Let’s stipulate right at the beginning that I’ve been lucky. Not everyone has access to the medical resources on which I’ve been able to draw. Most relevant here, Scripps College, where I taught for more than 35 years, offers good medical benefits and helps its faculty to continue those benefits into retirement.
My experience may not be everyone’s, but something at least as good ought to be.
Choosing My Medical Benefits
When I first became eligible for medical benefits, I had no idea which option to take. More importantly, I didn’t really want to think about the issue.
As a child, I’d had some form of asthma, but the attacks were never severe enough to put me in the hospital, and anyway I seemed to have outgrown the allergies that provoked them (mostly to dogs and cats). Otherwise, except for the occasional cold, I was pretty healthy.
Plus, I’d always had an irrational fear of doctors. I don’t want to overdo this. Mostly, I respected doctors and medical science. But even a grown-up isn’t a grown-up 24-7. In a marriage, for example, you hope that when your spouse needs you to be a grown-up, you’ll be one, and when you need her to be one, she will.
Anyway, it was my wife, Frances, who was then on the Scripps faculty, that talked me into taking the whole medical thing seriously. At her urging, I enrolled in Kaiser Permanente, which was her provider as well. And, with some more persuading, she convinced me to get a physical exam.
When the results were in, I was diagnosed with high blood pressure and glaucoma, or as I saw it, two blood pressure meds plus eye drops. And I had a primary care physician (PCP) and an ophthalmologist, both of whom would summon me once or twice a year for checkups.
My old phobia awakened. Here’s how I expressed it: “When I was a kid and got sick, I went to the doctor, he prescribed a drug, and I felt better. Now, I feel fine. Then I go to a doctor, he tells me I’m sick, and prescribes some drug with like 100 side effects to make me feel worse.”
Luckily, my grown-up won, helped in no small part by Frances’. Any sensible person would see the advantages of having his own GP and his own ophthalmologist keeping an eye on him. And both of them worked for Kaiser and could send me for tests to Kaiser labs and prescribe meds at Kaiser pharmacies.
Fast forward to this year. I’m retired, but I chose to join Kaiser’s Senior Advantage plan through the Claremont Colleges. A shade over $300 a month (plus $15 co-pays for drugs and $15 co-pays for office visits) keeps Frances and me as Kaiser members. In short, our access to Kaiser’s resources continued.
Discovering and Coping With an Illness
So it’s 2021. Things are gradually opening up. Frances and I got both doses of the Pfizer vaccine through Kaiser with no hassle. One day I got a call from my PCP’s nurse saying that he wanted me to come in for a checkup. (In normal times, he puts a year’s limit on refills for my prescriptions. Then, when I renew, it triggers a call to come see him.)
Mostly I’ve been feeling fine. But there’s this scabby thing on the top of my head. Frances has been after me to have the doctor look at it, but I’ve resisted. My PCP has already diagnosed me with seborrheic keratosis, which he said was pretty common in older people and not dangerous as long as, when I go outdoors, I put on sunblock and wear a hat.
So I just figured the scabby thing was nothing to worry about. (And besides, my phobic self didn’t want to think about where this might lead.) However, since I was seeing the doctor anyway, I promised Frances I would have him look at the scabby thing.
And here’s where the Kaiser network kicked in. The doctor looked at the scabby thing. As I recall, he actually said, “Hmmmmm….” Then he took photos of it and emailed them to Dermatology.
Shortly thereafter, I got a call to see a dermatologist. She looked at the scabby thing and decided to scrape some of it off and have it biopsied. In a few days, she called to say the biopsy had found squamous cells and that I would be contacted by someone from head and neck surgery. A few days later, a surgeon called and asked me to come in and see him.
Coming to Terms with Illness
Soon after this visit, I got a call saying that my surgery to remove the scabby thing had been scheduled for an upcoming Saturday morning. Between that call and the surgery day, I received calls from the head and neck surgeon, a plastic surgeon, and an anaesthesiologist. Each introduced himself, told me his role in the procedure, and answered my questions.
All of this was reassuring; none of it grim. I was in their hands. I had to trust their judgment. And they sounded trustworthy, as well as competent and experienced. However, this was the first time in my life that cancer-related language such as “squamous cell carcinoma” had been applied to me.
I’m 73 years old. I’ve already faced the idea that, when our 17-year-old cat dies, we will never again have the experience of living with a cat from kittenhood to death. And I’m not the only senior I know who checks the obituaries to see how many recently dead people were born later than I was.
Speaking of obituaries: Have you noticed how many of them include a phrase like “died after a long fight with cancer”? There were “fights” and “struggles” and “wars.” And my takeaway is that the final year (or five years or whatever) of their lives was all about fighting off a disease, which always won.
So, while I was coping with illness, mortality had sneaked into the forefront of my thoughts.
And I knew that the proper response was to fight, even though (or maybe because) you were bound to lose. At moments, I could strike that pose.
But, luckily for me, a different story line was available — supported, thank goodness, by the doctors. We had caught this thing in time: surgery and maybe (but only maybe) a bit of radiation would (probably) be all the fighting necessary.
Coping with Illness and Surgery
I could deal with this story line because, as scary as the prospect of surgery on the top of my head might be, I could see beyond it to a more or less normal future (except that hair probably wouldn’t grow on bits of my scalp anymore).
As the day approached and I could no longer think of the surgery as “next week’s problem,” I started calming myself with this thought: “You lie down. They put you to sleep. When you wake up, it’s over and you go home.” That turned out to be mostly true. Except that it wasn’t “over” in quite the sense I was hoping for. The surgeons needed to do a second procedure. So a couple of weeks later, I was back.
Here I should say something about the cost. On my medical plan, my hospital co-pay was $50 if they sent me home that day or $500 if they kept me overnight (which was always presented, in the interests of full disclosure, as a remote possibility).
I thought I’d be going home the same day this second time, too. Imagine my surprise when I woke up in what I assumed was the recovery room but was actually an ICU. And imagine my further surprise when medical people would walk by and say, “You’re OK!!” as though they were astonished.
It turns out that, after they put me in the recovery room, I was unresponsive. My eyes were rolling. The doctors thought I was having a stroke and ordered a long list of tests (which, by the way, added nothing to my charges). I believe they finally decided I’d reacted badly to the anaesthetic.
Everyone I dealt with in the ICU — doctors, nurses, even the guy who emptied the waste — was friendly and helpful and — perhaps best of all — willing to kid around with me. Holding onto my sense of humor has been as important as anything else in getting me through this episode. Frances and our cat, Lulu, know me well enough to know exactly what sort of support I need.
Friends and family are important, too, of course. But at times like this they’re likely to treat me as “poor John” undergoing a devastating experience and in need of sympathy and reassurance. Sometimes they can come awfully close to sounding like that part of me that envisions a years-long battle with cancer, ending inevitably in death.
But if I can keep my sense of humor, I can set the tone. I’m the same old me, except for my annoying trips to Kaiser for radiation treatments.
The Reality of Radiation Treatments
Yes, as I write this piece, I’m still coping with illness and undergoing radiation treatments. All the bits of my skull that the surgeon sent for biopsy came back negative. No more cancer. No more surgeries. However, the radiation doctors met to discuss my case and, after due consideration, decided to play it safe and radiate the place where the scabby thing had been.
I met with a radiation doctor, who went over exactly what this would entail and what the side effects might be (usually fatigue and a sort of burning sensation) and who answered all of Frances’ and my questions.
Naturally, I’d Googled “radiation” and read of many horrors.
I was all ready to refuse and cope with illness alone. But the doctor calmed my fears and spoke sincerely to the most rational part of me, the part that, for instance, looks down on the anti-science people who refuse to be vaccinated. I believe in Science. And now, since Science believed in radiation, I supposed I had to believe in radiation, too.
One odd thing that helped: The radiation doctor said I’d be having five treatments a week for five weeks. If I’d been on a sitcom, you would have seen a close-up of me gulping. But I was all in for Science, so what could I do?
Later that day, he called to say he’d made an error in arithmetic: I’d be having five treatments a week for four weeks. And I thought, “Only four? No sweat.” It has since occurred to me that this could have been a strategy on his part. In any case, it worked, and I was coping with both radiation treatment and illness.
I’m just a bit beyond the halfway point now. Everything’s pretty routine. Though we’re all masked in the waiting room, we sort of recognize one another and smile and say “Good Morning.” The feeling of camaraderie helps us all, I think. Whatever we are outside of Kaiser, inside of Kaiser we’re all patients undergoing versions of the same experience.
The Bottom Line on Coping with Illness
What helps me in particular is getting a little distance from the treatment. Writing this piece, for example, provides that. I’m not just the guy undergoing radiation; I’m also the guy telling the story of the guy undergoing radiation.
Early on, when I started coping with my illness, I started posting updates on Facebook. Nothing gruesome of heartrending; just little anecdotes and observations, with some basic information of what happened that day.
Knowing that I’ll be posting helps me get out of myself and be interested in the people around me and the music playing in the radiation room and what people wear to their treatments.
So I thank you for providing another audience that helps keep Mortality at bay.
Are you confused by your pre and post-retirement healthcare costs? We break down the basics here.