Tuesday, 29 January 2008
Here's to Your National Health
"So, is this the National Health?" I asked the doctor.
"Well this is my little piece of the National Health," she answered.
"It's not what I expected," I said, putting my shoe back on.
"What did you expect?"
"Oh, I don't know. Screaming crowds of children in the waiting room. Cancer patients stacked up outside the door. Misery and anarchy. That sort of thing."
What I'd found instead was no waiting and an unhurried 20 minutes with a Scottish doctor who wasn't wearing a white coat.
For the last couple of weeks I've felt a pain in my right foot whenever I walk. It's like a hot fork plunged into my sole between the big and second toes. (Why a fork and not, say, a dagger? I don't know; it's just more fork-like.) It only hurts when I walk and it hurts most in the morning. I can poke and prod the foot and it's fine, even grab my toes and wrench them back and forth like I'm trying to tear off a hunk of crusty bread. Nothing. But walk on it and ouch!
I felt there might have been two causes: I'd taken up jogging again as part of the British Army Fitness Program printed in the Guardian. Although my knees usually go before my feet, maybe I'd done my foot an injury. Then there were my new shoes: I'd bought a pair of cheap yet fashionable slip-ons, somewhat pointy of toe, and with a sole about one micron thick. Then I spent the day walking around London in them. I basically walked until I couldn't walk anymore. It felt like someone had taken a tire iron to the bottom of my feet.
You think maybe that could have been the problem?
Whatever the cause, I was afraid I'd broken something. Aren't we taught that the human foot is a fragile assemblage of bones, each no thicker than a drinking straw? Might I have snapped one of these? I waded into the National Health.
My college here has a practice that it sends students to. I phoned the doctor's office to explain what was up, went in on Friday to fill out some paperwork and returned for my appointment yesterday. True to form, by this point my foot wasn't hurting nearly so much. It still seared in the morning but by the afternoon it was just a dull ache.
There was one young lady in the waiting room when I arrived but she was in and out in 10 minutes. The doctor called me in and listened as I described my symptoms. I always feel a bit of a fraud in situations such as this. I mean, people are getting their arms hacked off in Africa and my widdle footsie has a boo-boo. But the doctor showed no disgust. She examined my foot, asking if it hurt here or here or here. No, I said sheepishly.
I think in the States the doctor would have ordered an X-ray, a blood test and a full-body CAT scan. Instead, my National Health doctor diagnosed plantar fasciitis, demonstrated some stretches I should do and printed out a leaflet. She was going to prescribe a powerful anti-inflammatory but noted that it might interact with my heart medication and so decided against it. I'd just have to wait it out. If the pain wasn't better in a few weeks I should make another appointment.
And that was it. An altogether pleasant experience and no bill to pay. Of course, I might feel differently if I'd been denied some cutting-edge cancer treatment. (The local paper is full of such stories.) And if it turns out I do have a broken bone and my foot falls off in a week I'll be annoyed. (The doctor assured me there were no bones where it hurts.)
I have very good health insurance in America. It's also very expensive, paid for by my employer and by me. And as much as I'm glad that my children and I are covered, I can't help but feel a little guilty when thinking of all those children and parents who aren't.
The NHS doctor's waiting room was a typical assemblage of months-old magazines and children's books. I did notice one interesting thing on the wall: A review of the Michael Moore film "Sicko." Five stars the Guardian reviewer gave it.