Wednesday, May 30, 2012

Single-Payer Sickness

I have been ill, and being ill in England is never fun, no matter how much anyone longing for they mystical, magical unicorn of single-payer health insurance might tell me how lucky I am.

First of all, most people who tell me this are only basing their knowledge of the system on something like Michael Moore's film Sicko, which was selectively edited to make the National Health Service in the UK seen wonderful. It is anything but.

And for anyone saying, "Ah, but at least you have health insurance," believe me - if an American had to live under such a system, there'd be mass pandemonium of protest in the streets.

I fell ill last Thursday, at 3pm precisely, when I stood up at my work station to experience an excrutiating back pain, followed immediately by a fit of shivers which lasted until I left the office to go home. Not that anyone noticed. In my particular office, where I am the only woman, if the men in question aren't talking about how fast a car is or how much money a soccer player they admire earns, their heads are implanted so far up their asses, it would take a surgical procedure to remove them.

All I knew was that it was a hot day, and I was cold. And tired. And feeling very ill.

I drove home with the heater full-blast, picked up my husband to go to the grocery store - telling, not asking that he go inside - and returned home by 6:30pm, only to stagger up the stairs, leaving a welter of shopping bags in the front hall, and collapse - literally collapse into bed, fully clothed and passed out to the world.

That's where I stayed until Sunday, unable to lift my head from the pillow longer than it took to answer a call of nature or vomit. And I vomited a lot. I noticed other symptoms: bloody urine, constant temperature and a nagging headache, itchy skin as well.

Did I ring a doctor? No. Why?

Well, because here's how it works under the National Health System: You get sick, and you ring the surgery to which you are assigned. A receptionist takes your telephone number and says a triage nurse will ring you back. Never mind the actual doctor with whom you're registered, if they NHS can diagnose over the telephone, it's that much less work for them to do.

Two hours later, if you're lucky, the triage nurse will ring you, listen to what you say your symptoms are, and  decide if you need to be seen that day. You'll either get assigned to see a nurse, or whatever doctor happens to be on duty. Making an actual appointment to see, you know, like the doctor whose list you're on, is more than a joke. You'll be given an appointment some two months in advance. I'd stand a better chance of an audience with the Queen.

I suffered through the weekend, stumbled back to work on Monday, and went through just that procedure - ringing the surgery, the receptionist, the triage call etc - simply because I was too damned sick to go through that bullshit the previous Friday.

By 11:00 am, the triage nurse had returned my call. She introduced herself as "Nurse Nancy" (like, we're all either morons or overgrown children) and suggested I come by the surgery between noon and 1pm and leave a urine sample, which I did. On the way back to work, along a winding country road, my cellphone burst to life. Manoeuvering away from the odd rabbit and speeding car, I parked up, long enough to receive a call from "Nurse Nancy."

"I meant for you to come to see me, not just do a sample and leave!" She shouted peremptorily.

"You didn't," I replied in the most cynical and laconical voice I could muster. "You just said leave a sample. I'm not a mind-reader."

She went onto say that I had a kidney infection (no shit, Sherlock), that she'd sent my sample "up to the labs" (wherever that was) and they'd have a result in a week. (In the UK, you never ever get test results earlier than a week, unless you go private). In the meantime, she was sending a prescription for anti-biotics in my name to the pharmacy attached to the practice, and I could pick it up before 6pm.

"I work until 5:30," I said. "I'll pick it up tomorrow."

"You can't!" she decreed. "I want you to start the meds today. Can't your husband pick the prescription up?"

I painstakingly explained that he couldn't, because my husband is a Luddite, who always leaves the house without his cellphone and refuses to answer the landline at home; but I agreed I'd try to get to the pharmacy before 6pm.

With eight minutes to spare, I presented myself at the surgery, clutching a ten-pound note in my feverish hand. I gave my name, date of birth and address to the pharmacist, who checked - first the shelves bursting with filled prescriptions, then the pile of unfilled prescriptions on her desk.

"When did you leave the script, Mrs Watts?" she asked.

"I didn't," I explained. "The surgery sent it over. Today."

Once again, she rifled through the stack of prescriptions, shaking her head, before she waved them aloft. "These are everything I collected from next door," she said. "It's not here."

On the hottest day of the year, I trudged back to the surgery next door and confronted the receptionist. I explained that I'd been in earlier, given the sample, spoken with Nurse Nancy, who said she was going to send a prescription for anti-biotics for me to the pharmacy next door ... except that it wasn't there.

Only deigning to look at me from the corner of her eye, the receptionist proclaimed, matter-of-factly: "That prescription went to Boots (another pharmacist, located on the main street of the small town where I live.)"

But why? I wanted to know. Boots is to the Brits what Walgreens is to us in the States. Unless I needed some perfume or a smelly gift for someone I hated, I had no dealings with Boots.

She merely shrugged and repeated that the prescription was at Boots. Because she's an employee of the NHS, whose salary is funded by my tax money, because her attitude was typically shitty, and because I was sick and feeling enough like a bitch to do so, I asked - nicely, of course - that she ring Boots to determine if the prescription actually was there.

Rolling her eyes, she did so, reluctantly ... only to find that it wasn't.

"Which means she actually didn't write it," I deduced. "Is 'Nurse Nancy' still on the premises?"

I was told that she was, but she was (of course) involved in a "lengthy consultation." However, the "duty doctor" would gladly write me a duplicat prescription, the receptionist said, jumping up from her throne and dashing down the corridor.

I waited. And I waited. And I waited some more, remembering how - twenty years before, a female doctor in the surgery, now a senior partner, had told me there was absolutely no way I could have breast cancer. It simply didn't happen to women who were pre-menopausal. Then she told me to go home and stop worrying. The lump would go away.

It seemed odd that I should remember that, when my attention was drawn to a pink laminated announcement on the reception counter.

It is with deep regret that we must announce the untimely and early retirment from our staff of Dr Wilshire, who has taken unlimited sick leave in order to sustain long-term treatment for cancer.

I smiled grimly, wondering if Wilshire, remembered her misdiagnosis and her pithy message to me at the time. I wonder if she remembered misdiagnosing my husband's shingles, some twelve years ago, as "stomach flu." I doubt she were misdiagnosed.

At that point, the receptionist arrived, triumphantly waving the "duplicate" prescription over her head, like St George's banner. It was signed by Nurse Nancy, herself, and no duty doctor, which meant it had never been written or dispatched in the first place.

"Nurse Nancy says she put that prescription out for collection at one o'clock," the receptionist announced adamantly. "She simply can't imagine what the pharmacy might have done with it."

I can. They did nothing. Because she never wrote it. And she couldn't even admit that and apologise.

Single-payer? No, thanks.


  1. I'm sorry to hear that. I hope you get well soon.


  2. I checked your blog every day and wondered if something had happened. I'm sorry to hear that you have a kidney infection. That's something I've experienced and it's not something I'd wish on anyone. Take care of yourself, Emilia. I'm sending blessings and goodwill your way for a speedy recovery.