Dreamrail

Number Five - Managed Health Care

PPO, HMO, Managed Health Care…..who’s doing the managing? Doctors? Hospitals? No. Lawyers? Maybe. Insurance adjusters? It would appear so. Two days stay normal for a given procedure, so get them out. My doctor isn’t on the plan, so what do I do? Change doctors to meet insurance requirement. It’s happening every day. Here’s what I fear:

Obviously, the following is a dramatization. Any resemblance to the truth is merely fictional and probably a few years premature.

The elevator doors slowly opened and Elana entered the long hallway. This section of the hospital maintained a quiet that appeared to be marred only by shoes on the glistening waxed tile floor. Nurse’s shoes, those of rubber sole, composed an ensemble to orchestrate music that became the last to ever be heard by those dying at the far end of this very same hall. Elana followed the young nurse with blonde hair and baritone feet. She could see three more women staggered down the hall ahead of them, each with their own sound, their unique tone, and strangely unified cadence. She followed in silence, so not to interrupt the music that may be heard by someone beyond one of these doors for the final time.

At the last room on the left, before the double doors that lead away from this ward, she stopped and pushed the door only part way open. Room four hundred held her father, held he whom she had waited for, he who now passed precious time. She stood hesitant, for what seemed hours and continued to listen to the death march being orchestrated endlessly on the glazed tiles behind her. She tried to see what conditions lay ahead through the nearly open door. She braced herself, as always, slowly pushed on the heavy wooden door until it retreated into the room, and finally, she entered.

Standing next to her father’s bed, looking at the monitor that he supervised, Elana found the familiar face that belonged to Alan Pendergrass, the lead prognosticator, the decision maker, the man with a plan. He turned to her as she walked into the room, adjusted the sleeves of his oversized black suit, opened his tight, gaunt mouth and finally said, “Hello.”

The word ‘hello’ sounded like it had been bellowed from a canyon to Elana who had heard no one speak in several hours. It shattered her frame of mind, and destroyed the attempted artistry being displayed by otherwise oblivious musicians with their shoes and the buffed floor in the nearby hall. It beaconed to Elana a message, a hint, almost a requirement that she must in turn, speak.

“How is he doing?” She asked the question that she has asked a hundred times before, and avoided looking to the monitor by which she could ascertain her own answer.

“He has come down to his final ten,” Mr. Pendergrass answered while looking at his own shoes, leather shoes, expensive shoes. He looked up again, studying the monitor once more, the glow of the display giving his face a pale green tint that Elana had seen before and as always, raised goose bumps along her arms.

“They will go fast then?” She asks of his remaining lot.

“I’m afraid so. We will need to collect the monitor right away. Please pardon that I stay with you at his side.”

“Is there nothing I can do?” Elana asks.

“We have searched his records very thoroughly miss. I’m very sorry, but there nothing any of us can do. He has run out. You knew he would eventually.”

“Yes, but the doctors said that given enough time, he could heal, he would heal.”

“Time. If only time could be dealt out like water. I’m sorry. He just ran out.”

“Yes. I said I understand, but I don’t have to like it.”

“No. I mean, he really just ran out. The meter shows zero.”

Elana looked first to the monitor, then to her father’s face, and finally understood what had happened.

“My God. Where is the doctor,” Elana asked. “We have to get a doctor.” Her calm voice had turned to a scream.

“The doctor has nothing to do with this,” replied Pendergrass. “Your father’s insurance ran out, his money ran out. You know that.”

He then began to disconnect the monitor, remove his company’s connectors, and unplug the meter.

“The Longchamp Health Insurance Agency has other customers to assist.” he offered Alana an explanation. “My services will be needed immediately down this very same hall.”

“But this isn’t right.” Elana fell into the chair, her hands to her face, not sure where to turn.

Mr. Pendergrass, having completed his disconnect saw Elana’s anguish, and informed her, “I have the final say in the matters on this floor. The doctors would just drag these things out. They would offer procedure after procedure to sell their wares.”

“Yes, but what if they did some good?”

“Who would pay?” Alan Pendergrass left the room pushing his meter stand holding the equipment that had monitored Elana’s father since his accident.

Elana sat in the blue plastic chair at the foot of her father’s bed. Her legs were clamped tightly together, and her feet were planted on the shining surface of the floor below to keep her from falling over. She could still hear the squeaky wheel on Mr. Pendergrass's monitor stand as it obliterated the harmony of the hall. She could no longer hear her father’s faint breath, no longer see any movement of the sheets atop his torso, no longer sense his presence in the room. He was gone.

**Portions of the above work of fiction were previously published in Nth Degree Magazine.

# posted by Mike Ripley @ 11:17 PM