and elevated.

As the day progressed, I came to believe I was being punk'd (7), that this was healthcare candid camera and the cruel joke was on me. First came the blood work. I named the target vein Osama, because the phlebotomist just couldn't find it. She stabbed at my arm like she was spearfishing blindfolded, and her bedside manner made me long for the charm of an airport security screener. Mission finally accomplished, she covered the scene of the crime with a bale of gauze and dismissed me without apology.

Then it was on to the MRI, where the disembodied voice of the disinterested technician floated down to me from his glass booth in the sky. I lay perfectly still while he and his magic magnet reenacted my birth about a dozen times. (8) When it was over, I searched his face for any reason for hope, but his expression remained inscrutable--the male Mona Lisa of the Imaging Department. He managed a fake smile as I left, but his eyes said, "It doesn't look good, faceless patient No. 12,781."

Thus ended round one, and I returned to my corner to gather emotional strength for the week to come, for new tests and consultations, with other unsmiling professionals, in different cheerless offices and sterile labs. Through it all, I learned to cling to one unfailing certainty--that wherever I stood on the medical continuum, I would feel powerless, uninformed, disrespected, and vulnerable. One can't depend on much these days, but at least I could count on that, and it was in its way reassuring.

Looking back, after subsequent shock treatments and extended hypnotherapy, I can finally see this dreadful experience for what it was--painful, but character building, and the exception, not the rule. This world is full of highly trained and committed healthcare artisans, people truly gifted in the art of delivering high-tech care with heavy doses of compassion. I know many of you personally, and now that I've spent quality time in the cold embrace of the dysfunctional system in which you labor, I appreciate what you do even more.