For most of the past twelve years I haven’t had any health insurance. A few times when I was working in the Middle East the contract did come with a medical plan, but I never really took advantage of it, outside of a bridge and crown I had done in Saudi Arabia in 2018, which both broke two years later, during COVID. Now my smile looks like a broken plate.
At the end of 2019, I applied for Medi-Cal online, and received notification that I’d been approved. I didn’t receive my card or provider package, but was eventually able to straighten those out and choose a physician. I’d been to the Alta-Med clinic on Beach Boulevard a number of times, since they work on a sliding scale if you’re unemployed, and chose them as my insurance network, since I’d be riding a bike and knew where to find them. I told them any doctor was fine, and they assigned me a certain Doctor Wu.
The DMV had sent me a packet with about ten pages of medical forms that needed to be completed, with sections that I needed to fill out, and sections that a doctor needed to fill out. Every time I looked at that bulky envelope it filled me with anger and despair. When I called Alta-Med to make an appointment, I first needed to listen to a ten-minute message about testing for COVID, and then got put on hold for an additional twenty minutes. They couldn’t see me for ten days, but that was fine. My court hearing was still almost two months away.
About two days before my appointment, I suddenly had a terrible flare-up of gout. That caught me by surprise. In the past ten years I’ve suffered through a number of crippling episodes, but hadn’t had a drink in three weeks now, and had always assumed the attacks were alcohol-related. In the old days, they referred to gout, an extremely painful and aggressive form of arthritis, which often targets the big toe, as the King’s Disease. They called it this because they believed it resulted from the diet you might find on a King’s banquet table, lots of red meat, seafood, and alcohol, like wine and mead.
I’d been diagnosed with gout during my first contract in Saudi Arabia, when I was making my own wine in a pressure cooker. Apple juice, sugar, and yeast. That was it. You were supposed to wait a month. After five days, I’d crack it open and drink the entire vat of that bubbling, yeasty ambrosia in one afternoon.
Then one day, after a weekend spent in my neighbor’s pool, playing volleyball, I’d awoken to a big toe so painfully swollen I assumed I’d stubbed it on the pool bottom and broken, it. I refused treatment and was limping up the school stairs with a stick, when some of my students laid hold of me and dragged me off to the hospital.
Gout is the worst name in the world for what it really is, uric acid that calcifies into crystals, and then gets between the joints and grinds like broken glass. I’ve had it in my toes, in my arches, in my Achilles heel, in my knees, and in my elbows, and have gone so far as to moan and shout in agony when a flare-up is starting to peak. Some guys I’ve worked with have been on disability for gout, because they were bedridden for weeks, unable to apply any pressure at all to the afflicted limb.
Anyone who knows anything about gout always think the same thing when they hear you’ve been diagnosed with it, and that is, how much do you drink, anyway? Even if it isn’t always the case, there’s a perception that alcoholics get gout. And now my right foot was being ravaged by it, two days before asking a doctor I’d never met before to help me get my license back, a license that had been lost due to a seizure caused by drinking. I resolved not to bring it up, if I could help it.
The day of my appointment, I could barely get my shoe over my foot, or take a step without wincing. I had all the paperwork in a little backpack and my Medi-Cal card and suspended driver’s license in my pocket. Every time my right foot touched the pedal, it seemed to inflate like a little hot air balloon. It must’ve been ninety degrees that day.
By the time I reached the clinic I was soaked in sweat and burning up. I needed to have my temperature taken before entering the building and was surprised that it was normal. Like a yogi treading on hot coals, I managed to rise above the pain and walk towards the reception without a limp. Then I walked up a flight of stairs and sat in the waiting room, everything below my right knee throbbing like an inferno.
A nurse called me back to weigh me and take my pulse. I’d lost twenty pounds since I’d last been on a scale and my blood pressure was so high it almost qualified as a medical emergency. I admitted that I’d been under a bit of stress lately. I had my story ready for the doctor, how my evacuation from Vietnam had led to anxiety attacks, how the anxiety had led me to drink way more than normal, how the drinking had probably had something to do with the seizure, but it probably had more to do with the fact that I hadn’t slept in six weeks. I wanted to ask about medication for anxiety, and hopefully be cleared when I started taking that.
Instead, the doctor only shook his head when he saw the DMV papers I had in my lap, claiming that he couldn’t clear me to drive, that I’d have to see a neurologist, and that he couldn’t make the referral because my Medi-Cal card didn’t clarify that Alta-Med was my network, even though that’s who I’d requested.
Doctor Wu looked to be a Chinese teenager. He said it was a bummer that I’d lost my license and it sucks that the DMV do that. If I got my insurance cleared up, he could make the referral. In the meantime, there was nothing he could do. He prescribed medication for high blood pressure and anxiety, and seemed in a hurry to get out the door. I didn’t even mention the gout. It too, was a bummer that sucked.