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A Hand in the Health Debate

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Tuesday, March 17, 2009

The last thing the surgeon said to me before they rolled me into the operating room was, "You know, if you and Obama had your way with health care, it wouldn't be me doing this operation. It would just be some guy."

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I tried to tell him -- somewhat disingenuously, and through a haze of painkillers and anxiety -- that I had an open mind on the issue.

All is well. The surgery was on my left hand, and when I woke up in the recovery room it was still attached to my left arm, with all five fingers. More than a week later, it only hurts when I type.

My up-close-and-personal investigation of the American health-care system is something I can joke about now, since the ending is a happy one and the tale has such an air of "Seinfeld" about it. When people ask about my bandaged hand and hear the story, they often advise me to make up something more heroic, or at least más macho. The most common suggestion: "Just say you were in a bar fight."

On Sunday, Feb. 22, I was in my kitchen making a salad. I was scooping the pulp out of an avocado and must not have been paying attention to the task, because I poked myself with the fork I was using -- two tiny puncture wounds on my palm, right at the base of my ring finger. The wound yielded only a couple of drops of blood. No harm, no foul; I washed my hand off, slapped on a Band-Aid and went about my business.

Five days later, I noticed that my hand was a little sore. The following day, a Saturday, my finger was so swollen that I had to take off my wedding ring for the first time in many years. By Sunday morning, my finger hurt like the dickens, and I doubt I'd have been able to get the ring over the swollen knuckle. Monday morning, much worse -- obviously, a pretty bad infection. I called my doctor and he prescribed an antibiotic.

By Wednesday, I was at the doctor's office for an injection of a more powerful antibiotic and a new prescription. By that evening, I was at Georgetown University Hospital with a bloated, misshapen claw where my hand should have been and an IV pumping industrial-strength antibiotics and painkillers into my bloodstream. They kept me in the hospital until Sunday, and the care was so excellent that I didn't mind the doctors' jokes about "killer guacamole."

None of the truly awful things that could have happened actually came to pass. It turned out not to be one of those dangerous new drug-resistant staph infections but rather a garden-variety strain of streptococcus bacteria that doctors know how to kill. It was caught in time, just before the odds of emerging with all my extremities intact would have begun to turn against me. The wisecracking surgeon who operated on me specializes in hand and elbow surgery; I'm grateful that he was doing the slicing and not "some guy" who might not have been as adept or experienced at working around all the nerves and blood vessels that fingers need to function.

Did the experience change my thinking about the health-care debate? Probably.

My misadventure wasn't relevant to one of the central questions, which is whether the most expensive high-tech tests and procedures will somehow have to be rationed if health-care costs are to be brought down. The most exotic test that was done on my hand was an X-ray. The antibiotics I was given are widely used.

What is relevant is that I have good insurance, which I obtain through my employer, and haven't paid a dime out of pocket for my treatment. If I were among the 46 million Americans who are uninsured, I'd be looking at a huge hospital bill. No one should face financial ruin because of a mishap with a fork and an avocado. The way we ration health care now -- according to the individual's ability to pay -- is immoral, and if higher taxes are needed to ensure that no one has to choose between health and bankruptcy, I'll pay. That was my position all along, but now it's personal.

What's changed is that I also feel more strongly about the ability to make my own choices. I decided where I would be treated and, ultimately, what would or wouldn't be done. I'm willing to pay for that, too.


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