THE THIGH BONE'S CONNECTED TO THE
HANGNAIL ...

by sonya hammond


 While everyone in DC has apparently given up arguing about creating a health care plan, thus allowing Congress to return to the more important issues of funding studies on the impact of cow flatulence on our air quality, the rest of us are left to cope with the 'greatest health system in the world' as it is known primarily to those who cringe in terror at the suggestion that the average citizen should be able to afford to use it.

Although portions of our health care may still be superior, the implication that it is based on some sort of 'system' is gross exaggeration. My personal scientific observations indicate that if the concept of a 'system' [which presumes a coordinated body of efforts] were explained to health providers, a major obstacle to streamlining our health care would be removed.

In the least alarming illustration of current misuse of the term, let's say you have a hangnail the size of Pittsburgh. Understandably, you want to get rid of it, so you call to make an appointment with your Primary Care Physician.

After 48 minutes of Muzak interspersed with insincere recorded expressions of gratitude for your patience, a human may finally, and with deep reluctance, demand to know why you think you deserve an appointment, and may, should you sound convincingly obsequious, schedule your visit for sometime in the current year.

Rule No. 1 - If this is your first visit to a PCP, arrive 3 hours in advance unless:

Rule No. 2 - The scheduled hour of your appointment has absolutely nothing to do with the time your name will be finally be bellowed out by a  PCP Assistant will forcibly weigh you, take your blood pressure, perch you on an examination table and proceed to ask you every single one of the questions you just finished filling in on the form she will not bother to read. After taking copious notes this person will order you to strip and don a paper gown designed to expose your more intimate body parts, and leave you to freeze in the arctic temperatures proscribed for all examining rooms. who will finally grant you access to the inner medical sanctum.

This humorless person will forcibly weigh you and take your blood pressure before demanding that you answer every single one of the questions you just finished filling in on the form she will not bother to read.  After taking copious notes on the purpose of your visit, and ignoring the fact that your complaint is limited to the finger of one hand, the PCP Assistant will order you to don a paper gown designed to expose most of your more intimate body parts, and leave you to freeze in the arctic temperatures proscribed for all examining rooms.

Just prior to hypothermia setting in, your PCP will arrive and, proving the point that reading is no longer a required element of medical school curriculum, instigate his own thorough medical quiz before concluding that you should see a hangnail Specialist.

In the meantime he will order you to complete various tests that involve donating many tubes of blood, humiliating exercises with tiny plastic cups, and scans by machines that transfer pictures of your parts onto computer screens where they will be evaluated by highly trained technicians and sent to a test burial ground somewhere in Nevada.

Rule No. 3 - Before you are granted an appointment with the Specialist, your hangnail will grow to proportions that make it painfully difficult to complete the 679 pages of forms this new medical expert will require.

Rule No. 4 - The waiting period in a Specialist's office will be multiplied in direct proportion to the higher fees he will charge for his services.

Fading fast, you will be eventually be led away by the Specialist Assistant who will weigh you, take your rising blood pressure, and subject you to the inevitable oral exam of your medical history before firmly handing you your paper gown.  By now it should be obvious that the location of hang nails has not been well documented in any medical text book.

The Specialist is either less overworked than your PCP, or makes a lot more money, because he will have time to read both your and his assistant's version of your history before taking his own survey and ordering you to submit to additional blood-letting, aiming at plastic cups, and portraits that require ingestion of isotopes.

Rule No. 5 - Unless you are already brain dead, you should at this point declare in a loud voice, 'Been there; done that!'

Indignantly complaining at the lack of professional cooperation that precluded anyone forwarding your previous test results to him, the Specialist will go off for several hours to have them faxed. It would be quicker for you to run across town to get them yourself, but your paper gown makes that an impractical alternative. Not that it matters.

The Specialist will return with faxes of your most recent mammogram, 2 x-rays of a toe you broke in 1974, and the results of someone else's pap smear. In his expert opinion none of these are conducive to a better understanding of your hangnail which in the past hour alone has grown another 2 feet.

All of this will waste time, very expensive medical equipment, the expertise of several levels of medical personnel and enough paperwork to impress the Pentagon.

Persons capable of logic, none of whom hold elective office, might presume that any country capable of programming a computer to audit our income taxes back to the Iron Age ought to be able to put our medical histories on a database accessible to any physician. If they don't bother to read them, that's their problem.

In the meantime, however, you will inevitably find yourself back on hold suffering through Muzak's medley of Pat Boone's Greatest Hits. Your hangnail may be cured, or you may have cut it off in desperation, but you will need to see your PCP about a new problem.

You'd just better hope there is such a thing as a Writer's Cramp Specialist.

© sonya hammond 1997

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