Healthcare

I’m Really Glad Earl Lost His Job

A big healthcare change came too late for me

This is the story of my battle with someone named Earl, the guy who decided to deny me a biopsy.

I was enraged by Earl’s decision. I’d just had one biopsy, which didn’t get what was needed, and was scheduled for another when I learned the insurance had nixed it.

“Who, exactly, made this decision?” I asked my insurance company.

It was someone named Earl. Seriously, it was.

I asked for Earl’s phone number.

I was determined to talk to Earl.

Who the hell was Earl to decide? He isn’t a doctor and I’m pretty sure he’s never seen my breast. Why should he have this power over me and my health?

I made a mental list of things to say to Earl:

• So, Earl: Let’s talk about why you think I don’t need this biopsy. Do you assume I enjoyed my first one so much that I wanted another just for fun?
• Let me describe to you, Earl, the process of my first biopsy. Let me explain how very not-fun it was. I will describe it in such a way that you will never again touch a breast without thinking of my biopsy. I will ruin heterosexual sex for you forever, Earl.
• Next, Earl, I’d like to emphasize how sore and bruised my poor breast was, and how the thought of having this breast fucked with again less than a week later when it was still tender scared the shit out of me but had to be done.
• Earl, are you familiar with how it feels when you don’t know if you’re actually fine or if you might have a terrifying and potentially disfiguring and fatal disease? Would you like me to describe it? Because I would really like to describe this to you.

Spoiler: I didn’t manage to talk to Earl at all.

While I was trying to track him down, the HR people kindly navigated around Earl for me. I got my biopsy as scheduled. It was even more not-fun than the first one.

But I was glad to have it.

Long story short, the second biopsy showed I needed a lumpectomy, and I got one in short order. The lumpectomy was also a not-fun procedure, but I was glad to have it. I’m healing, and while I’ll always have to be on guard for future lumps, I expect my doctor to tell me I’m OK for now. I am extremely grateful.

Here’s the thing: When you are dealing with a situation like this, you are scared and vulnerable. You are not in the mood to deal with the insurance bureaucracy. You do not really want to do battle with them; you are already doing battle, and you need all your mental energy for other things.

So when I read a front-page story in the Wall Street Journal that my insurance company has decided to roll back much of the rigamarole involved in getting pre-approvals, I cheered for others who won’t have to deal with what I did.

I’m bitter that this common-sense change came too late for me and millions of others.

I spent a whole day stressed and crying and dealing with shit that I shouldn’t have had to deal with at all. I hope a lot fewer people have to deal with this in the future.

Besides the human costs, it’s a stupid waste of money. Physicians’ offices have to employ an army of people to deal with the administrative nightmare that prevents some people from accessing life-saving care.

Does this mean Earl will lose his job?

I really don’t give a shit. Earl was being paid to make people miserable. Let Earl do something useful instead. Maybe he can hold people’s hands when they’re undergoing painful procedures.

Breast lumps are terrifying.

My younger sister and my maternal aunt had breast cancer. My mother had benign lumps removed. I am at high risk, even though I had my children in my 20s and breastfed them full-term — pretty much the only parts of my breast cancer risk level under my control at all.

I can do nothing but be watchful, and my insurance company should not be making it more difficult for me to do so. Can we all agree on that?

The American health insurance system sucks.

It’s amazing that we still have healthcare people willing to work within this exasperating system.

All the actual healthcare professionals involved in my care were wonderful. I am so very grateful to every single one of them. These are people who spent a lot of their youth and a lot of their money studying nursing, medicine, radiology, anesthesia — I’m sure I’m leaving some people out, but they were all fantastic.

None of these jobs are easy. They all require an expensive education. They require a certain mindset. Could you insert a long wire into a breast compressed by a mammography machine? What if the woman is clearly scared and has tears running down her face and you know you’re hurting her? As I sat there, perfectly still, breast squashed into a pancake, I knew this was a job I wouldn’t be able to do.

The wire had to be inserted deep into my breast so my surgeon had an exact path to follow to the lump. The breast was quite bruised, swollen and sore thanks to having been biopsied twice in short succession.

I’m pretty sure the radiologist who pushed that wire into me, commenting it had been more difficult to do than usual because there was a hard shell on the lump he’d had to push into, wasn’t enjoying himself at that moment.

I know I wasn’t enjoying myself.

I know the nurse who gave me her hand to squeeze during the first biopsy didn’t enjoy herself. (She probably lost the use of that hand.) They gave me a spongy object to squeeze for the second biopsy, which was probably a good choice.

None of us were having a good time. We were not there to have fun. We were there because this thing had to be done. And all the insurance people did was make it harder than it had to be.

And yet the insurance industry has apparently assumed patients were having unnecessary tests and operations. Seriously? Believe me, I would not have subjected myself to any of this if I could have avoided it.

Getting rid of most preauthorizations is good.

But it’s not enough.

We know we could have a better healthcare system because almost every other country in the world already does. Ours causes untold human misery.

We can’t do anything about some human misery, but we don’t need to make it worse. Our system makes it worse, and tinkering around the edges of our system will only take us so far. Scrap this shitty system. Adopt universal healthcare.

For more:

I’ll warn you, this one was written under the influence:

About me:

I’m a writer in central Illinois. Find me on Substack, Mastodon, Twitter or LinkedIn.