Saturday, September 19, 2009

Boxers or Briefs

1. Monogamy, monotheism, monomania. The concentration of wide energies to make a passion, or the inflation of slight energies to resemble one?

2. Chronic skepticism, like chronic credulity, takes root in a lack of experience. Inquiry into everything–or nothing–shows a lack of sophistication, a shrinking from the amplitude of the partial.

3. If writing brings me face to face with the mediocrity of my mind and the frequent coldness of my heart, it also reminds me of the agility of my spirit and the robustness of my appetites.

4. The landscaper makes his living, as do I, from people's disinclination to turn their own soil.

Monday, September 14, 2009

An Anti-Horror Story

Dear Jenny,

Thanks for your email. You say that down in Florida you're hearing horror stories about Canada's socialized medicine, which have got you more worried than ever about Obama's proposed health care reforms. You ask if I can shed any light on the matter.

I'll try. We hear the horror stories up here, too. In fact, most of us have told a few. Stories about long waits, bad doctors, wrong treatments, no treatment–all the ways a system can let you down just where you feel it the most: your health. They're like stories of bad car crashes or miscarriages of justice, with this difference: no one claims that privatized roads or courtrooms would eliminate those ills.

Come to think of it, I can't remember the last time I heard a Canadian suggest we abandon our public health care system in favour of a private one. Even those with a financial incentive usually advocate privatizing parts of the system; they want to tinker up their returns, not tear down the house. Everyone wants the system to work better, but they want it to work better, not be scrapped for another one that does not guarantee universal coverage.

Complaining is natural; everyone does it. When it comes to putting a bad spin on a good thing, Canadians take a back seat to nobody. Still, we need to balance the horror stories with other kinds of stories, just as true and happening every day. Call them anti-horror stories.

Here is one.

I used to go years without seeing a doctor–not smart. I still put it off too long sometimes. But this past month, a perfect storm of health problems caused me to seek medical attention from eight different doctors and at least a dozen nurses, in half a dozen clinics, offices, and hospitals. It was a very thorough, if involuntary, sampling of socialized medicine. What were the results?

Across the board I received competent, courteous, compassionate care. And surprisingly promptly, too, given that wait times are Monster A in horror stories on both sides of the border. But “across the board” is not a story; only details are. Here are a few of those. I've had several skin cancers. At this month's checkup, my dermatologist gave me some free ointment for a spot she didn't like the looks of. She asked about my latest book and gave me good advice on a public speaking possibility. A few days later, I developed an infection in my face that spread rapidly. It was Friday afternoon. My G.P. was gone till Monday, so his secretary located the walk-in clinic closest to me. I went there, was examined by a nurse and doctor, and within two hours was back home with my prescription for antibiotics filled. The next morning the infection was much worse. I called Tele-Health, and after a rapid but detailed phone interview, was advised to return to the clinic, where I would likely be referred to a hospital emergency room. I was.

On each of the next four days, I returned to Sunnybrook Hospital's ER to get IV antibiotics. I saw three different doctors; each had my thickening file to consult, and each examined me anew, listened and asked questions, and discussed the treatment. Staff remembered me and greeted me with a smile, despite the constant stream of patients they were dealing with. From triage nurse to treatment to parking lot cashier, I was through in about three hours each visit, which seems to me a very acceptable turnaround time in a busy urban hospital. A few days later, the infection coming around, I met my psychiatrist for our regular appointment; she helped me as sensibly and conscientiously as ever, asking me to update her by email every two days about the new drug we are trying. Finally, today I see my G.P. to follow up on the infection and to ask about new ear pain which may be related. He is a careful doctor, so I wouldn't be surprised if he sends me to an ear, nose and throat specialist.

Sorry for the litany, Jenny. But I had to show you how thoroughly I'd tested the system here. None of it cost me a cent; I simply showed my health card on each visit. If I'd had to pay for it all–well, that would have given you your horror story. And so, I fear, would my trying to find an insurer, assuming I could pay for one, that would accept me given my serious pre-existing conditions and my age (54).

It's just one person's story. But so is each horror story.

What is “socialized medicine” anyway? Public schools are run by governments, and so are public roads, but I don't hear people worrying about socialized education or socialized transportation. Comparing my Webster's and Canadian Oxford, I find that the bogeyman of socialism is third on the list of meanings of “socialize.” Before it come the senses of making social or sociable. Which means, my dictionaries tell me: fitting to organized society; concerned with the mutual relations of human beings; ready and willing to talk and act with others. That doesn't sound scary. It sounds more like the antidote to scary, as if the secret meaning of “social” might be “un-scary.”

What's the alternative? Health care that is, by design, un-social? Anti-social?

Against that possibility, we all need all the anti-horror stories we can tell.

Best wishes,