The Squeaky Wheel

The Fairy Blogmother was feeling rather guilty about all the venting she's been doing about her broken ankle and ensuing medical treatment, especially because there are many people experiencing life-altering hardships these days. But with this mornings' New York Times, Metro section came absolution for me.
An article by Joyce Purnick touted the benefits of the complaint. "Sometimes complaining is a civic duty," she advised. In New York City, citizens complain about pot holes and such, and they get fixed. In New Orleans, citizens didn't complain about housing conditions and the inadequate levee system because they felt that they wouldn't be heard, and they weren't.
So the Fairy Blogmother advises you to stand up for your rights, speak about injustices, and complain until someone to listens to you and does something about your complaints. What was it your grandmother used to say? "The squeaky wheel gets the oil."

Medical Care Concerns 2005

Medical Care in the ‘Burbs in 2005

I don’t have physician phobia or physician aversion and don’t want to partake in an unjustified doctor bashing, but I have real criticism of the orthopedic doctor I’m seeing for my broken ankle, and I like to hear other opinions about my treatment. Maybe I’m over-reacting?

Understand that the Fairy Blogmother lives in a small city, although ‘the powers that be ‘ prefer to call it a town as it gives its occupants a feeling of quaintness and safety. There are about 45,000 citizens in our insular township, one or two good restaurants, a multitude of café type eateries and fast food and chain restaurants, one movie theater, a Curves and two or three other fitness centers, a Wal-Mart, a Home Depot, several grocery stores, a book store, two high and middle schools, nine elementary schools, and even a prestigious private prep school. The Town is said to hold the record for the most liquor stores for its size. (Guinness Book of Records.) We have about 50 doctors listed in the yellow pages. In times of emergency illness, our citizens use the community hospital in the adjacent town, or they travel to one of two bigger cities, each within one half hour’s drive. Consider the scene set. We are essentially the ‘burbs.

At 7:15 AM on a Saturday morning in August I slipped down a small hill near my home and injured my ankle. In thinking about my medical care, I choose the community hospital with a good reputation for care, and the one in which I would most likely receive a speedier response than I might expect in the big city ER. Maybe the injury was a simple sprain, I reasoned while trying to decide in which direction to drive for help that morning. “Less crowded in the E R, easier parking,” my husband said, and thus, the small town mentality took over and we drove 10 minutes north. And no, the hospital was not the problem. I was seen quickly, treated respectfully, x-rayed, fitted with splint and crutches, and on my way out of the sliding ER door before 9 AM. I was given two Rx’s for pain and the name of the orthopedic doctor who was ‘on duty’ at the hospital that morning. with instructions to call him by Monday for an appointment. The doctor was not at the hospital. I saw the PA in the ER. I guess my ankle break was rather ordinary. I considered that a positive thing.

I was given an appointment for the following Wednesday and ordered off the injured foot until I met with the doctor. I obeyed the instructions, and checked the internet to learn how to better navigate stairs while on crutches. At the appointed date and time, I arrived at the orthopedic office on my crutches and waited by the receptionist’s desk while she spoke on the phone for 5 minutes. It seemed like 20. (Not even a nod!) I was surprised and a bit annoyed at the insensitivity, and wondered if this was the normal orthopedic greeting. (Encourage the crippled to fend for themselves; the build character sort of idea?) A little sensitivity training including a day on crutches might work wonders with the staff here. But eventually I was told to go around the corner to a waiting room, and after a brief wait, the PA introduced herself and brought me a wheel chair to make my trip to the treatment room. ( A good sign.) Once seated on the examining table, she looked at my hospital x-rays, and the ones taken there in the office. She began to fit me with a plaster cast. “Will I be seeing the doctor?” I asked. “Not unless you go to the funeral,” she replied curtly. (‘How to talk to patient’ training might be fit into the sensitivity training class as well.) The PA then went into a defensive lecture listing her training and history in the practice. Had I transgressed a boundary? I understood the Orthopedist absence, my admonishment, and made a second appointment for three weeks time. Surely I would see the doctor then, and most likely he would call to discuss my treatment beforehand. After all, this was the orthopedic specialist with the best reputation in our town. Alas, I expected too much - No call. Why even my dentist and the dog’s vet call after a procedure. Perhaps they have more business savvy, are more caring, and are less arrogant.

I arrived ten minutes early for my second appointment three weeks later. (It is difficult to estimate the amount of time one needs to crutch or wheel in and out of buildings My husband, not a patient waiter, accompanied me, and we both knew we were in for quite a wait as the patient room was over-flowing with people. “Double booking” is what they call it in airline vernacular. (I fantasized inciting a mutiny with my fellow patients.) I had my own wheeled seat, but my husband was left with the last seat in the place- the child’s stool. He squatted there by the table with the blocks and next to a double bounded woman whose two shoulders had been dislocated in a seizure. (I do make conversation with everyone.) I didn’t have it so bad after all, At least I could hop and feet myself, so I waited my turn patiently as was expected, no doubt.

Carol wheeled me into the treatment room an hour and twenty minutes later. (Maybe triple booking is at work here?) This time another x-ray was taken to determine my progress or lack thereof. “Ah, bone is beginning to heal,” was the Nurse Practioner‘s assessment. I had questions: “When will I see the doctor? Will I be getting a walking cast before my good knee gives out completely due to stress of doing the one-legged stance? Both questions were given short shrift. . Not today was the answer to both of my queries. At that point I was unsure if I was more upset about the doctor’s absence and my demotion from PA to Nurse, or the fact that I would have to hop around on one foot still. “Does the doctor look at these x-rays you’ve taken? I questioned Carol.
“Oh, yes. He’s here, but in with another patient. I have been trained by him and I know exactly what to do,” Carol replied. (That seemed to be the company line.) I think I was speechless. Surely, he’ll pop in and ask if I had any concerns I thought... It’s not only a professional way to do business, but just common sense for him to reassure a new and as yet unseen patient on his billing list. Hey what about the Hippocratic Oath he took?

But I was disappointed once again. Dr. Axtmayer never came into the examining room, or hallway, or waiting room. I wouldn’t know this guy if I bumped into him on his favorite golf course.

Nurse Carol removed one cast, and gave me a removable one. I think she sensed my frustration, or perhaps she knew how seriously I needed to shower without plastic bags. Carol then told me to make an appointment for 4 weeks time. “No weight on the foot at all until we see you,” were her parting words. “What about the $80 blue boot from the last appointment? Can you give it to another patient- one who might not have insurance?” my husband asked. No verbal reply was forthcoming, but the eye rolling said it all: It’s all about the money, dear, I assumed from the non-verbal gesture.

Four more weeks???? I couldn’t believe it. “Here’s a band, wrap it around your other knee from bottom to top as a brace. See you in a month,” Nurse Carol said on her way out of the room.

The busy receptionist gave me an appointment for five weeks time. I tried to insist on a change, but was assured that the doctor would not be in during the time I requested if I changed the date. “So I will see the doctor next time? “ I asked. “Oh, you’ll see the doctor while you’re under his care, but you’re scheduled to see the PA, but she and the doctor often switch between patients. Don’t worry, you won’t be released from the office care for a while,” was her comment. Was this the bait and switch technique? I’m still in shock. I should have asked if I would be billed at a discount rate.

And this, I think, is what is wrong with the American medical system. Patients caught between greedy doctors and controlling insurance companies, and protected by our elected officials who receive hefty donations from both groups. Lawmakers won’t take sides yet they fret and warn patient/consumers of the dangers of socialized medicine. “You’ll have to wait too long for service. You’ll rarely see a doctor,” they warn us. How does that differ from my present experience, I wonder. Is this why people pay a fee over and above insurance payments to guarantee the availability of a certified physician when they need one? Will decent health care soon be limited to the wealthy only? Or will insurers, doctors, drug companies, and legislators all come to their senses as more operations and medical care is out-sourced to foreign countries?

Am I sorry that I didn’t brave the wait at a big city hospital? Yes

Would my care have been better or more professional? Maybe, maybe not.

Have I grown more cynical about medical care? Be assured of that.

Will I bad-mouth this local doctor? You bet I will- loud and long.

Is current medical care all about the money? It sure seems so. The more patients seen, the more money on the bottom line for doctor and insurers.

Do I have questions I’d ask before making an appointment with any doctor in the future? You bet. And the first two would be:

1. Is it your custom to actually examine and meet with your patients at scheduled appointments, or do you use PA’s and Nurse Practioners and excuses?

2. How many children do you have in college?

What do you think?

How goes the battle of the broken ankle?

How goes the battle?

Well, the pillow plumping is finis, over, kaput. Family members can keep up the good works only so long, and anything past three weeks is too long. How unfortunate that after three weeks on crutches to protect a broken ankle, the other leg begins to yell, “What about me, Randy?” “Share that cold pack of peas and corn with me,” screams the right knee to the left ankle. " I need an icing down, too.” And just when the going gets tougher, the toughs slip and slide out of sight. Burnout big time comes for family members. And the funny thing is, the patient becomes lots less patient and irritability comes in like gang busters on the heels of frustration. (Pun intended.) Anger simply bounces around the place from caretaker to patient and back again. In short: it gets ugly.

Thank goodness for great friends. They continue to call, especially those who too, have worn the big blue boot, and rode the four-wheeled chariot with foot pads. The mailman brought a box yesterday which the big brown dog sniffed with great pleasure. Inside were two fruitcake tins filled to the brim with homemade chocolate chip cookies, sent from some 1000 miles away, and simply the answer to a family’s prayer for deliverance from the B A. (Sometimes referred to as ‘Bad Atmosphere,’ ‘ Bummed Attitude,’ or more commonly ‘the Black Ass.’)

The packing of those cookies itself was a thing of beauty. No doubt “Wrapper Bob” had received such a gift in long ago days, and remembered the taste of the morsels eaten from tin to tongue, and thus had carefully packaged these beauties so well that not one among them was broken. The gift could have been gold, frankincense and myrrh, or so it seemed to me. It was the pillow plumping that I had been missing and had been seeking these past few days. And it arrived just in time to quell the household anger in the form of the edible delight. The diet be damned, the cookies were for the soul as well as the body.

The only directions I received with the kind gift from the sender, was a promise to give the big brown dog a cookie now and again, and to share with the caretakers. I do both faithfully, especially sharing a piece of each cookie with the dog who has yet to leave my side in three weeks time. Woman’s best friend she has proved to be. And the caretakers need to come to the sight of the cache to claim their share, and I snare them into a “Will you bring me…?” Brilliant!

So: Be good to the disabled, even those for whom the condition is only temporary. For in the end, they will be as faithful as the big brown dog, and will never forget the kindness. I’m not sure about the leg licks though, that’s not in my repertoire.

Wheelchair Primer

The Fairy Blogmother, having experienced three weeks as a one-footed person, has some suggestions for wheelchair use she'd like to share.

Quite honestly, I was shocked at people's insensitivity towards those who use walkers, wheelchairs or crutches. Even in the orthopedic office, I was amazed to be left leaning on crutches for more than five minutes while the receptionist chatted on and on with a patient or family member.

It is difficult to navigate public places without the use of two good feet. People out there: where is your sensitivity? Your patience?

Fairy Blogmother's Wheelchair Primer:

Rule #1: Don't assume that the rider will know the ins and outs of chair use at first seating. Read through these rules before you or a friend takes to the movable chair for the first time.

Rule #2: Always, always put the brakes on the wheels before doing a dismount or a sit-down. Failure to do thus will most likely lead to the dangerous slide and bounce and possibly further injuries. These brakes can be found near the top of the wheels and are hand manipulated.

Rule #3: Never assume that walkers will give you the right of way or any other such courtesy like going to the front of the line. For some unknown reason, many healthy people seem resentful of those who are in a wheelchair.

Rule #4: Be prepared to be talked down to, and I'm talking both literally and figuratively. When seated in a wheelchair, you sit lower than most standers, even those who are vertically challenged. For some strange reason, taller stance empowers people and brings on an air of arrogance in some cases condescending conversation.

Rule #5: Other people, not "wheel-ees", seem to think that because you are unable to walk, you are unable to hear, talk, and respond to questions. I am amazed at the number of people who will direct their questions not to me but to a walking companion. ( This happened to me in the Motor Vehicle Dept while applying for a handicap sticker: "Does 'she' have a license?")

Rule #6: Give yourself ample time to get into the handicapped accessible rest rooms in public places. It takes a great deal of coordination to navigate the wheel chair through the restroom door, then into the cubicle. Next the wheel-ee must get up on one foot and onto the toilet seat. Plan well ahead so that you have ample time. Rushing can be disastrous.

Rule #7: Don't allow someone who has a history of road rage while driving a car permission to push you while seated in the wheel chair. You might just experience velocity similar to a speeding bullet. Watch your feet and hands when being pushed- keep them away from the wheel spokes and floor- more broken bones you don't need.

Rule #8: Many stores have complementary wheel chairs for disabled customer use. I can assure you that the job of charging the batteries on these motorized chairs is left to the lowest man on the payroll. Although easier than gathering the empty carts from the parking lot, for some reason, the clerks don't like to plug in the chairs. More often than not, the cart will run out of juice just when you reach the far end of the store. That will bring forth an "Oh shit" moment. The store with the best record for charging the chairs, (and I wince when I say it) is: Wal-Mart. The senior greeter at the front door is in charge of this function and he takes his job seriously. Hire more seniors is my new motto.

Rule #9: It is wise to carry a cell phone with you at all times. If you don't have one, a whistle on a string around your neck is just as effective and possibly more so, A sharp blow will bring immediate attention inside and outside your home. It is an excellent tool for leveling the playing field between the wheel-ee and the stand-ee.

Rule # 10: If or when you no longer need to live and travel by the wheel, read through the above 9 suggestions once again, and show some respect and kindness to those you meet in a wheel chair.

From Spot's Point of View

The Fairy Blogmother's broken bone has curtailed more than her daily doings. As a matter of fact, an illness or accident upsets the entire family, even the favorite pooch. So distressed was Lucy at her masters' fall, she felt the need to express her feelings via the Blogmother's brother. They spoke on the phone and through a series of barks and whines, the Optomist translated and sent along the following:

FROM SPOT’S POINT OF VIEW….

- A guest blog entry from “The Optimist” aka the Fairy Blogmother’s brother.

Hello, my name is Lucy, and I’m a large chocolate Labrador retriever. I’m an adult dog with a puppy’s spirit. The Fairy Blogmother is my best friend. We have gone for long walks almost every day since I was born. But she has broken her ankle and I’m helping her out by writing her blog for her. I’ve never done this before, but she tells me it’s not difficult .The way I figure it, a blog is an electronic form of fire hydrant sniffing.

I had thought of using this opportunity as a forum for an anti-human rant, but my better nature thought I’d go for some interspecies understanding. After all, we’re all creatures on this small planet, and if we remove some of our misunderstandings, we’ll all live on a higher plane.

I guess we dogs could work on improving our patience a bit, and you people could spring for a sprinkling of ground chuck on top of our Kibbles, and maybe a little scratch behind our ears, now and then. And another thing: due to our anatomy, we have a disparity in walking speeds. As we have twice as many legs as you have, we are forced to walk an an impossibly slow crawl to keep at an even pace with you while we’re on the leash. And while I’m on the subject of legs, you’d think with only two legs, you could keep them from getting tangled up and falling and breaking bones and such.

I don’t understand the obsession that people have with dog poop. When I’m on a walk and I drop a load, it is quickly picked up in a baggie and put in to a larger plastic bag. What is that about? I’ve talked with other dogs who report the same human behavior and we’re stumped. One dog even suggested that it as a ‘fear factor’ type of ritual. However, I refuse to believe that. It turns my stomach. Well, whatever you do with those plastic bags, enjoy.

Another thing that we canines need clarification on: I’ve noticed lately that the traffic is growing worse every day. It also seems that many of the nice old fields and woods where I used to chase rabbits have sprouted cheesy town houses and other ugly developments. This can only mean that humans are galloping toward over-population. I think you folks should contemplate the words of your great prophet, Bob Barker, and get yourself spayed or neutered.

Well, that’s all I have on my mind now. Please keep a prayer in your heart for the Fairy Blogmother’s quick recovery. I sure do miss our daily walks and chasing the tennis balls in the back yard.
Thanks, Lucy

Katrina-gate

The Blogmother's questions to ponder about the recent debacle in New Orleans, and nearby areas in Mississippi, Louisiana, and Alabama are these:

Should the American people accept an investigative panel to be appointed by the very administration who failed to act in a timely manner to save people and property in the storm called Katrina? (Is it wise to put the fox in charge of the hen house?)

Should we insists that the money that might be used on a panel be put into funds for feeding, clothing, sheltering, and relocating the people displaced by the storm and helping them as they see fit in their time of need ? Should that be done before anyone tries to assess blame?

Should the 'friends of George' be allowed to benefit from the tragedy by being given lucrative no bid contracts to clean up and rebuild the area?

Wouldn't it make more sense to give the local people the contracts? Don't they need the work and money? Don't they know the area better than outsiders?

Are most Americans so gullible or so stupid as to believe that photo ops of our president on the back of a truck touring the flooded regions, and shaking hands with survivors at a shelter are proof of a caring and motivated leader? ( If so, is the Brooklyn Bridge still up for sale?)

We might assume our president learned his empathetic skills at his mother's knees (having heard her statements at the Houston Astrodome last weekend), but where did he learn his administrative skills? Was he hanging out at street corners in Boston or at a used car sales office instead of participating in the classes at Harvard Business School?

When a person continues to make poor decisions over and over and over again, can we assume that he shows poor judgement or perhaps he errs because he is afraid to make a decisions for fear of upsetting his politcal supporters?

Isn't the president supposed to look out for the interest of all of the people in our country, not just those who believe as he does ?

Perhaps the American people should tell him?

SPIN

SPIN
(n) slant or bias; (antonym: honesty and truth)

-Can be used synonymously as the term which describes the substance most often found in cow pastures among the blades of grass- often covering them.

-The ultimate goal of which is to distort the truth and confuse those who are spinned so that the spin-ee appears in a more positive light to others.


Did you ever play “Pin the tail on the donkey” as a child at a birthday party? Do you remember the dizzy feeling after being ‘spinned’ and blindfolded and pushed towards an invisible target? Well, the Fairy Blogmother warns you to be aware of the spin around you. Don’t be gullible and taken in by distortionists. They abound in society. You find them everywhere- people use spin in sports, in schools, at work, at bars, in the media, in government, and especially in political circles.

You can easily identify talk as SPIN when the speaker, or”spin-ee, ”chooses any or all of these techniques:

-The speaker may raise his/her voice in an attempt to emote sincerity, strength or simply to overcome his/her opponent.

-Often this loud speech is accompanied by a smile, or tears to connote actual feeling.

-Sometimes, a sideways cock of the head is used and it seems to signify: “You know what I mean!” (These manipulative techniques and body language signals are employed because the speaker learned that they were effective in third grade, and perceived by parents as “cute.” Why not continue to use them into adulthood?)

-Spin-ees’ answer few direct questions, and in fact ignore the directness of others, and turn away, usually with a grimace that shows irritation.

-Spin-ees’ rarely if ever admit guilt or take responsibility for any errors .

-Spin-ees’ always look for a helpless scape-goat, usually an underling, to place the blame in a crisis or when caught in an error or lie.

-A spin-ee always looks for support from the naïve among the crowd. He gets the support by acting as if the supporter is important and will be rewarded by being allowed to enter the spin-ee’s special clique.

-The spin-ee will insinuate that if you choose not to join with him and his faithful followers, you might be abandoned and certainly unpopular.

-When the spin-ee comes across someone who disagrees with his viewpoint, he/she will attack that person (if not directly, he/she will get someone in the posse to do it for him/her), but will not attack the person’s beliefs or ideas, and certainly never challenge this person to a debate.


If it sounds like ‘spin,” seems like ‘spin,” and smells like “spin,” walk away before you become a gullible supporter and empower a spin-ee who makes a fool out of you as he struts and smirks about in his self- absorbed sense of reality.

Touche'

"One Upmanship" is a term I learned in the 1960's while sitting in a movie theater near the intersection of 18th and Rhode Island Ave in Northeast Washington, D C.

As the youngest and only female child in the family, I often went to the movies with my parents. From their point of view, it was cheaper and more educational to take me with them than to leave me with a sitter; and from mine, it was lots more entertaining. And after all, movies were milder then and I was most a most amiable tag-a-long.

My father was a true fan of the British comedy and loved the actor Terry Thomas. Terry was most discernible by the rather large gap between his front teeth, much like Lauren Hutton, model in the '70's. (There is something refreshing about imperfection, isn't there?)

"School for Scoundrels" was a classic black and white example of the Brit humor of the time. In the movie, the character was trained in the art of making his opponent look foolish, while he assumed a cavalier air. Using a variety of circumstances and games, our man Terry was transformed from a 'wuss' to polished gentleman, while forcing his opponent to be seen as an idiot.

I thought of the movie, Terry Thomas, and the art of 'one upmanship' this morning when I read of Fidel Castro's offer to send 1000 Cuban doctors to the hurricane-battered area of our country. And I did wonder if Fidel had a recent viewing of the movie, or is he simply a benevolent humanitarian? (Is Fidel mellowing?)

Either way, guess who looks like the fool, especially if he defers to his stalwart conservative base of supporters and rejects the offer? (Not only the New Orleans refugees are mired in mud, you know.)

The Fairy Blogmother's advice for Mr. Bush-- Take the high road and the extended helping hand- and do it graciously.

Not to Nag, but....

It's what my two children say I do so well: remind, prompt, prod, rouse, and attempt to motivate. It's also why I have become the Fairy Blogmother. "Spread the wealth, share your insights, bug other people via the internet and a blog," my progeny advised me.

So: Have you sent a donation to those affected by Hurricane Katrina? Lots of ways to do it, and a check always works. In our community, we have several large trucks parked outside grocery stores, and the Salvation Army is collected goods of non-perishable kind to transport to the needy. No money, but some time? Ask if you can volunteer in the area, or in your own perhaps making calls to solicit donations.

And if you happen to be an animal lover with extra money, consider a second donation to the ASPCA in the New Orleans area. Many animals have been displaced and they too are in shock. First the people, but don't forget their pets either.

New Orleans needs your help

The disaster that has befallen the city is horrific. It is difficult both to watch and not to watch the news coverage of so many people in shock and agony. And how sad that our government has been so slow to respond with help. The mayor of New Orleans, Ray Nagin, has said it best in an article I have just read on Yahoo:


"Nagin's interview Thursday night on WWL radio came as President Bush planned to visit Gulf Coast communities battered by Hurricane Katrina, a visit aimed at alleviating criticism that he engineered a too-little, too-late response.

Bush viewed the damage while flying over the region Wednesday en route to Washington after cutting short his Texas vacation by two days.

"They flew down here one time two days after the doggone event was over with TV cameras, AP reporters, all kind of goddamn — excuse my French everybody in America, but I am pissed," Nagin said.

Nagin said he told Bush in a recent conversation that "we had an incredible crisis here and that his flying over in Air Force One does not do it justice ... I have been all around this city and that I am very frustrated because we are not able to marshal resources and we are outmanned in just about every respect."


My hope is that everyone in America will find it in their hearts to give support to the homeless, hungry and suffering people recently affected by Hurricane Katrina.

Give money to your favorite trusted charity. Donate food, clothing, water, or shelter. But as Mr. Nagin implored in a most direct way, talking and observing won't help those in need in New Orleans- action will. So act.

The Fairy Blogmother? Why I plan to send a check directly to Mr. Nagin. He is the godfather of his city.