The Sickness Club

            Think about the concept of a hospital.  It’s an ass-backwards idea when you get right down to it.  Bringing sick people into an enclosed building with a bunch of other sick people in order to cure them of their sickness?  That’s the polar opposite of how we’ve treated the diseased for most of recorded human history.  Isolation used to be the norm, the idea, which makes much more sense than its now normalized opposite, being to keep sickness away from well people and to keep sick people away from sick people of a different type so they won’t cross sickenize each other.  That makes sense.  House calls make sense.  Every city with more than 10,000 people having its own celebrated illnessatorium where we pay the collectors of infirmity outrageous sums of money and hope our daughters marry one of them and, on top of that, pay these sadistic affliction hoarders thousands of dollars for the honor of being poked and prodded by them makes less sense.

            And that’s just the tip of the iceberg of wrong that is our modern health system.  What’s baffling is that we really have made some amazing scientific strides in medicine and yet we haven’t figured out that hospitals are stupid.  We’ve made progress in medical side of illness, while going backwards in the human side.  We’ve cured polio, tuberculosis, and male pattern baldness.  We’ve created Band-Aids with Hello Kitty pictures on them.  We’ve allowed our doctors to ignore borders.  We can keep kids from catching measles and rubella.  We’ve mapped the human genome.  We’ve shared research across the globe and are well on the way to curing the dominant plagues of our time (provided drug companies can bilk us out of millions first). 

            And yet we still throw all the sick people into one building.  We paint the walls white to fool people into thinking that it’s a perfectly sane idea to gather sick people together in the same place.  We collectively fool ourselves into thinking that diseases could never figure out how to cross through cotton tarps that you pull to make the world’s thinnest walls.

            Some hospitals have grown to the size of a small liberal arts college.  They’re so big that they need old lady docents to give mini-tours and guide us around the confusing labyrinth of segregated disease parks.  They’re so big that they justify having glass-windowed walkways in the sky connecting various wings, so the sadists who prefer to torture our kidneys can have space enough to not have to see the sadists who prefer to torture our brains.  They’re basically their own little towns, with cafeterias, parking lots, cops, elevators, lounges, TV rooms, exercise facilities, and laundromats.  In my local hospital there are people who aren’t sick and who aren’t visiting sick relatives actually coming to the hospital cafeteria for lunch.  The food is that good and the other options are that bad.  They hired really good chefs.  At some hospitals they have little fast-food stands that serve Chick-fil-A or Subway, often without a trace of irony.  They’re considering adding a moving sidewalk from Subway directly to the ICU.  They’re so big that they justify having their own government, with a president, and his army of financial advisors telling him how he can get away with passing local bond issues to get you to pay for his yacht with your taxes even if you’re not sick.  They’re so big that they have to build the elevators to go not only above ground, but ten miles below ground, to accommodate the cavernous parking garages for all of the people who want to visit Sickney Land.   

           And the saddest place on Earth is even more expensive than the happiest place, if you can believe it.  You have to buy insurance before you even enter the door.  You have to pay to park.  You’re in the middle of having a heart attack and you have to take a ticket and then PAY to park your car before you can even get inside and then pay somebody to perform both necessary and unnecessary tests on you, because the sickness whisperers are terrified of being sued so they’ve increased their prices yet again, and all this is before they’ll deign to attempt to save your life in between rounds of golf.

            I admit I’ve got an anti-medical bias.  My father before me had the same opinion, and he wound up working for a hospital, a good one.  So, it’s family tradition to distrust doctors.  The Craig family crest is a guy in a white lab coat with a stethoscope around his neck handing a piece of paper the size of a Volvo to an angry guy with gauze wrapped around his head and a shocked and angry expression coming out of his bloody mouth.  It’s one of the few family crests that has dialogue bubbles.  The doctor’s says “Will that be cash or credit?” and the sick guy’s is a string of expletives where most of the letters have been replaced with $!@#E$!*& symbols.  It’s an heirloom, so my ancestors wanted some degree of class, also cuss words don’t always translate well across time.  So, by being skeptical of medical professionals I’m not just ranting.  I’m trying to make my father proud. 

            The twenty-first century has added a few even weirder layers of creamy nougat and squishy caramel to the candy bar that is the hospital.  For one thing, HIPAA privacy laws make it almost impossible for doctors and nurses to tell a patient’s family, much less their friends, what’s wrong with the patient.  AND THAT’S THEIR JOB.  I had a nurse lead me down two hallways (we took a right turn, then a left, and then ducked into an empty room) before we found a place with no one in earshot before she could tell me what was wrong with my friend the last time I was in a hospital.  And that was after she forced my highly doped-up, semi-comatose friend to confirm that I was actually his Emergency Contact like the form and my driver’s license said and not merely an undercover medical tabloid writer who hangs out in ER waiting rooms with a notepad and a camera the size of a ladybug.  I know that there are good reasons to protect our medical privacy.  These laws exist for a decent and understandable reason, but like so many other bureaucratic spiderwebs of legal nonsense, they often wind up doing the opposite of their original intention. 

            The epidemic of over-specialization that has infected America in so many other businesses is perhaps at its worst in the medical world.  There are doctors who only work on the knee.  That’s it.  “Could you check out my swollen foot, Doctor Peterson?”  “Sorry, kid, I’m an elbow, thumb, and outie belly button specialist.  But I can refer you to Doctor Steinwick.  He’s the best little toe man in the business.”  “Can he help me with the bunion on my middle toe?”  “Sorry, he only works on the piggy who went wee-wee-wee all the way home.  However, Doctor Adelman is a roast beef toe specialist.”  Yes, I exaggerate, but that’s what I do to make a point.  And it’s getting worse.  These doctors have to learn about the entire human body.  They have to absorb massive amounts of data about the bones, joints, ligaments, muscles, internal organs, diseases of the past, present and future, courses of treatment that work and those that don’t and why, surgical procedures, drugs and their side effects, and how to help someone pee into a plastic lemonade pitcher with dignity.  That’s a lot.  I’ll be the first to admit that successfully graduating medical school is an impressive feat.  But then these doctors, well these almost-doctors, follow a bunch of random guys around and decide which minute quadrant of the body they want to spend the rest of their lives looking at.  “Should I spend forty years looking at spleens or gall bladders?  Which is less gross?”  Again, I think we can look to our past to see a better way.  In the past all doctors were general practitioners, and they all made house calls.  They all knew a little bit about a lot of things and could help you with a wide range of problems.  Now, thanks to over-specialization, the GP is a rarity and most doctors forget ninety-five percent of what they learned in medical school after ten years of practicing. 

            And what was that word I just used?  What is the common term for what doctors do?  Is it working?  Is it the work of medicine?  Is it the perfection of medicine?  NO, it’s the practice of medicine.  That’s like saying that you, the patient, are basically a white rat and your body is a giant maze where all but one path leads to a dead end, pun entirely intended.  We don’t call what airline pilots do “the practice of hurling through the air at thirty thousand feet going hundreds of miles per hour with your life in their hands.”  The practice of medicine.  That’s the phrase.  And yet we expect doctors to do, not to practice.  Admittedly, that’s partially our fault.  We want to live and they’re the ones who can help.  But, we think that because doctors play it that way.  They act like they’re doing and not just practicing, whether they actually do or not.  It’s sort of an unspoken lie that benefits all parties involved, like the airline myth that wearing a seat-belt in a 747 is going to protect you if you hit a mountain.  I kind of get why patients want to believe that doctors aren’t guessing, even after they’ve had their meds adjusted ten times, even after three different surgeries haven’t removed the toenail clippers you swallowed to get here in the first place, and the ear light the surgeon left in there the last time.  But I really think that both the doctors and the patients would be better off if doctors admitted that half the time they’re just guessing.  Why wouldn’t that make us feel better if the first few attempts don’t work?  Why wouldn’t that let us explain away the extra nose you grew on the back of your neck as a side effect from that blood thinner you took?  I think a little admission of uncertainty might be a good thing for us.  But, maybe I’m in the minority here.

            We can do better.  I’m too squeamish and too biased against medicine in general to have studied enough to know exactly what we could do to do better, but I know that we can.  We can look to the past when doctors were respected but not worshiped, when they knew how to do a hell of a lot more than operate on the uvula and only the uvula, when they came to your house and recommended that you give the sick person some space and not cram him into a tiny room with nothing but basic cable and good drugs to keep him occupied while his disease meets, gets to know and forms an elite Navy Seal team with hundreds of other diseases that we stupidly let congregate in the same building, when you didn’t have to pay tens of thousands of dollars for a painful, invasive operation that most shamans could’ve cured with incense, prayer, some fungus, a little pixie dust and a handful of goat dung.  We probably had it right at some point, but then went too far and screwed it all up, but we’re humans. 
That’s what we do.