Larry, Moe, and Curly
It makes no logical sense that I carried on with my life like that ER doctor was right, except I was convinced that going to another doctor would just result in the same kind of dismissal. And having the worst pain of my life pooh-poohed was both hard to believe and expensive, placing a repeat consultation with a doctor way up there on my list of things to never ever do again, ever.
When the hospital bill came a few weeks later, I found out how little my health insurance had decided to cover and how much the hospital said I owed them. I was still paying the mortgage on the condo in Indianapolis–yeah, that building no one lived in–while paying rent in Champaign-Urbana. Dan’s chronic illness made it impossible for him to work, and he wasn’t eligible for disability. So we were a single-income household. My new-ish job as a technical writer paid decently, but not well enough for me to have an apartment and a summer home in another state. I didn’t panic at all those zeros on the hospital bill though, at least not immediately. There was an 800 number in bold print halfway down the page prefaced by the words “For financial assistance, please call.” I called.
“I’m sorry,” the woman said, “but you make too much money and you have insurance.”
“But I am paying rent and a mortgage, and insurance didn’t cover a quarter of what you guys charged me,” I pleaded.
“I can arrange a payment plan for you,” she offered.
“Okay.” My hope returned. A payment plan. Yes.
“How much do you think you can afford to pay per month?”
“Well, I could probably do fifteen dollars.” Truthfully, that wasn’t really an option either. Trying to turn zero dollars into fifteen wasn’t any easier for me than trying to turn zero dollars into a million, but being unable to afford the fifteen felt like failure on a smaller scale.
“Well, our plans are based on the total bill and your reported annual income. You’ll have to out the paperwork for official approval, but it looks like I can do $100 a month,” she said.
I forced back tears and my throat tightened, pinching of my voice. No, no, no, no, no. I’m not going to cry on the phone with a complete stranger, I thought. But fighting the emotion only made things worse. I sucked in my sad hiccups and moved the phone away from my head for a brief second so she wouldn’t have to hear me inhaling my own snot, then immediately returned to the conversation. “Okay,” I said, giving up too easily. “One hundred dollars.” It didn’t matter what arrangements she noted in my billing record. I would have agreed to pay her three hundred dollars and a zebra every month if it would get me off the phone faster. I needed to lock myself in the bathroom and have a good cry about how I was no longer just sick, but sick and accruing medical debt.
I don’t think healthy people can understand how psychologically damaging it is to be charged an impossible amount of money for help during a medical emergency. When the hospital says you owe thousands of dollars for an hour stay in an ER bed, a dose of Mylanta, and an admonition to avoid spicy food, you quickly come to understand that the bill isn’t so much about assigning value to the resources used, it’s about punishing you for having the audacity to seek medical care as a poor.
I got the message loud and clear, and for the next six months I pretended my doctor was right with his self-induced indigestion diagnosis. I downed Extra Strength Gaviscon tablets like a teenager downs Tic Tacs after a first date at Fazoli’s. I ate things with the flavor profile of lightly salted cardboard and drank lots and lots of skim milk because I remembered hearing my uncle say once that a glass of milk worked better on his heartburn than any antacid he’d ever taken. My new diet of milk and chalky tablets did keep any accompanying indigestion from exacerbating whatever was really wrong with me, but it didn’t improve my overall condition. It wasn’t the absence of pain that kept me out of the emergency room, but my recently acquired ability to ignore it.
The following April, though, I had an attack so bad I couldn’t pretend it away. I bolted upright from sleeping around 1 a.m. and clutched my upper abdomen–the attacks always came at night when I was lying down. If the episode last Fall had registered at a 9 on the pain scale, this was easily a 13. I gently shook Dan’s shoulder and whispered, “I need to go to the ER.” The “again” was implied. He didn’t ask me what was wrong, just threw on jeans and a T-shirt and drove me to the ER. This time delivering me to the other hospital in town.
I told the resident my symptoms and she had me lie back in the bed. I closed my eyes to block out the blinding white of the overhead lights and was overtaken by the smells of plastic and bleach. The doctor asked if she could feel my abdomen. I nodded yes and she put the pads of her fingers on the upper right quadrant of my belly making a swirling, circular motion while pressing toward my spine.
“Gahhhh!” I screamed. Tears immediately rolled down my cheeks as if she’d located and depressed a secret “cry” button near my rib cage. My head and feet lifted from the bed, my butt anchoring me in the shape of a human V. I didn’t have to explain how badly it hurt.
She looked at me sympathetically, “I’m sorry. I had to check—“
“I know, it’s OK,” I managed to whimper.
“Does your mom still have her gallbladder?” the doctor asked a few minutes later, raising the bed rail.
“No,” I said, my body relaxing. It was clear from her question she believed me, and that alone did wonders for my condition. The Dilaudid pumping through my IV a few seconds later didn’t hurt either. “My grandma had hers out too.”
“Seems to run in families,” she said. “We’re calling in an ultrasound tech to be sure, but it looks like you’ve got a gallstone.”
There were three, it turned out. I named them Larry, Moe, and Curly. Emergency surgery wasn’t required—their words, not mine—so they sent me home with a bottle of Percocet and instructions to schedule a cholecystectomy with one of the hospital’s surgeons during normal business hours.