Doc’d Up

greencardIn the waiting area of clinic 4E at the Detroit Medical Center, women in various stages of pregnancy and early motherhood are leaning against walls, sitting on plastic “kiddy” chairs, and pacing around the rows of empty chairs around them. They are waiting for their name to be called, and they will wait for hours. They’d like to sit in the chairs, but will not, for fear of bed bugs.

There are a number of unavoidable symptoms of pregnancy: swollen feet, morning sickness, drowsiness, sure. But parasitic insects? They have no part on that list.

I found the Detroit Medical Center on my health insurance list of covered providers and made an appointment for a routine annual gynecological exam. I particularly wanted to see a doctor because I am dating someone with an STD. I would very much like to have sex with him. Also, I would very much like not to get it. Web-searches can only get me so far, I need to talk to an expert about how to keep me as safe as possible.

I arrive at 1:30 for my 1:45 appointment- you have to show up early if you are a new patient, I was told. First contact: I meet with the Intake Nurse who handed me New Patient paperwork. I sit back down to fill it out. With the exception of one self-conscious man and a couple little boys, everyone here is female. With the exception of me, every else is black and pregnant.

Second contact: I return the paperwork to the Intake Nurse and sit back down. Third contact: I am called by a different Intake Nurse who hands me a green appointment card (“bring this every time you come here”) and directs me to a different waiting area where the women are mysteriously hovering around the many empty chairs, some of which are covered in plastic sheeting. The appointment card has rules including #2: PLEASE ARRIVE ON TIME and #3: Please DO NOT BRING CHILDREN.

I begin to sit down when I am told sharply by a very pregnant woman (expecting her first child, a girl) that I better not. She tells me and the other women that she has just been a bitten by a bed bug. She is very convincing because she is itching her skin all over in the paranoid way of someone who fears they have been exposed to an invisible insect. It’s hard to control the urge to scratch myself all over too. I’m reminded of that inevitable overwhelming scalp itch that occurred exactly at the moment when, as schoolchildren, we were told there was a lice outbreak in the classroom.

I can see that there are a lot of other women waiting and I am grateful to have some reading material and interesting people to talk to. I don’t mind sitting on the tiny plastic kid’s chair next to the cute girl with beads in her hair who plays with the wooden block toy. Fourth contact: my name is called by a nurse who takes me back to weigh me and take my blood pressure. I am directed back to the waiting room.

One hour past original appointment time I am getting peeved. Usually when I’m in the company of pregnant women or little kids, I feel that deep inner ache of longing for motherhood for myself. It’s not happening today. Today I’m grateful I only need to see the doctor once a year rather than a couple times a month. Fifth contact: my doctor calls me to her room and we have a brief discussion. She leaves so I can get undressed.

Sixth contact: my doctor returns and gives me a super-speedy pelvic exam.  My legs are still up in stirrups and she’s halfway out the door as she asks if I have any more questions. “Actually, yes” I say. “Ok, I’ll come back.”

Seventh contact, Q&A. I tell my doctor about the situation with my current love interest and ask “what can I do to reduce my chances of contracting?” She tells me STDs are passed through skin-to-skin contact so, “you’re gonna get it.” My j aw drops, that’s your advice? I could get better advice in a Yahoo forum. She writes me a prescription and tells me to wait to get blood drawn. I return to the waiting area.

For another 45 minutes I wait. My reading material is no longer enough to calm me down, I am beyond pissed. I see the same women I was waiting with before, we are all passing our afternoons away in a dirty bug-infested waiting room. One of them gets called to see her doctor mid-conversation “I’m sure I’ll be back” she says by way of farewell. My patience is wearing thin.

Eighth contact, I am called back. My sleeve is already rolled up, let’s get this over with. But no, it is not yet time for me to get blood drawn. 45 minutes after seeing my doctor, I am now to meet with the Discharge Nurse. She is there to physically hand me the prescription my doctor wrote for me and to schedule my next appointment. “You mean a year from now?” I ask. “Is that what I’ve been waiting for?” I am very conscious of the fact that this is not her fault but I cannot contain the rage building within me. This is complete and utter bullshit. She asks me when I would like my next appointment to be and I tell her she can put down whatever she wants because I won’t be coming back. Ever.

Ninth contact, I go to the lab. In 90 seconds I am in and out, blood drawn. The piercing of the needle has the strange effect of calming my nerves and my nurse Alexis is patient, gentle and sweet. She asks how I’m doing today and I tell her “honestly I’m pissed. I’ve been waiting for 3 hours.” Alexis tells me she hears that all day.

On the elevator ride down, my blood is pumping wildly, my hands are balled up in fists. I throw my green “appointment card” away on my way out the door- never going to need that again. The sight of a parking ticket on my windshield (expired meter) almost sends me back into the doctor’s office for an aneurism. I saw 9 different people over 3 hours for a total of 10 minutes of “health care.” After the inefficiency, incompetence and filth I encountered today, I will never come back. For me, this is a one-time waste of an afternoon. But for the other women there, those who will have to return time and time again over the course of a single pregnancy, this is an absolute outrage. I am horrified on their behalf. Even those lucky few who have maternity benefits through their work can’t afford to take a half-day off every time they need to see the doctor. No employer would stand for it, nor should they. Is it even possible to be pregnant and keep a job in a system like this? And what should the women do with the children they’re not supposed to bring with them to the doctor during the hours they waste in this vacuum of functionality?

Most of my time in Detroit, I maintain the naive outlook that the city just has a rough reputation and really isn’t that bad. Today I got another perspective on how this city operates and it was beyond ugly. If this is representative of medical care in this city, it is not alright. At a restaurant if you have bad service, you can complain to the manager, or you can decide never to come back again. But for many of these women, there is no other option. They fucking deserve better.

On the positive side, I can’t recall ever having a better lesson in abstinence.

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