I had walked out that day, and I subsequently received a call notifying me that I had an appointment with my primary care doctor on a certain day and time. A patient does not have to make an appointment at The Medical Center because it makes that appointment for you and tells you when you must be there regardless of your schedule, if you happen to have one. That works out fine for the staff and for unemployed Medicare and Medicaid seniors who have nothing better to do and are happy to have something to look forward to including free round trip transportation in the big van with drivers who speak the language. Sad to say, many seniors are virtually abandoned by their families, and their mates and friends may have passed away.
“Do you have a support system, family and friends?” my Primary Care Doctor asked me the standard question, as if I were “elderly.”
“Oh, dear, you are my only friend still in this city. My family could care less about me, and I deserve it since forgiveness is no longer ethical.”
I love my Primary Care Doctor. We usually get along fine, but this time she was abrupt and would not chat, giving me cause to suspect that the Director had had a word with her about my complaint headed: “Do Not Go To The Second Floor!”
Well, maybe she was having a tough day. I started my long career as a Successful Loser working in hospitals. There is no way I would have her job, the job she says she actually loves even though people expect her to be far more than their doctor.
“Are you depressed?” she asked another standard question.
“Not after seeing the people in the lobby.”
“So, you did not see the rheumatologist I recommended?”
“No, I waited three months for the appointment and then several hours on that day. I walked out.”
“You are a bad boy.”
She often says that, and she is right. I cannot help it. I am antiauthoritarian. I ran away from home a week after my thirteenth birthday. I would rather die working out at the gym than in a hospital. I do not want to hang out at medical clinics. The Medical Center is popular, however, and several patients seem to practically live there.
“There is always a problem with waiting on the Second Floor,” I declared, knowing very well that she knew it. “Anyway, I do not think it is rheumatoid arthritis like you suspected.”
“The blood test indicates RA.”
“But that is not the only factor on the test, although dominant. We do not know what causes RA.”
“It is an autoimmune disease.”
“So what causes the immune system to attack my hands? I think my whole body is mad at my hands because of the way I have been using them. I do not think this is RA. I believe repetitive motion on computers and cell phones has caused of the problem. I know my thumbs joints and my first middle finger knuckle on my right hand hurt like hell.”
“The rheumatologist will know what it is. She can help you. She can give you shots.”
“Shots? Really?”
“Yes, she will help you,” she said very confidently.
“Okay, then, I shall go to the Second Floor again,” I said. I had Googled the rheumatologist and discovered an endless number of rave reviews, nearly half of them, however, complaining about the wait time.
So I was given an appointment late in a day when the doctor was scheduled to make her next monthly call to The Medical Center. I was adamantly assured that I would be seen on time then.
Not. The appointment time went by, as usual, and, as the time dragged on and on after that, I preoccupied myself conversing with the others present in the waiting room. I noticed the ladies present were entranced by an album playing on the public system. A male crooner was singing romantically in Spanish, backed by a subtle Latin rhythm.
“That's Mexican music,” I announced to all.
“No, that is Cuban music,” proudly said the van driver, who was waiting to take a patient home. The Medical Center is predominantly populated and staffed by Cuban Americans, some of them newly arrived. I have often wondered why that is, but it never worried me because I knew Cuba had one of the best medical care systems in the world when Castro was in charge.
“Sure sounds like Mexican to me. I grew up with Mexicans in the Midwest. My Aunt Renee married a Mexican doctor. Who is that singing?”
“Oh, that is Luis Miguel,” a woman said and sighed.
“Never heard of him.”
“He is an international superstar,” the driver said. “You should see the Netflix series about him.
“I don't have Netflix. I only have rabbit ears.”
“The music is from Cuba,” he continued. “It is bolero. It was invented in Cuba by the troubadours. Luis is a Puerto Rican, but he was raised in Mexico. There was a problem so he identified with Mexico. He is called the Sun of Mexico.”
“I just looove his voice,” the woman gushed.
“Famous handsome singers attract pretty women,” the driver explained in a low voice. “He was married to Isabella Camil.”
“Never heard of her.”
“Her family is rich. They split up because of different perspectives. He loves many women in general because they come to him. It is not so easy for the rest of us.”
“He has a pleasant voice,” I observed, “somewhat like Elvis Presley.”
“Elvis was his idol. He studied all the Elvis songs when he was young.”
“Didn't we all?” I said. “I practiced them in front of the bathroom mirror. But this fellow Luis is too smooth for me. And so is Gloria Estefan. She sings bolero, right? As for Latinas, I like to listen to La India. She is a New York Puerto Rican, you know. As for Mexicans, I liked Selena. What a tragedy that was when her manager murdered her. I love Thalia, although she wiggled around too much half naked in the same way and looked silly trying to look sexy. I would have her watch Madonna videos and take some modern jazz dance classes. Now this fellow Luis Miguel is boring, really, much too polished for my liking, and he doesn't move around. He missed something important in the Elvis videos, I think.”
Everyone in the waiting room was listening intently to my English. Two ladies scowled at me. The driver walked away and started conversing in Spanish with the receptionist—I tried to break into the conversation but was ignored. Finally, an aide came out and called my name, an hour and a half past my appointment time, and walked me down the hall to the doctor.
The doctor was sitting in her chair, looking down at her right hand when I arrived at the door of the office, using her left hand to point to the exact spot mine had been hurting so badly.
“So you have seen my X-ray?”
“What? I have not seen your file.” She looked up at me.
“The X-ray of my hand. The problem is in that first knuckle of my middle finger, the one you were looking at on your hand. My hand does not like how I text on my cell phone.”
“My hand was itching there.”
“What a coincidence. Carl Jung would call it synchronicity.”
“Are you familiar with Ouspensky?” she asked. “I read him twenty years ago.”
Who was this doctor? You never know whom you might encounter in Miami! Coincidentally or not, I had recently written a little book, entitled The Sly Way of Gurdjieff & Ouspensky.
“Yes,” I answered, “he was popular with us back in the Sixties when Dr. Leary was experimenting with LSD. We were interested in Ouspensky's search for the miraculous. He said we are machines and had better wake up and remember ourselves, that a person is just a bunch of little i's who thinks he is an I but can work at becoming one. I remember Gurdjieff said each part of the body has its own mind overridden by the whole body. Come to think of it, I believe my body wants to get rid of my hand, or my hand wants to go off on its own like Gogol’s nose.”
“Sit down here and let me see your hands.”
“My doctor thinks I may have rheumatoid arthritis,” I said as she gently examined the metacarpalphanlageal joints of my right hand. “Both first knuckles on my thumbs hurt too, from using the mouse on my computer for so many years. My right toe suddenly began to hurt so badly I could not walk, but I think that is because I was doing pirouettes on a sticky floor—I was a dancer long ago, and I still practice.”
“Are you familiar with the ballet, 'The Struggle of the Magicians', Ouspensky mentioned in his search for the miraculous?”
“Of course. The ballet scenario was a piece of nonsense conceived by Gurdjieff, a key to understanding how his method worked. “
“Does anyone in your family have gout?”
“No, but my father complained about his feet a lot, and said shoes are ruining our feet. He marched a lot during the world war, and sold ladies shoes when it ended.”
“This is not rheumatoid arthritis. It is osteoarthritis. Very common. Almost everyone who lives long enough has it. Let me find your file in the system here.”
“I have the X-ray of my right hand on my cell phone. I used it for the cover of my book, My Hand,” I said as she fiddled with the computer. She located the image before I found mine.
“This is not bad for your age. You are strong.”
“I decided I am a big baby after seeing all the people in pain in the waiting rooms. I should just ignore the pain. I try to do that when I do pull ups at the gym.”
“Why would you want to put so much weight on your hands?”
“I was in a terrible fire that killed people in Manhattan. Maybe I will be in a fire and have to hang out of a window until the firemen arrive. That is what real men can do, and I don't want to be a big baby.”
“We are all big babies. You have good, strong genes. We have been on Earth for millions of years. The strong survived. Now we have medicine for those who are not so strong. Why not help them live? You are strong, but why should you suffer needlessly when we have medicine for your pain?”
“What kind of medicine is it?”
I think she said it was “chloroprednizone with an anesthetic,” but I must be mistaken: I looked it up later and saw that chloroprednizone is a topical drug that has been around since 1960, not well researched because it is seldom used since it is not as effective as other derivatives. I wonder, given her mention of Gurdjieff, if the drug she uses has a transcendental effect. Gurdjieff said the drugs used by yogis in certain schools are not merely narcotics. Wyrd.
“I heard about prednizone and I am worried about taking it,” I said, “because people have had bad experiences with gaining weight, and especially with withdrawal. Some of the most beautiful actresses in the world had to take it. They gained weight and their faces swelled up like full moons. And then there is suspicion that it might make one more susceptible to Covid-19.”
“Quite to the contrary in respect to Covid because it reduces inflammation. In any event, injection into the joints is superficial, quite different from injecting drugs into the bloodstream or taking the drug orally for absorption in the stomach.”
“A friend of mine had a steroid injection in her knee pending surgery, but she did not have to get the surgery because the pain did not return although the drug was supposed to be only effective temporarily. Later on she had an injection, somewhere in her arm, I recall, and she suffered a lot of pain for days.”
“A tendon was probably injured. I am very, very good at this. They call me Doctor Shot. Do not worry, this will not hurt.”
My hands hurt like hell. I was not about to resist after waiting so long to see her. She gave me a shot in each first thumb joint and in the first middle finger joint of my right hand after feeling for the right spots away from the tendons. I barely felt the shots. I could not feel my middle finger at all after the shot, but she assured me it was working fine and that the anesthetic would soon wear off.
“Your hands will feel better in a few days.”
“I hope so. My main concern for the last year is fatigue in my legs and feet, and cramps too. I thought I had thyroid disease, but now I believe I have a clot.”
“A clot where?”
“My doctor asked me that too. I don't know.”
“We will need images of your spine.”
She had taken her time with me. No wonder people had to wait for so long to see her. Many doctors have little time for each patient because they have too many of them or are too busy making money. The clinic was past closing and her assistant was getting impatient. I helped carry one of her cases to her car outside.
Oddly, the fatigue in my legs was gone and has stayed gone for several weeks now. My hands have gotten much better, with just a hint of discomfort now and then. So far so good. Who knows? Maybe the doctor is a miracle worker. Just tell her something hurts and it stops hurting. Maybe the mind is closely related to the body or one with it.
I called my friend Aliz in Washington and told her all about my visit with “Doctor Shot.” Aliz has a great deal of experience with top notch doctors, sometimes spending several thousand dollars for a single visit via a concierge system.
“Your Doctor Shot is a Healer. She could make a fortune on house calls.”
I tend to agree with you on the discussion about Latino singers who have larger audiences than most American singers. However, while you charmed your audience in the waiting room with your knowledge, your attitude quickly turned them off. I'm glad you wrote it though. Not afraid to write the good, the bad and the ugly. Sue me for that quote, Sergio!
I'm going to forward this to a fellow AD member who has been suffering pain in her hands recently. Unfortunately, she may not be able to get to Miami.
Ron