Chapter 3: You Want Pills With That?

If the choice is between Prozac and a movie, I’d choose the movie. It turns out, insurance companies will make a different choice.

The dateline for this is early July, 2005.

We were losing him, and not to staph. He’d fought his way back from that hideous allergic reaction, his blood cultures were MRSA negative. The reconstructive surgeon was talking about surgery in a week, if my son could get the yet-reccurent morning fevers under control. But despite all this good news, my son had become mired in depression, a funk so deep it hauntingly resembled, to my well-trained eye, despair.

Concerned, I spoke to one of his nurses about this on my way out from a visit with him. I didn’t realize what a mistake that was until I got back the next day and found him frowning at me in stern dislike.

“They want me on anti-depressants,” he said curtly. “What did you tell them, anyway?”

“Um,” I began, floundering a little. “Well, I told your nurse yesterday that I was concerned about your state of mind. And I am. You’re getting better physically, but emotionally, you’re a wreck. I didn’t know they wanted to shove more pills down your throat, though.”

He looked away, turning to the window to gaze out at the cars in the parking lot below. The doctors had the best cars, of course. He never really tired of looking at them, and in cheerier times would name them off to me, from a distance, discussing the benefits and drawbacks to each model.

“I’m not depressed,” he stated flatly.

“You are,” I said, as gently as I could. “I treat people in depression a lot, son. You show all the signs.”

A glancing scowl from him could, by that time, do a lot to tear into my heart. It spent most of the summer in tatters, anyway.

I’ll forego relaying the rest of that conversation. He finally stopped fighting me on my diagnosis, and I agreed with him that anti-depressants were not the proper answer. The problem was, it was the easy answer for the hospital staff — so, of course, they were pushing it.

What I had had in mind was getting the kid some R&R, to use an old military term. He needed some time outside, away from the confines of the hospital and the endless rounds of needles and diagnostics. I wanted to take him to see “Star Wars: Revenge of the Sith” in the local theater. It was much harder to arrange for something like that, it turned out. Not because we weren’t ingenious enough to get him there and back on the batteries of the VAC unit perpetually perched on the foot of his bed.

No, it was, quite simply, because insurance wouldn’t pay for it.

This took me aback, the first time one of the doctors said it. I wasn’t asking insurance to pay for the trip — I was going to pay for that.

“No, I mean if he’s off-campus for any length of time, his insurance company may start to ask why he needs to be hospitalized at all. They may refuse to pay for the stay.”

This confounded me so deeply that I retreated in abject confusion for a bit. I asked myself, and not for the first time, what kind of health insurance company would refuse to pay for a hospitalization just because a long-term patient went out to a movie for an afternoon? Would they really rather put him at risk for another series of bad reactions to medication than have given their blessing to a harmless trip to the movies?

It didn’t surprise me, by then, to have learned that any insurance would prefer to pay for more pills than for an outing at the theater. I’d long known that the insurance and pharmaceutical industries were in bed together, and had prostituted most of congress and the senate in order to have their way with the insured. Malpractice suits and higher insurance premiums for hospitals and doctors meant that both were in thrall to their corporate masters, with orders (sometimes written, sometimes not) not to do anything that sniffed remotely of liability.

As my son’s battles continued through the summer, we’d often enough been threatened with the consequences of insurance not paying for his stay if we decided to do something or other, usually anything that was “Against Medical Advice.” It didn’t phase me, usually — I’m enough of a rebel that had it been me inside those bedrails, I’d have done what I wanted and to hell with the consequences. But, at 21, my son is a different person, with his own values set. The threat of a half-million dollar hospital bill was enough to make him go along, or at least seek out a compromise in his treatment, where he could. And if I’m honest, I think that at 21, I’d have been intimidated by a $500,000 dollar debt, too.

He still refused the pills. I cheered him on for that, and went on a recruiting drive, getting friends and family more interested in visiting where they could, phoning him where they couldn’t. The nurses did manage to find an unused TV/VCR which they rolled into his room,
so he could watch movies. I brought in a boom box, and his CDs, so he could listen to music. The nurses also began bringing him things — home made cookies, snacks from the snack bar, milk shakes. Slowly, his spirits began to lift, and life and hope returned to his eyes. I
nearly wept for joy when he cracked the first joke after this interlude — I laughed harder than the quality of joke probably warranted, but I wasn’t the only one.

Insurance wouldn’t have paid for that, either, even though it was a healthier alternative than Prozac or Zoloft.

There are a lot of interesting things that have come out of this “lost summer,” but the most significant is, I think, my understanding that what we have in this country is actually disease care, not health care, and that it is inefficient, blind, arrogant, and expensive. Even though there are professionals in the industry who do care, who do their best to help the patients in their charge, the industry as a hole does not “care” at all. It couldn’t “care” less, where the health of the whole person is concerned . It’s only “care” is for the overall health of the corporate bottom line.

It’s a system ripe for change.

The third in an ongoing series of attempts for the author to make sense of the expensive, inefficient, and nightmarish health care system, and her family’s experiences while trapped in it.

Quote of the Day: Change is the constant, the signal for rebirth, the egg of the phoenix. –Christina Baldwin

Metaphors For Life’s website