I was always a pretty healthy kid; usual childhood diseases like measles, mumps, chicken pox etc. but never any serious illness. My parents led me to believe that doctors were right up there with God and Stan Musial: all knowing and performing near miracles. If Doctor Wilson told you to take two aspirin, you took two aspirin – not one or three. Some even came to the house to consult. Neither did I suffer any broken bones nor significant rupture, not even rapture. The side benefit was minimal interaction with doctors.

But, inevitably they become part of one’s life. Luckily, I saved most of my medical moments for old age, when I assumed I’d have the time to analyze, scrutinize, compartmentalize and mull over each as they occurred.  I’m also inclined to self-medicate. A single malt Scotch or Vodka can cure many maladies.

There was a time, not too long ago,  when I sought out the youngest physician in town believing he would have the latest skinny on whatever malady was in vogue since he was recently in medical school where they teach all that shit. I don’t believe that anymore.

Now I go to the older guys because they are more understanding of my problems, having experienced many themselves. (One of my favorites is my 280 lb. cardiologist who tells me I should lose weight.)

But it’s important to choose carefully; I don’t want the guy who’s been treating  me for years dying before me, leaving me to fend for myself. I now ask all doctors more about their problems than they ask of me.

It works. We all like to talk about ourselves. Right? The result has been a coterie of doctor friends with whom I can talk about anything. I’ve even exchanged vacation houses with two of them.

But I digress.

I recently suffered an enlarged prostate and spent nearly two years with a guy name Rick who assured me the best approach was to wait, watch and take pills to reduce size of the little pisser. “Prostate cancers are slow growers,” he assured me.  In the course of watching and waiting I had to submit to an exam every six months for one test or another. Fortunately all were negative but the prostate kept growing as did my friendship with Rick. I learned about his son who was an addict and his wife who was badgering him to retire. His outlet was golf.  The downside of all this was prescriptions for at least eight medications, over time, all guaranteed to shrink the prostate. (Flomax, Cardura, Uroxatral, Rapaflo, Avodart) to name a few. Not so fast!  None of them worked.

During those 24 months of office visits I noticed an increasing number of guys in suits carrying briefcases lounging in his office waiting room. One day I asked Rick about them.

“Oh, they’re drug salesmen,” he said.

Now my hackles began to rise. “Are they paying you to push these f***ing pills,” I asked.

“No, but they throw lunches for the staff, pay my airfare to conferences, etc.”

I asked naively. “Is that legal?”

His response was staggering:

“Let me explain by describing my day. I get to the hospital at 5:30 – 6:00 a.m. to begin rounds from the prior day’s admissions. I’m in surgery at 7:00 a.m. through noon, when I begin the second round. From 12:30 p.m. until 6:00 p.m. I have office hours. I leave at 6:00 to return to the hospital to check on today’s surgery patients. I get home at 9:30 p.m. to finish and sign the paperwork that was started by the office staff. A mountain of paper is required by the government for Medicare reimbursement. And. . . I get paid an average of $65/patient visit.  Nearly all urology patients are Medicare or Medicaid patients. Very few children suffer prostate problems. By the end of day, I’m exhausted. I simply have no time for research or further study. That’s where those guys in the lobby come in.  They bring me the latest news and advances in the field.

I was stunned. “Sorry I asked. My prostate feels better already. ”

“Good, because I’m planning to retire at the end of the year. I’m burned out,” he said.

“But what about me? Who will I see when you’re gone?”

“No problem,” he said. “There is no cancer to worry about so we’ll do a Trans Urethral Resection Procedure (TURP) and enlarge the passage through the urethra eliminating the painful blockage and that need to pee frequently.  We call it the Roto Rooter procedure. You’ll pee like a race horse within the week.”

And he was right. But I’ll always wonder if it was Rick’s hand on the scalpel that day or; was it that of the guy in the suit who winked at me on the way into my last office visit for a final check up.
You are welcome.

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