by Dave Barry
But the point is that you definitely want anesthesia for your vasectomy. Tell your doctor you want the Full Coward Package. Tell him you don’t necessarily want to wake up during the same month as your procedure. That’s what I did. I was totally out for the whole thing, and it worked out fine, aside from the video that later appeared on YouTube featuring a close-up of my privates dressed up in a tiny Elvis outfit.
I’m kidding, of course! It was a large Elvis outfit.
No, seriously: Nothing happened. I went home with my jockstrap and my peas, and in a few days I was able to resume my regular exercise regimen of mostly sitting around. So if you’ve been thinking about getting a vasectomy, my sincere advice to you is: Do not read this essay. You’re welcome.
The Health-Care Crisis
Wash Your Hands After Reading This
When we analyze the American health-care system, we see that the most important questions facing us, as a nation, are:• How should we pay for health care?
• Who should make our health-care decisions?
• What is this weird little skin thing on my right forefinger that won’t go away?
I think we can all agree that our highest priority, as a nation, is my weird forefinger thing. So far, I’ve been following the standard course of treatment recommended for diseases in general by the American Academy of Physicians with Framed Latin Diplomas, namely, picking fretfully at the affected area. But after months of fretful picking without any forefinger improvement, I’m thinking of breaking down and going to see the skin doctor.
I’m reluctant to go see any doctor, but especially my skin doctor. I went to her a few years ago when I contracted a rare and very serious disease consisting of cancer combined with small-pox, leprosy, cholera, heart failure, and the bubonic plague. At least that was my diagnosis based on the symptoms, which consisted of: pain. But it turned out, according to my skin doctor, that what I actually had was “shingles,” a disease that gets its name from the fact that it is transmitted by roofers, which, as a resident of Florida, I am exposed to constantly.
The skin doctor gave me medicine for my shingles, but she also told me that I should (1) eat a lot of broccoli, and (2) not drink alcohol. I asked her if she meant I should not drink alcohol while I had shingles, and she said, no, her medical opinion was that people in general should never, ever drink any alcohol. At all.
Well, I may not have a framed Latin diploma, but I know crazy talk when I hear it. Alcohol has been an important part of the human diet for thousands of years. The Bible is filled with references to people drinking alcohol, such as this quotation from the Book of Effusions, Chapter Eight, Verse Six, Row 7:
And yea, they did smite the Phalanges, and to celebrate they heldeth a party and they dranketh some alcohol in the form of wine, and it was good. So they also diddeth some shooters. Then they saideth, “Hey, let us doeth some more smiting.”
Oh, I’m not saying that alcohol is perfect. It has caused its share of problems. Russia is only one example. But throughout history, alcohol has shown that, used correctly, it can be a powerful force for good. I personally have won many crucial arguments at parties because alcohol gave me the conviction to keep arguing until my opponent had no choice but to leave, even if he or she was the host. And consider this: If there were no alcohol, there would be no straight white men dancing at weddings. There also would be no such sport as “luge.” And virtually none of the scientific discoveries concerning what happens when you launch bottle rockets from a set of human buttocks would ever have been made. Is that the kind of world you want to live in? Me neither.
I have, however, been eating more broccoli.
But getting back to the American health-care situation: It is bad. Consider the following disturbing facts:• FACT: American health care is a $2.5-trillion-per-year industry.
• FACT: And yet it cannot make a hospital gown that completely covers your ass.
• FACT: This year, 253 million Americans will seek emergency medical treatment.
• FACT: If you have to go to the Emergency Room, ALL of these Americans will be waiting in line ahead of you.
• FACT: And the waiting area will have a TV playing episodes of Judge Judy at the volume of the Daytona 500.
• FACT: On average, Canadians live 1.7 years longer than Americans.
• FACT: But because they live in Canada, it feels more like twelve years.
• FACT: And because they use the metric system, this is actually the equivalent of 15.3 American years.
• FACT: The male hammerhead bat, which attracts females by making a honking sound, has a larynx that takes up more than half of its body.
Clearly, we have a crisis on our hands. The question is: What should we do about it? To answer that question, we must first figure out how we got into this mess in the first place. So let’s review:
The History of Medical Care
In prehistoric times, people believed that sickness was caused by angry spirits invading a person’s body. To get rid of these spirits, sick people went to see primitive medical specialists called “shamans,”21 who would “cure” them by sacrificing a goat. Of course this was all a bunch of superstitious nonsense. We now know, thanks to modern medical science, that the shaman was actually making things worse, because when he sacrificed the goat he released the goat’s spirit, which was (Who can blame it?) really angry, and which would proceed to invade some totally innocent human. Scientists now believe this is what happened to Nick Nolte.
The first big breakthrough in medical knowledge was made by the ancient Egyptians, who discovered that the human body contained organs such as the pancreas, and if a person became sick, and you took out one or more of these organs, the person would get better. Or not. But either way you could charge the person, or his heirs, money. This was the beginning of surgery.
The next big players in medicine were the ancient Greeks, who believed that disease was caused by an imbalance of the body’s four “humours”: blood, bile, phlegm, and sarcasm. This made for some really disgusting treatments, especially if you were diagnosed as being phlegm-deficient, in which case you had to have a transfusion from a compatible loogie donor.
The greatest Greek physician of all was Hippocrates, who is often called “the father of modern medicine” because he invented the concept that remains the foundation of all medical care as we know it today: the receptionist. Prior to this invention, when patients came to see the doctor, the doctor had to actually see them, which as you can imagine took up a lot of his valuable time because they were always nattering on and on about being sick. But all of a sudden, thanks to Hippocrates, incoming patients could be intercepted by a receptionist, who would (1) tell them to take a seat, and then (2) avoid making eye contact with them for the rest of the afternoon. This breakthrough meant that a single doctor could schedule as many as 375 appointments per hour, which is the system we still use today.
After the ancient Greeks came the ancient Romans, who advanced the cause of medicine by inventing sewers, running water,22 and of course Latin, without which modern diplomas would not be incomprehensible.
This was followed by the Middle Ages, during which medical care consisted of putting dress pants on the corpses.
Then, in 1676, came one of the most important medical breakthroughs of all. A Dutch scientist named Antonie van Leeuwenhoek, who had developed an improved method for making optical lenses, was peering through a microscope at a drop of his saliva, when he made an astounding discovery: the letters in “Antonie van Leeuwenhoek” could be rearranged to spell “Look, Nun, at Weenie Heaven!”23
Unfortunately, Antonie didn’t speak English, so he didn’t realize how entertaining this was. Instead he went back to looking through his microscope, and he made another astounding discovery: Some very tiny things were moving around in his saliva. Upon peering closer, he realized that what he was seeing were actually living creatures—but very strange-looking creatures, unlike anything ever seen before:
Thes
e creatures, of course, were bacteria, which are one-celled animals that thrive in places such as nasal passages, armpits, public restrooms, and yogurt. When van Leeuwenhoek publicized his discovery, medical scientists realized that these tiny organisms in our bodies were the cause of many diseases. This in turn led them to the conclusion that the logical way to treat these diseases was to . . . sacrifice a goat. So there was still a long way to go.
By the 1800s, animal sacrifice had been largely discredited as a medical procedure; today it is rarely used outside of Miami. But nineteenth-century medical care was still quite primitive by modern standards. Hospital patients were routinely tied to their beds with leather restraints and told to bite down on pieces of wood while surgeons used unsterilized saws to cut off their arms or legs. And these patients were being treated for ear infections . You don’t want to know what happened to people with hemorrhoids.
Things really started to improve in 1895 when German physicist Wilhelm Roentgen, while doing some laboratory experiments to see if anything came after W-rays, discovered X-rays. This made it possible for the first time for doctors to look inside living human beings and spot problems such as cancerous tumors, which, as it turned out, were caused by exposure to X-rays. So this invention came along just in the nick of time.
The twentieth century saw a tremendous improvement in the quality of medical care thanks to such advances as—to name just a few—penicillin, the artificial heart, liposuction, the little hammer that the doctor uses to hit your knee, the answering service, the six-year-old Woman’s Day magazines for patients to read in the waiting room, the deductible, the artificial wart, the sphincter transplant, and the consumer-safe pill bottle that the consumer cannot open without power tools.
Today, in the twenty-first century, America is the most medically advanced nation on Earth. And yet many Americans are unhappy with our current health-care system. To understand why, we must first type a subheading that says:
The Current American Health-Care System
The journey through the American health-care system typically begins when a typical American, whom we will call Mary,24 is watching television and sees a commercial for a prescription drug with a name that sounds like a Star Wars planet, such as “Lipitor” or “Zoloft.” This commercial shows trained actors pretending to be regular humans just like Mary, ruefully telling the camera how foolish they feel because they failed to ask their doctor about the prescription drug—we’ll call it “Endor”25—that paid millions of dollars to make the commercial. The commercial does not make it entirely clear what Endor does, but it is clear that if you don’t ask your doctor about it, you have the IQ of spinach.
At the end of the commercial, an announcer warns Mary about the possible side effects of Endor, including (but not limited to) headache, nausea, spontaneous combustion of the eyeballs, and death of the patient and the patient’s entire extended family. But Mary isn’t paying attention to the announcer. She’s thinking that, although she feels perfectly healthy, she doesn’t want to be the kind of idiot loser who fails to ask her doctor about Endor.
So Mary calls her doctor’s office and speaks to a semi-medical professional who tells her that the doctor will be able to see her in . . . (tapping of computer keys) . . . three months. Mary puts this on her calendar, but there’s really no need for a reminder, because over the next three months she will see the Endor commercial 783 more times. She reaches the point, emotionally, where pretty much all she wants to do in life is ask her doctor about Endor.
On the appointed day, Mary goes to her doctor’s office, where a semi-medical professional conducts a thorough examination of Mary’s health-insurance ID card, then instructs her to take a seat. She is left to season in the waiting room with three or four dozen other patients (several clearly deceased) and old Woman’s Day magazines for a period ranging from one to four hours, after which another semi-medical professional calls her name.
Now, finally, after all the waiting and the worry, Mary will have the opportunity to . . . be weighed. Weighing patients is an ancient medical tradition, dating back to the shamans, who believed that a person’s weight indicated how large an evil spirit was inhabiting his body. The semi-medical professional doesn’t even bother writing Mary’s weight down.
Mary is then ushered into a small, stark examination room furnished with a plastic chair, a paper-covered examination table, and a large, detailed color diagram of the human endocrine system to remind Mary that there are many important things about medicine that a layperson like herself cannot hope to understand. The semi-medical professional leaves, closing the door. Mary sits there, alone, looking at the diagram. The minutes tick past. Fifteen minutes. Thirty minutes. Mary begins to wonder if they have forgotten about her. She also becomes increasingly convinced that something is wrong—very wrong—with her endocrine system.
Then, just when she’s about to give up hope of ever receiving medical care, she hears footsteps in the hallway. Suddenly, the door opens, and in steps: another semi-medical professional. She’s there to make sure Mary has not died of malnutrition, and to let her know that the doctor will be with her shortly. This is accurate: The doctor will be with her very shortly, because he has 374 other patients to see during that hour, which means he has budgeted 9.6 seconds total for Mary, including pleasantries.
When, at last, the doctor appears, he moves at the speed of an HBO vampire. He emits a .016-second pleasantry burst and immediately starts writing things down. Mary has no idea what he is writing, but she realizes that if she doesn’t ask her question quickly, the doctor will be gone. So she blurts it out.
“I’m wondering if I need Endor,” she says.
“I’ll schedule some tests,” the doctor replies, writing furiously. And then, with another pleasantry (truncated to .009 seconds, as the doctor is running late) he is gone, leaving no trace of his visit except the gentle rustling of the endocrine-system chart on the wall.
What Mary doesn’t know is that the doctor, focusing on completing his paperwork, heard her incorrectly; instead of “I’m wondering if I need Endor,” the doctor thought she said, “I’m wondering if my feet are tender.” So he has ordered X-rays of Mary’s feet, and—to protect himself from a potential lawsuit being filed by the medical-malpractice attorneys who flock around his building—orders a full blood workup, urinalysis, bone-density scan, electrocardiogram, MRI, full-body CAT scan, several biopsies, and a barium enema.
Mary, following the directions on a piece of paper handed to her by a semi-medical professional, goes to a medical laboratory, where needle-wielding technicians in medical attire systematically drain the bulk of her bodily fluids. She then goes home to wait, and fret. Several days later, she gets a call from a worker at her doctor’s office, saying the doctor wishes to speak with her. A few moments later, or possibly forty-five minutes later, the doctor comes on the line personally. He tells Mary that he has good news and bad news. The good news is, there appears to be nothing wrong with Mary’s feet.
My feet? thinks Mary, but before she can say anything, the doctor springs the bad news: One of the tests has turned up a troubling result—a small, strange-looking spot showed up on one of the test scans:
The doctor assures Mary that the spot could very well be nothing. In fact, it is nothing; it was caused when a lab technician, while processing Mary’s images, sneezed up a globule of mayonnaise from the tuna sub he had for lunch. But the doctor doesn’t know this, and he is not about to take any chances with the spot, because looking out his office window, he can see a flock of medical-malpractice attorneys watching him from their perches in a tree across the street. So he tells Mary he is sending her to a specialist for additional tests.
A few days later Mary goes to the specialist’s office, where, after the standard seasoning and weighing, she is ushered to an examination room containing a realistic full-sized model of the human spine that looks like a huge prehistoric insect. She stares nervously at this until the specialist materializes. In his all
otted seconds with Mary, he can’t find anything that might have caused the spot, but to be on the safe side, he orders Mary back to the lab for additional tests involving the removal of whatever bodily fluids Mary may have left. Several days later, the specialist gets the results. They do not shed any light on Mary’s spot. The specialist is on the verge of telling Mary it was probably nothing when he hears the distinctive sound of restless attorneys scuffing their wingtip shoes on his office roof. So he decides that, rather than take any chances, he will refer Mary to another specialist.
The process repeats itself, again and again. Mary becomes a human hot potato, passed from specialist to specialist, each of them sending Mary back to the laboratory for more tests because none of them wants to have to explain to a jury, under questioning from a malpractice attorney, why he or she was the only doctor in this chain of specialists who failed to see the need to subject Mary to more medical care.
Mary is now a psychological and physical wreck from wondering what is wrong with her, not to mention giving out more fluid samples than a Napa Valley winery. Also she’s not getting much sleep, because every day the postal person wheezes up to her mailbox and deposits a large bale of insurance-company statements, which look like this:EXPLANATION OF BENEFITS
HealthLifeCorp