by Doctor Science
On Wednesday my husband D had both his old knees replaced with new, shiny robot knees. I am now married to a cyborg.
We can rebuild him. We have the technology. We can make him better than he was. Better...stronger...faster.
We've had the technology for a while, but because of the frakked-up US health care system, we haven't had the *money* until this year. You don't get to talk about "wait times" in the US unless you factor in the people who have to wait years -- or forever -- because they can't afford care they need.
This is D's first hospital stay since the early 1980s, when his right knee was reconstructed for the first time. There've been a lot of changes in medical care since then. For instance, I don't know when patients scrubbing themselves down before surgery became standard -- it wasn't done in the 80s -- though I helped a friend do it about 5 years ago, so it's not all *that* recent.
I remember when studies proved that keeping patients warm during surgery is a huge plus -- operating rooms are kept so cool (so the surgeons won't sweat) that, before the late 90s, most surgery patients ended up with some hypothermia. So part of prepping D for surgery was to put him in a garment attached to a hose to blow warm air on him as we waited. It looked (and felt) kind of hilarious, but also like what we call the Bed-O-Blaster: the hairdryer we use to warm up the sheets at bedtime on cold winter nights.
I thought it was pretty funny that the OR nurse kept calling him "doll" when she was going over things with him in the pre-op room, but figured that it was just her version of when the waitress at the diner calls you "hon". D thought so too, and reports that when he got to the actual OR both nurses were calling him "doll" or even "buttercup", which would have caused dangerous laughter if *I*'d been there. But then he heard one nurse talk to the other about what they were going to do with "the doll", and he wonders if they were using the word "doll" instead of "patient" as a way to sound friendly to the patient, while giving themselves enough emotional distance to help, y'know, cut a human body apart and put it back together with new bits.
I don't know as much about OR nurses, but it's notoriously the case that surgeons can be a little ... weird. In fact, I have a friend whose father, an ER surgeon, is a, for real, sociopath. He's a really *terrible* father, but he makes a pretty good surgeon, especially in situations (like an emergency room) where he has to make timely life-and-death decisions about people he's never met. Cutting into a living human being takes a *lot* of detachment, objectification, and self-confidence -- a state of mind that comes easily to a sociopath. At least my friend's father was able to use his powers for *some* good, even though he was pretty crappy to his family.
My husband's surgeon seems pretty nice, so presumably he just feigns sociopathy in the operating room. (I'm mostly kidding.) When he actually opened D up, he was appalled by the condition of D's right knee. He told me, "I don't know how he's been doing what he's been doing" -- D is a fencing coach and referee, and still competes as a veteran, though not surprisingly he hasn't been doing all that well lately. I said this was because D has a fairly high pain threshold, and also is actually the stubbornest person in America.
But the fact is, D's right knee has been bone-on-bone for *seven years*, but we couldn't afford the co-pays (and all those little uncovered extras) for the surgery. It's only because things improved financially a lot in the past year that he's able to do this now.
And that's why I hate the US health care system. When people talk about how Americans don't have to wait as long as Canadians for knee replacements, I just want to spit. Americans don't have to wait as long if they can afford it -- but those short average wait times come by not factoring in people, like D, who wait *years* for procedures that people in any other wealthy country can get in months, even if they aren't personally wealthy.
The hospital D went to is brand new, and the joint replacement ward can only be called "swank". Every room is a single, the food is pretty good, and there's a concierge, for cryin' out loud. The atmosphere is more like a nice hotel than a hospital. It reeks of money, and of the fact that the US *already* has a two-tier health care system, just not the kind feared by Obamacare opponents. Or maybe it's a three-tier system, because in the US one large tier has been made up of people who are unable to get needed health care -- because they've had no or inadequate insurance, because they can't afford the co-pays, because they have a realistic fear of medical bankruptcy. *That's* the problem Obamacare was kludged together to address, and that's the problem that no Republican is willing to buckle down and fix.
And in the mean time, D had Seven. Years. Of bone-on-bone pain in his knee, grinding down, damaging his hips and his vertebral disks (at least 2 have collapsed). I would have traded the luxury hospital like a shot for a sane, Canadian-style (or Swiss-style, or French-style) health care system seven years ago. And maybe if we'd had a sane system for all those years, there wouldn't be so much incentive for the hospital to spend so much money on things other than health care. I'm sure the bill is going to be appalling, and it will be completely out of line with what it would cost in another country.
On Tuesday I happened to walk by a Fred Astaire Dance Studio, and I stopped and wondered, maybe we can do that again. In college our gang went dancing a lot, but D and I weren't each other's favorite partners. After we got married, we had a kind of fight when we realized we didn't dance together all that well. Rather than give up dancing, we decided to take ballroom lessons. This turned out to be a lot like marriage counseling (the teacher told us we were both wrong; we learned to pay closer attention to each other), only *much* more fun. And you get to dance!
1. IMHO the factory warranty on the human knee only covers 35 years of normal use -- after than you're on your own. Note: normal use. I'm pretty sure taekwondo voided the warranty on his right knee -- like many modern sports (including dance), it doesn't count as "normal use" as far as the evolutionary factory is concerned.