Tuesday, January 8, 2013

Small Talk during Surgery

     I was doing skin surgery on Mrs. Y.'s back, and therefore she was facing away from me.  Nevertheless, we were able to carry on a conversation. 
     We talked about her CPAP machine settings, and how hard it is to lose weight.  I asked if she'd been taking her blood pressure readings at home, and whether she was sleeping well, and if she'd gone to the mammogram and colonscopy appointments we'd set up.  The usual stuff.
     "That reminds me," she interrupted.  "I forgot to tell you about my insurance company."
     "What about it?"
     "They keep calling me.  They called a bunch of times in November, and in December.  So, finally, I called them back."
     "Why would your insurance company call you so insistently?"  I asked.
     "Beats me, but it got pretty annoying."
     "Did you reach them?"
     "I got hold of the lady who'd been making the calls, and it was so...weird."
     "What do you mean?"
     "She asked a lot of questions."
     "Like what?" 
     There were three moles to excise, so we had time for this digression.  The moles were probably benign, but with alabaster skin like Mrs. Y.'s, dark brown moles with asymmetric borders might be skin cancer.  Nobody wants to bank on probably, so I was removing them to send to a pathologist for a microscopic diagnosis
     "She asked me how long I'd been coming to see you, and if you were a good doctor."
     "That's strange," I said, thinking aloud.
     "I told her you were the best doctor I'd ever had."
     "Thank you," I answered.  "You're not just saying that because I have a scalpel in my hand, are you?" 
     "No, no," she laughed.
     "It seems unusual for an insurance rep to ask questions like that," I mused.
     "She also wanted to know if I'd had any tests done that weren't really necessary,"  Mrs. Y. went on.
     "That sounds familiar," I said, directing my gaze to the nursing assistant, who nodded her head.
     "We've heard that story before," the nursing assistant said.  "But it wasn't an insurance rep asking the questions."
     "The woman also asked if you saw me at every visit, and if you spent very much time with me."
     "It's not necessary for me to see you every visit," I said, recollecting the details of the clinic's contract with her particular insurance company.  "You're allowed to be seen by the nurse practitioner."
     "I know that," she answered.  "And I like your nurse practitioner. But that woman wanted to know if a medical person was seeing me, or not.  She wanted to know if you billed for things you didn't do."
     "Wow.  We don't do that."
     "I know," she said.  "I see the insurance statements."
     "What else did she ask?"
     "She wanted to know if I had ever been in the office when nobody else was around."
     "What did she mean?"
     "I don't know.  I told her, well, one time I was the last patient of the day, but there were still lots of nurses and other people here.  They had to check me out!"
     "I don't think that caller was from your insurance company," I told her.
     "Who else could it have been?"
     "The FBI.  Those are questions that FBI agents have been asking patients.  The agents pretend to be from insurance companies.  I guess they're hoping to find something I've done wrong."
     "Yeah," the nursing assistant added, handing me a scissors.  "They're getting desperate."
     "I can't believe it!" Mrs. Y. shouted, and tried to get up.
     "Wait, wait, wait..." I said.  "I need to clip the tails on these stitches."
     "You mean to tell me, that was the same people who raided you?"
     "That's my guess," I said.  "Insurance reps don't call patients and ask such questions."
     "That's disgusting," Mrs. Y. went on.  "I love this doctor's office.  I am so upset you're closing.  I can't believe what they're doing to you.  How dare they call me like that, and pretend to be someone else.  How dare they pester me."
     "I think it's disgusting, too," I said, removing the surgical drapes from her back and studying my handiwork.  The sites would heal well, I surmised--with hardly a scar.  I applied vaseline and gauze dressings, and we were quiet together.
     Mrs. Y. sat up.  Her face was red, and tears were spilling from her eyes. 
     I put arm around her, but couldn't think of anything to say. 
     "I've been to lots of doctors in Gainesville and I haven't found anyone I like so well," she told me. "You've taken such good care of me.  I wish you weren't closing."
     "Thank you, Mrs. Y."
     "I just wish I could talk to that woman again, and give her a piece of my mind!"
     "I know how you feel."
     "I'm telling you...I'm telling you..." she stammered, her fist in the air.
     "Those bastards."

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