Health & Science

Can Health Care Reform Make My Mother's Doctor Less Condescending?

He didn't want to tell me what was wrong with her.

This article is part of Double X's ongoing coverage of health insurance woes. Read Sarah Wildman's story about being denied coverage for her maternity care, and readers' tales of health insurance woes.

Over the years I’ve been remote-controlling my parents’ health care from New York, I have noticed that the doctors in my relatively folksy hometown of Birmingham, Ala., tend to act very grand indeed. Maybe it’s because, unlike some of their big-city counterparts, they don’t have the ego-checking experience of constantly reading about their patients in the New York Times. But the physicians in Alabama seem to be barricaded by more phone menus, honored by more waiting room penance, and committed to more textbook terminology per sentence than any Upper East Side superdoc I’ve encountered. The young cardiologist on my father’s heart-attack team favored us with so little information that I figured med schools must be teaching students to deal with lay people the way child-rearing experts advise parents to respond to their kids’ questions about sex: Volunteer no details not specifically asked for! During my mother’s most recent medical crisis with her long-term medication, her doctor went all Mister Rogers on me. “Do you know what a diuretic does?” he asked, before explaining my mother’s course of treatment.

Coinciding as it has with the Obama administration’s health care offensive, Mama’s latest setback has given me some firsthand insight into the strange and shifting battle lines, in which the opposition seems to consist mostly of the jerking knees of phantom limbs. No one has produced a reason to save the current system. Indeed, amid the town hall guerilla attacks and the “death panel” rumors is scarcely a peep about the usual argument for private medicine: the sanctity of the doctor-patient relationship. Judging from my family’s experience—at a “high end” of medical care, at a “prestigious” hospital, in a region renowned for hospitality—that fundamental aspect of health care is so far from sound that fixing it is going to require more than landmark legislation. Socialized medicine, hell. How about a cultural revolution?

My late stepfather used to joke that if he were to die during a Grand Slam tennis tournament, my mother would never get around to burying him. And so it was that Mama, now 81, ended up in the hospital during the final days of Wimbledon, having refused to turn off the TV and get to a doctor in time for less drastic measures to treat the dangerous build-up of calcium in her blood, or hypercalcemia. Her aforementioned physician was about to take off for a long weekend and handed her over to a “hospitalist,” after reassuring me that she had “already lived past her life expectancy.”

Given that one of her medications had caused similar symptoms on two previous occasions (and that my mother, a Micawberish narrator under the best of circumstances, was by now in a practically hallucinatory state), I felt some urgency about communicating her history to this stranger, the hospitalist. On her third day in, when neither my brothers (on the scene) nor I (still in New York) had spoken with any medical professional, I tracked down her nurse, who suggested that I ask the switchboard to page the doctor. As soon as I answered his phone call, I could feel the frost forming on my end of the receiver.

Allowing that my mother’s calcium levels had been returned to normal by intravenous fluids, this doctor said, “I’m not going to discuss her case.” I assumed that he was invoking medical privacy law (the Health Insurance Portability and Accountability Act of 1996), so I confidently recited the PIN that the hospital gave my brothers and me to show that we had clearance. Then I asked the doctor if he had determined why her calcium levels had risen to such an alarming concentration in the first place. “I can tell you why,” he replied, “but I don’t need to tell you why.”

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