Old western movies never show an old western medical clinic. No long hallway with small rooms across from each other and a waiting room at one end. No nurse in blue scrubs scurrying around looking for a thermometer or pointing at a scale to take your weight. And no gnarly piece of pine to tie your four-legged flatulent mule too. His name is ‘Ruth.’
If true to history, old western movies show a minimalistic approach to healthcare. If you were bedridden, at home, or close to death, then Doc Adams would be summoned for a house call. Grim-faced, gray-haired, and wearing a western bowtie, the good doc would furrow his brow and stroke his chin and then mumble to the gathered family or fellow outlaws the grim news. “Yes, Slim was going to die. Keep him liquored up as much as possible.” They’d tip hats to one another out of somber respect as the doc departed for his next house visit.
I’m watching an old rerun of ‘Gunsmoke’ on a big screen TV in my doctor’s office. I’ve been summoned for a visit scheduled long before Corona landed. The TV is hard to see as my glasses are all fogged up from the face mask I’m wearing.
In this particular episode, Festus, the sheriff’s sidekick, was in bed writhing in pain, having taken a bullet to the leg. Doc Adams goes to his bedside and immediately goes to work. There was no discussion regarding health insurance, no questions of his family’s prior medical history, no looking at patient charts, no taking of X-rays, and no apparent concern about having a virus. The scene ends with Festus sweating profusely and biting down on a rag infused with the era’s best-known pain killer as the doctor attempts to ferret the bullet out by making a small incision. Remarkably, Festus was never referred to a specialist, nor did he ask for a second opinion, and he was back in the saddle for the very next episode. That is good healthcare!
Eventually, a gal in blue scrubs opens the door to the long hallway and announces my name. “Slim?” I follow a safe six feet behind her as she points at the scale. I mumble something about how doctor office scales lie. They always show me about ten pounds heavier than I am. She doesn’t offer a smirk or sympathy- she just jots down what the lying scale displayed.
It’s a late appointment so it is possible that I’m the 63rd patient for ole doc Adams. He goes to reading some notes in a chart after readjusting the height of the stool. He mumbles something about scooting up onto the exam table with my shirt off. For this appointment, I’m to take my pants off too. The doctor needs to access my prostate.
The doc attempts some casual chit-chat but I find that difficult when nearly naked in a six-foot square room with a fully clothed man. He’s got a clear advantage, and I’ve yet to bend over. Momma said I’d have days like this.
Doc Adams attempts to slide on a ‘green’ latex glove silently as if hiding the ominous loading of a hypodermic needle from a child’s eyes. The latex snaps and slaps as it is pulled on tight. Even the squeeze of a tube of lubricant makes a bit of noise. You’ve heard that sound before but where? Maybe that was why the doc was chatting.
Stories have survived from the gulags and concentration camps of prisoners when faced with unbearable pain or forced to humiliate themselves. They would bend their minds to find another dimension. With nearly an out of body experience, these poor souls could then survive nearly any barbarity or indignation. So it was for me, standing naked and bent, my imagination kicked in just in time to rescue me. I found myself in the year 2039 as Mr. Wayne Decker, an 84-year-old superhero.
Technology had come up with another miracle cure for a rare cancer. A ‘bio bomb-let,’ inserted under the skin would send out an army of carefully arranged molecules that would seek out and destroy this rare cancer. By 2039, new healthcare laws allowed only those under a certain age to receive this treatment. I was too old and getting too expensive to repair, having various comorbidities- at least that was what the NDHTLHS (National Do Not Hang-around Too Long Healthcare System) told me. It was in a letter. Dear valued citizen, “No.”
But the world is still a big place in 2039 and anyone who could still travel could engage the services of clandestine clinics to receive the treatment necessary to survive. So I took a cruise to Belize.
While docked for the day, I lay perfectly still held firm by the grip of a robot in a coastal clinic. The robot did much of the surgery, but the actual placing of the bio-bomblet was accomplished remotely by Dr. Arias’ skillful hands. He was located in a dimly lit room wearing khaki shorts and a polo shirt. He had a 1:30 Tee time.
He was also performing surgery on several other patients at the same time. He slides from workstation to workstation performing the same task. At each station was a tactile, ultra-sensitive digitally connected glove that could precisely replicate every movement and pressure of the good doctor’s hands. On the other end was a synthetic ‘hand’ made from polymers and carbon fiber animated by micromotors and carbon fiber wires as tendons. With just a dim hum, the hand replicated the doctor’s every move.
The procedure left me awake as local anesthesia was all that was necessary. With this animated hand now carefully making a small incision into my abdomen, I asked the sole attending nurse why the hand, amazingly lifelike including fingernails and joint creases, was painted ‘green.’ She smirked as she recalled the story behind the ‘green’ doctor’s hand.
“Well, the manufacturer first sent us a robot with the hand painted as if it were a ‘white’ doctor’s hand. Some folks took exception to the idea that the hand must be white as if every doctor is white, which, of course, is not true.”
“We then tried to offer patients a choice. So we ordered just the ‘hand’ modules in white, brown, or black so we could interchange them. This way, we could offer our patients options.” The nurse stops to see if Wayne was still paying attention. He was.
“Offering choices had its challenges,” the nurse continued. “With a choice, patients now insisted on knowing the skin pigment of the actual doctor performing the procedure. So we hung on the surgery room walls pictures of the doctors with each hand to avoid any semblance of misinformation. Unfortunately, that made a mess with the scheduling of our available medical staff as now patient choices were being made on the basis of skin pigment and not availability. Soon the brown pigmented doctor was getting less work than the black pigmented doctor. Our white pigmented doctor was hardly getting any work at all.” The nurse again paused, not certain how far Wayne wanted to go with this story.
“You keep saying ‘pigment,’ nurse. Are you talking about race?” asks Wayne as he watches the ‘green’ hand carefully separate the small opening in his skin and snuggle in a small oval object the size of an aspirin capsule. He felt no pain but seeing a couple drops of blood trickle into his belly button mildly nauseated him. He decided to look away.
“Oh… yes. But Mr. Decker, race is mostly a result of two genetic markers that determine the shade of skin pigment. So I just see the difference in skin pigment. But you’re right. We’re talking about different races. I’m sorry for the confusion,” apologized the nurse. She took a sponge and dabbed up Wayne’s blood.
After a moment, the nurse continued. “Patients would come into the surgery room, go to the wall with just a three-sided surgery gown on and stand at the wall making their decision. Back and forth they’d go looking from one doctor to the other as if looking at a color chart in anticipation of repainting the guest bathroom. "But you know what amazed me the most Mr. Decker?"
"No one asked me about which hand was the most competent."
The story, the way the nurse described it, my own imagination, and with a ‘green’ hand now preparing to suture up my incision, my funny bone decided to move with laughter. Unfortunately, funny bones are connected to all the other bones in my body, and I began to heave with each chuckle coming in rapid succession. I tried to suppress it realizing I was in the midst of surgery. But my attempt at suppressing my laughter was somehow making it worse. Each heave caused my abdomen to move and the ‘green’ hand to pause. After a few heaves, the ‘green’ hand slowly moved away from me leaving a semi-circle suture needle in one flap of my skin and red lights flashing.
Feeling some responsibility but not knowing why the nurse attempted to calm me down. “Wayne, I need you to stop laughing. The robot and the doctor can not sew you back up if your body is moving from laughter. Mr. Decker! Please get control of yourself,” the nurse pleaded.
Just when I thought my laughter under control, I would look at the ‘green’ hand and then at the wall. My imagination saw the pictures as if still hanging on the wall. Patients were choosing between the shades of skin color with their backsides exposed. Uncontrollably, I would burst into even greater convulsive laughter. This went on for minutes. It was like when I was a young boy and old Uncle Pete, listing nearly thirty degrees, had fallen asleep in church. Just as the choir assembled for Christmas carols with the director about to raise the baton, Uncle Pete tooted. He cut wind as if someone had pulled his finger. Loudly. The entire rear half of the church heard it as it echoed off the balcony. And if you had the hearing and sense of humor of a 14-year old, well…
Throughout the entire singing of ‘Silent Night,’ every youngster attempted to contain their laughter. The greater the stern stare from mother, the more they convulsed. Some resorted to sliding down in the pew. A few crawled under the pew, hoping it would muffle laughter already muffled. Some held their nose, actually believing an odor had emanated from the still sleeping Uncle Pete. Seeing Danny hold his nose just sent everyone back into uncontrolled laughter. Mother recalibrated her strategy at laughter control and attempted to ignore the disruption and enjoy the choir. “… all is calm.”
“Mr. Decker, please calm yourself!” demanded the nurse. She quickly snatched a hypodermic needle laying on a tray next to the bed and poked it into Wayne’s arm. It was there just in the event a patient would become agitated.
As Wayne’s world began to grow foggy, I found myself putting back on my clothes and the doctor snapping off the ‘green’ glove while mumbling, “Slim, it’s where I expected and the appropriate size.” With that bit of good news, I wished ole doc Adams, “Merry Christmas.”