July/Aug 2004

ARTICLE TOOLS

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Like many people in my demographic slot (female, near retirement age), I have become a keen, if reluctant observer of medical culture in America. Not only do I deal with my own three medicine men (one of whom is a woman), but, for the past seven years, I have tangoed with more than a dozen doctors treating my parents' various ailments.

I have filled out medical history forms for my parents in four different counties, stood beside them in examining rooms, er cubicles, and intensive care units, signed consent forms, and watched monitors record their test data. The experience has caused me to ponder any number of questions, not least of which is, how do we hold together our parts when they have been divvied up among various specialists? Or simply when, without medical assistance, they begin to shut down on their own and there is less and less of us.

For several decades, Dr. S has been my parents' general practitioner (now known as a PCP or "primary care physician"). An Ethiopian immigrant with grizzled white hair and gold-rimmed glasses, Dr. S, like most PCPs today, mainly treats colds and flu and minor infections. His wife serves as receptionist. The waiting room is always crowded, mostly with Medicare and Medicaid patients. His examining room is piled with tattered trade journals, freebies from pharmaceutical companies, and half-used cartons of supplies.

Dr. S mostly acts as a referral agent to specialists, each of whom gets only a piece of my parent to work with. Like butchering diagrams in cookbooks, only more complicated, the body is divvied up among various specialisties, all as adamant about their boundaries as Balkan nationalists. My mother's neurologists got her brain. The orthopedist got her bones and the dermatologist ...