July Fourth weekend, out of the blue, my right knee blew up like a balloon and felt like fireworks. My regular doctor was away, so I drove to a walk-in clinic.
“Do you have an appointment?” was the walk-in greeting. “Appointment? The sign says Walk-In.”
“You need an appointment to walk in.” “I can barely walk.”
“This is routine.” “A comedy routine?”
“Do you want an appointment or not?” “Sure. Do I need an appointment to make an appointment?”
Next day, I saw a physician’s assistant from a local hospital who moonlights at the walk-in. He said my right knee was so hot that I must have bursitis with an infection. No history taken, no blood taken, no aspiration of site, no uncertainty of opinion. I walked out of the walk-in with a prescription for heavy-duty antibiotics.
A week later, feeling no better, I consulted Dr. Google and learned that good old-fashioned gout has similar symptoms. Having never had a bout of gout and knowing nothing about gout, I sought out a gout doctor and got gout tests and then got gout medicine and refrained from strenuous exercise for a couple weeks, resulting in, as they say, a significant reduction of swelling and pain.
On the mend, I resumed activities. Walking the dog was fine. Tennis was fine. Life was fine. Until Labor Day. Suddenly, both discomfort and inflammation increased to such a degree that I feared real damage was being done to my poor innocent knee, so I visited a well-known orthopedist who schedules a patient every 15 minutes.
I know the intervals of his schedule because the patient before me checked in as Mr. Two O’Clock, I was Two-Fifteen, and the woman following me was Ms. Two-Thirty. While I waited for my turn, mesmerized by the colorful slow-motion fish in a large tank, Ms. Two-Thirty was ushered into the doctor’s inner sanctum. Puzzled, I approached the front desk.
“We cannot talk about another patient,” said the secretary. “HIPAA rules.” “HIPAA rules?” I echoed. “No one is asking about another patient. I am asking about your special clock that has 2:30 coming before 2:15. I don’t even think Superman an do that, or Superwoman.”
“Would you like to speak to the office manager?” “I would.”
Ten minutes later, I was told, “The office manager is not here today. She’ll be back next week.”
So I quietly continued waiting until led to the X-ray room, where, like a child passing a cemetery, I held my breath as long as I could; neither death nor radiation will be inhaled by this superstitious creature.
“The doctor will see you now.” “Thank you.”
The doctor sees nothing amiss on the fresh X-ray, so he prescribes an M.R.I., which I get at the nearby hospital the next week; a half-hour of unhummable-ersatz-John- Cage-techno-percussive clanking. When I exit the tube, I realize that I had stupidly forgotten to remove the smartphone from my back pocket. Gasps and guffaws accompanied the prediction that no phone could survive magnetic resonance imaging. Alas, the iPhone was fine. Reception was splendid. Photographs were sharper than ever. Not recommending an M.R.I. for anyone’s phone, mind you, but mine seemed to relish the raucous whirligig experience.
Good thing too. I expected a call from the taciturn orthopedist any minute. Even though walking was problematic at this juncture, I patiently waited a week before calling his office, whereupon Ms. HIPPA told me I can’t call in for the results, but have to make another appointment to walk in to see the doctor to hear the results of the M.R.I.
Oy.
When I saw the doctor, this is what he said (I paraphrase): You have some arthritis and a medial meniscus extrusion. Can’t do anything about the arthritis, but you can have a total knee replacement for the meniscus tear or you can have arthroscopic surgery to clean it out or corticosteroid injections or plasma platelet therapy or do nothing at all and learn to live with the pain. Your choice.”
“Which do you recommend, doc?”
“Up to you.” “Up to me? You just presented five choices and I don’t know what any of them entails. Or costs. In time or money or medication or rehabilitation.” “There are pros and cons to all of them and no guarantees for any of them. Up to you.” “Up to me? I don’t even know what a medial meniscus is.”
“It’s cartilage that acts like a shock absorber.” “I could use a shock absorber right about now. Why is my meniscus extruding?”
“Wear and tear, I suppose. Too much tennis. Take up golf.” “Does a medial meniscus ever heal on its own?”
“Maybe. If you were younger, you’d have a better chance.” “I hate golf.”
“Your knee, your call.” “My call? Doc, you must’ve seen a thousand knees like this and I have no experience whatsoever with this or any other knee. What do you recommend?”
“Your knee, your decision.” “Your license, your profession.”
“The sooner you decide, the sooner we can get to work.” “My decision, huh? Well then, hmm, what to do, what to do?”
As usual, when confronted with a decision that might change my life, even a smidge, I just sit down and write about it.
Which is what you just read.
p.s. In the fall, I found a great physical therapist who prescribed a battery of exercises. Within two months, I no longer had any discomfort and never picked up a golf club. Tennis is better than ever. The health care system is something else.