as if i never said good-bye

I am having trouble adjusting to being north of the border.


Thursday morning was a perfect example.


One of the down sides of Coumadin is the amount of time needed to find and maintain the proper level of medication.  In my case, I have been visiting the Coumadin clinic in my doctor's office once or twice a week.


A prick on the finger.  A drop of blood on the tester.  A quick explanation of what I need to do before my next appointment.


Each appointment has been for a specific time.  And each time, I have sat waiting to be called.  Up to a half hour after my scheduled time.


Getting specific appointment times was a shock.  After a year in Mexico, I am accustomed to simply driving over to my doctor's office to see if she is there.  Seeing her immediately if no one is waiting (the customary experience).  Waiting if she is with another patient.


In the rare instance when a specific appointment is set, I have almost always been seen as early as I arrive.


But that is not the American system.  We like to give the impression that our appointment system runs as efficiently as Mussolini's trains.


But it is an impression.  Appointments are more like guidelines.  And it is not just doctors.  I have seen the same indifference to time by a number of professionals -- including barbers and head waiters.


The last time I went to the clinic, I told the nurse that I was a bit disappointed with her tardiness -- without an explanation why I was forced to wait.  She apologized and said it would not happen again.  She was on the telephone and had not noticed the time.  That was last week.


Thursday morning I showed up at the clinic about 20 minutes early.  I brought work to occupy me until my appointment at 11.


I finished the work a bit after 11.  And sat.  And waited.  And watched the minute hand march down the face of the clock.


Twenty minutes late for my appointment, the nurse I saw last week came by to tell me that if the other nurse did not see me in 15 or 20 minutes, she would be back to test my blood.


I asked her if that constituted being on time, as she had promised last week.  She offered to see me right then.


As we walked down the hall, I asked her if all of my appointments would be that late.  She said that most patients are seen 15 or 30 minutes after their scheduled times.


Reaching for humor, I told her that I could easily just show up 30 minutes late if that would be easier for her.  To which she responded: No.  You can't do that.  You have to be here on time.


Now, several witticisms flew threw my head, but I decided on the direct approach that the system seems a bit rude to the patients.


That must have hit her patience point because she responded: Maybe it's you who is being rude.


About every ten years or so, I get angry.  Red in the head angry.  I guess Thursday was just my time.


That's it, said I.  This appointment is over.


It would have been a dramatic exit line -- if I could walk.  Instead, I fumbled around for my crutches.


But leave I did.


When I was in private practice, I had a policy if I did not see my client at the appointed time, I would not charge the client for the services.


The only asset in life that can never be recovered is time.  When it is gone, it is gone.  Wasting people's time is wasting their lives.

I suspect the nurse may have been a victim of the clinic's own scheduling system.  Trying to eke as much money out of employees and customers is an age-old employer practice.  Sometimes, The Man is to blame.


But acquiescing to it will not fix it.


Of course, not having my Coumadin levels monitored will not fix it, either.


I am looking at some alternatives to testing.  Self-testing through an online service looks interesting.


Of course, if I had stayed in Mexico, none of this frustration with the American medical system would have occurred.


More importantly, I have only five months left before I can return home.  With no further need of Coumadin.