Revisited: Time for the annual physical

Last week, I underwent that periodic humiliation known as the annual physical. Like the cautious, prudent 50-something guy I am, I trooped off to my doctor’s office with the proper forms filled out in advance, my insurance preauthorization in place, and my stomach growling like an angry beast. “No food on the day of the physical,” I had been warned, but hadn’t been smart enough to think through exactly what that meant for a 2:30 appointment.

What it meant was that I was in one foul mood by the time arrived at Shiland Hills Medical Center (village motto: “just a ‘t’ short of what it’s really like to live there.”) If the purpose of the NPO order had been to test my grumpiness quotient, I was fully prepared to be off the chart. I knew from previous experience it was actually for the blood tests I’d need to undergo following the physical part of the exam, and it didn’t make me any happier when the nurse noted cheerfully “you know, you could’ve done the exam today and the blood tests on a Saturday.” Yes, and you could be doing a better job of living up to the “care” part of healthcare.

I arrived fifteen minutes early in a waiting room filled with elderly folks in wheelchairs and well-dressed young professionals. It wasn’t hard to tell the patients from the cheerleaders-turned-pharmaceutical reps — the reps had a desperately unwell look in advance of what was sure to be yet another no-sale. I signed in at the front desk, then took a seat between the only non-coughing old guy and a Newsweek magazine.

As soon as I got comfortable reading the latest news on hunger in Africa (growl), the receptionist called me forward. I sheepishly passed those who had obviously been waiting longer and more desperately needed to see a doctor and approached the desk.

“Has your insurance coverage changed since your last visit?” she asked.

“Oh yes,” I replied. “It’s much worse now.”

She took my card, made a copy and buzzed me through to the hallowed inner sanctum. A nurse greeted me just inside, asked how I was (still hungry) and escorted me to the scales. I weighed in at a trim two-oh-migod and was then taken to examining room number eleven, my personal favorite because of a particularly well-rendered watercolor landscape therein. She took my temperature, then affixed the blood pressure cuff to my upper arm and puffed away until she heard something important in her stethoscope. She read out some numbers – I think it was like 400 over 12 – but didn’t tell me if this was good, bad or indifferent. I assumed it meant I was alive.

She left me alone on the finely tissued examining table for just a few minutes before the doctor arrived. Dr. Jackson has been my personal physician (gee, that makes me sound important) for as long as I can remember, and has always treated me well. We exchange handshakes, which I wish were our only physical contact, as well as brief small talk before the prodding begins.

The actual mechanics of the exam always seems a little too cursory to me. He pulls out his little keychain penlight and peers into my throat, my eyes, my ears, every head-based orifice except the nostrils of my nose. I’m not real sure what he expects to find in these recesses, but I’d love to surprise him some time with perhaps a coin or an insect. He thumps my chest, listening to my deep breathing with a nicely feigned interest. After a quick caress of my neck to see if I have glands and lymph nodes, it’s time to drop the trousers and pry into the nether fissures (mine, not his). I won’t belabor these details here; suffice it to say we talked sports the entire time.

We occasionally encounter each other at the Y, so he told how he had changed his exercise routine lately, moving his running indoors to a treadmill because of the effect outdoor concrete was having on his knees. He said he was trying to reduce his speed a little and go more for endurance, as he had recently realized the drive and determination that had gotten him through medical school 30 years ago was wearing him out now that he was in his fifties. He was also trying to eat a little better, no more fast foods on the way home from being on-call at the hospital. I noted that I too exercised, and he thought that was nice.

We talked about the drugs I’m currently taking, whether or not I needed to continue them and if I needed any refills. He sat there dutifully writing out prescriptions for cholesterol and insomnia medicine, almost like a waiter taking my order for a chicken finger appetizer (hold the honey mustard sauce; I’m trying to lose a few pounds). I had the feeling that if I mentioned problems I was having with stress and reality, he would’ve gladly scribbled out a script for heroin. I almost regret not having given it a shot.

Finally we were done and he walked me down the hall to the laboratory, where I’d have various sera drawn and examined. With the lack of food for the previous 18 hours starting to affect my judgment, I was momentarily tempted to have fun with the lab workers. I could either squeeze a little extra blood from my still-dripping vein into the urine sample I was providing, or sneak a little pee into my blood vial. Or maybe I’d cross them up entirely and leave a five-dollar bill in the urine collection jar; that’d be funny.

Now it was time for checkout. There were at least a dozen nurses back there (I think of them all as nurses but I’m sure they were really just insurance specialists, collection agents and people in charge of not getting crushed by the rolling vertical files) yet still I had to wait in a short line. The signs warned me to stand back, so I wouldn’t infringe on the privacy of people like the lady in front of me, who unfortunately had something called watermelon stomach, no insurance and a detectable stench. When my turn arrived, I reminded the cashier I had no co-pay, which sounds like a good thing but just means I have to pay later.

At last I was freed from the medical establishment, judged relatively healthy and able to eat. There’s a Burger King conveniently right next door to Shiland Medical, and I must admit I had the chicken fingers.

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One Response to “Revisited: Time for the annual physical”

  1. fakename2 Says:

    I totally cracked up when I came to the “Has your insurance changed?” and your reply. I wish I had thought that quickly. Last week I made an appointment for my annual mammogram (a less-invasive procedure than what your physical involves, depending on how you define “invasive”) and got the insurance question. It has changed. They told me the new insurance is out-of-network. And I said, “Your point is…?”) They said they just wanted me to be prepared. I wanted to ask, For what? Had I been totally honest, I would have said, I understand–that means that the balance I won’t be paying after the insurance pays will be higher than the amount I didn’t pay you last year.

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