THE TRUTH ABOUT OLD MEN - Chapter 11

CHAPTER ELEVEN

When we are young, the more frugal among us look forward to the savings we’ll enjoy as seniors in such places as the theater box office and the line waiting to buy condoms at the drug store. Too late we learn any such considerations are offset by the additional money we will spend on medication. So here are some things about doctors and the way in which they practice the modern day version of bone sawing that can save us all money -- things only an old man can know, but which are too often only learned after a small fortune is squandered on needless pharmaceuticals.

The regimen of a physician is best understood when looked at through the filter of a garage mechanic. It’s no coincidence that the guy who works on your car refers to the chassis as a “body." And it is a small stretch to think of the hospital as a “body shop”... for the mechanic and the doctor approach their work in very much the same way.

In the old days (a term seniors must learn to avoid, except when in dialog with other seniors) a mechanic scratched his chin while he listened to a customer explain the problem that brought him down to the garage.

“Uh huh,” the mechanic says, gaze riveted to the ground, deep in thought, his mind analyzing the possibilities. “Crank her up,” he says, wiping his greasy palms on a greasier rag. He cups an ear, leans toward the bonnet and his eyebrows knit with interest. “See whatchoo mean.”

Next comes an educated guess about the reason for the difficulty. He will not expect you to pay for any work he does based on an incorrect guess. His profit depends upon “right” guesses, and this is what separates him from inferior mechanics, who usually live next door to you or are related by blood.

Since you’re in a fixing mood and your car will now get you there, you visit the doctor to deal with the annoying pain in your scrotum. In the old days, a visit to your doctor closely resembled a trip to the mechanic’s garage. You explain the pain in your pecker. “Crank her up,” he says. He pokes about your torso for a bit, the metal flange on his stethoscope almost as cold as your wife’s touch, and then makes an educated guess about the difficulty. If his diagnosis is incorrect and you suffer the loss of a testicle needlessly, he will not expect you to pay for this. “Oops, my bad.” In the case of an old man, he might add, “Well, you weren’t using it anyway.”

In the old days this is how things were done. The practice of medicine is quite different in these bright shiny new days, but the parallels between the mechanic’s approach at the body shop for cars and doctor’s approach at the body shop for folks remains in force and, though it may be lost to kids, it’s plain as plum punch to the old man.

No need to explain the problem you’re having with your car now. It’s not even necessary that something be wrong with it when you arrive at the garage. The cost for the diagnostic will be the same whether something’s wrong or not. And just because the inept 12-year olds who siphoned gasoline from your tank last night left a section of garden hose hanging from your gas tank does not mean the mechanic will notice a connection between it and your complaints about a sudden, unexplainable decrease in gas mileage. This is because the mechanic was not listening when you explained the problem. The diagnostic will be relied upon no matter what a trained ear or an opened eye might suggest.

When results of the $60 operation are produced, it’s plain your carburetor is not properly carbureting. You buy a new one and go home believing in the marvels of modern tinkerage. The kids next door are happy to see they will not need a new section of garden hose tonight. The one they used the previous evening is still dangling from your gas tank, and it will find utility on tonight’s visit to your car.

You’re back at the garage tomorrow with the same complaint, the hose section still haplessly flapping in the wind, but left there this time by design so that the kids next door can use it tonight.

Somewhere during the days you spend at the garage dealing with your mileage problem and AFTER you have replaced every malfunctioning device from the cigarette lighter to the CD player, the kids next door move their garden hose section to a car belonging to another old man down the street, and your gas mileage is magically improved. No one will ever know which of the operations performed by the mechanic was responsible for improving performance, but you will certainly receive a bill for each and be expected to pay for all.

You have, probably, already noticed the ways in which the modern doctor’s approach to your body conscripts the handbook used by the modern mechanic. Of course, you will pay for all the needless medicine and procedures used to cure your irritated scrotum and no one will ever know flannel underwear was responsible for the rash. All you will ever know is that the removal of one testicle brought about new considerations in the selection of under shorts and the problem miraculously disappeared somewhere during the process.

Working with the elderly is a challenging enigma for a 12-year old doctor. Like the secrets lawyers learn in law school, he acquired certain information during his education at medical school, which guides him. What he will never tell you is that he does not know a solitary doctor in the history of humanity who ever saved a single life. Every one of the patients eventually died. This tells him there is no such thing as a “cure” for anything. And THAT wisdom is the fulcrum upon which his approach to medicine is balanced. The challenge for him is to arrive at a drug cocktail precisely tailored to the pain you are having that considers the unique character of your particular body and whatever he has been taught by the pharmaceutical salespeople who visit him weekly. This will involve the keeping of charts on which the results of tests are recorded over a long period of time which reflect the impact of the drugs he prescribes. Once your under wear no longer contains flannel and the mysterious irritation in your scrotum vanishes, you will remain on the last cocktail prescribed for the balance of your days. You will, of course, die anyway and be buried in a pauper‘s grave, because your life savings were spent on medication designed to save your life.

If this information does not assist young people in the acquisition of useful wisdom only an old man possesses, a more pragmatic solution can be drawn into use. Simply estimate the cost at doctor’s per-hour charge for the time your physician spends in conference with sales representatives of pharmaceutical companies. If you are not good at estimating, just look at the bill from your doctor BEFORE the insurance company ponies up and you will see the results of that cost, because in the end YOU will pay for it. Add that to the cost of the time he spends attending drug seminars. And then consider the recent e-mail circulating among seniors from Ms. Sharon L. Davis, budget analyst for the U.S. Department of Commerce, concerning the difference between the cost of the active ingredients in many popular drugs and the price you pay at the counter for those drugs. For your dining and dancing pleasure, here are just a very few on the list I recognize.

CELEBREX - Cost of 100 tablets: $130.27. Cost of active ingredients: 60-cents.

CLARATIN - Cost of 100 tablets: $215.17. Cost of active ingredients: 71-cents.

PROZAC - Cost of 100 tablets: $247.47. Cost of active ingredients: 11-cents.

XANAX - Cost of 100 tablets: $136.79. Cost of active ingredients: 2.4-cents.

And, finally, consider how long it would take an ordinary grocery clerk to notice and track the difference in the numbers on the charts which mark the results of various drug cocktails, adjust the dosage to bring about a result within tolerance and pronounce you healed once your underwear is changed. Then think of how much money you might have saved by taking 6-weeks out of your life at an early age to attend a medical seminar designed for people who will, some day, be old so that you, too, can know everything relevant to the treatment given by the 12-year old doctor you are visiting and then, die just as decisively as you would no matter who administered the treatment.