"YOU FELL IN THE WRONG STATE"

Without giving our exact ages away, let me say that -- thanks be to God -- my wife and I have been around for a while, and have seen a lot. We have been privileged enough to have seen, close up, the finest traits in human nature, and, I'm afraid, have been sobered by witnessing traits that are, shall we say, not so fine.

In 2011, we drove down to the D.C. area -- for years our favorite holiday destination -- to visit some museums. The hotel we chose was in Maryland. On the evening of our second day, my wife tripped over some uneven bricks in the Hotel's courtyard, and fell hard, face forward, onto the brick surface. 

She extended her arms to break the fall, but the shock of her landing traveled up her arms and broke both shoulders. 

Tbe staff at the hospital -- a satellite of Johns Hopkins -- could not have been more caring or more efficient. The orthopedist on call was likewise professional and caring. "The most important thing." he said, is to call your orthopedist and have him see you -- at once, with no delay. You understand, right?"

Of course we understood.

We had come by car, with two close friends as passengers. If they hadn't volunteered to cut short their vacation and drive home with us, the trip would have been even more difficult than it turned out to be. We got home too late to phone the orthopedist's practice, but we called early next morning, and were told the my wife could not be seen for two weeks. I begged them to reconsider, but they were adamant -- no doctor would be available. Now this was the dominant orthopedic practice in our area, with more than a score of excellent physicians, one of whom had actually treated my wife recently. "But this is an emergency," I pleaded,"what if the bones set wrong?" They were sorry; there was  nothing they could do.

I was beside myself. We called our family physician, who is as scrupulous as she is smart. She phoned the orthopedic practice and went to bat for us. Result: We had an appointment the next day, in Poughkeepsie, where the physician, after an x-ray, pronounced Carol's bones well aligned. Then, indicating the sling she was wearing, said, "that sling looks terribly heavy and uncomfortable; shall I get you another, lighter one?" 

It was true that the sling, which had been issued us by the Maryland hospital, was solid and well built. "Do you recommend we change it, Doctor?" I  asked.

"I think she may be more comfortable in the new one," he said. And he brought out a very light rayon sling, which looked as if it couldn't have cost more than a few dollars to produce. The consultation had lasted 30 minutes.

That day, our family physician told us to have my wife sleep in a recliner chair. From personal experience she had learned that a recliner chair was the only way to get to sleep despite the pain. Trouble was, we didn't have one. So right after the visit. we went to the local furniture store and found a nice, modest sized one. I asked if they would deliver it, but they said  not for 3 or 4 days at the very soonest. It was going to snow tomorrow, and the store policy was to make no deliveries while it was snowing, or if it was in any way slippery. I begged them to make an exception, indicating her sling and rehearsing the whole sad tale. But they said store policy was store policy, and that was that, adding that the store was going to close in 15 minutes.

"Oh my God," I said out loud, "what are we going to do?"

At this moment I heard from behind me the words, "will you allow me to help you sir?" uttered in a deep, bass voice. I whirled around, and then looked up: The man who had spoken was enormous -- at least six-foot three, and built like a fullback. "I have a pick-up truck outside," he continued in his basso profundo," and if you'll allow me, I can put it in the truck and follow you home."

I just stared at this giant, thoughts of caution warring with thoughts of caring for my wife. I must have stared for a long time, because I finally heard from her, "just say yes." 

So I said yes, paid for the recliner, whereupon the giant picked up the recliner as easily as if it were  a Teddy Bear, put it in his pick-up truck (it was starting to snow already),  followed us home, and easily ported it up the stairs to the top floor of the raised ranch we were living in at the time. I took my wallet and offered to pay him, but he refused: "It would be wrong to take money for doing a kindness," he said. 

"Surely you must know someone who could use the money," I insisted.

He said his father was Minister of a church in Newburgh. He might know who could use the money.

So I pressed the money into his hand and said, "Do me a favor: Give this to your father, and say that we trust him to spend it well."

"I will, sir," said the giant, "but before I go, will you allow me to pray over you?" And before I could reply, he placed an enormous hand on me, and the other on my wife. "Dear Lord," he intoned, "bless this woman with swift healing, and may she and her husband know joy for years and years."  And then he was gone.

After a few days, when I had established a routine, I phoned the orthopedic practice to ask why they had initially refused to see my wife for a couple of weeks. "Oh," I was told, "we'll connect you to the Ombudsman." I was connected to the Ombudsman, and heard that worthy explain to me that while they had reciprocal agreements with many states, they did not have one with Maryland.  

"What does that mean?" 

"You see sir, the largest share of insurance reimbursements goes to the doctor who treated you initially, and any other practice gets short shrift.  A reciprocal agreement would have ironed out such problems, but we have none with Maryland. You fell in the wrong state."

I was incredulous. "You mean you would risk my wife's health because of something like that?!"

"I see I didn't explain it well enough, sir," said the Ombudsman.

"You could have sung it to Mozart, "I said, trying to control myself, "but it still would have stunk to high heaven!"

When, a few months later Medicare sent us the statement, we found they had been charged some $400 for the Poughkeepsie visit, the operation code specifying "surgery." Immediately we phoned the office, telling them that we feared that there had been some mistake. No knife had come anywhere near my wife's flesh, let alone cut into her. All that had happened was the taking an x-ray and the issuing of a very light sling.

"Oh, don't worry, sir," said the respondent at the other end of the line, "this is the code we always use in these cases."

When, in time, we considered all the expenses incurred by my wife's injury, we determined that the lion's share of reimbursement was not enjoyed by the Maryland doctor, but by the Kingston practice -- despite the lack of a reciprocal agreement.

A side note: My wife attended Radcliffe, which imparted to her "a Harvard education for women."  By the time of her 50th reunion, Harvard had subsumed Radcliffe, and the alums in her class were given the privilege of attending the commencement. As each school was declared graduated, that school's students threw their caps into the air -- except for the graduating class of the Business School. What they threw into the air was not caps, but money -- lots of it, My wife was shocked  But in retrospect, she asked herself why was she so shocked?  This was why those students had gone after the Harvard MBA in the first place  -- to make money, and lots of it. For them, the bottom line was the bottom line, and a person's worth was quantifiable.

But not everyone is like that, not even all Business School graduates, I keep telling myself. There are people for whom things unseen can sometimes be more important than what is material. That does not make us losers, nor does it make us suckers. Carol's friends were not losers. Her family doctor wasn't a loser. The giant wasn't a loser. They were human, because they sensed something more important than money. Those who don't agree want to define us. determine us, rule us.

We mustn't let them.

Dio

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