Thursday, February 23, 2012

The Doctor Will See You on Gallifrey Now: My Dream of Universal Health Coverage

It might have been something I ate, but my wife is pretty sure my dream came from using the DVR to watch "House" back-to-back with several episodes of a certain long-running, sci-fi show from BBC America.

"From the way you were mumbling," she said when I woke up, "it sounded like you were dreaming about a TARDIS."

"As a matter of fact, there was a TARDIS in it. And he still called himself 'the Doctor,' but it was because of his knowledge of internal medicine, not the outer reaches of the universe. At least that's what I thought at first."

"Tell me about it."

And so I tried, peering through the mists of sleep and relaxing the hand that only a moment ago had seemed to be clutching my insurance card…

"What's happened is that a rupture in the time-space continuum has opened up between the frontal lobes of your brain, which will lead to a complete metabolic shutdown if we don't find a way to close the portal."

A door in my head? Is that what he was telling me my problem was -- this animated, bow-tie-wearing medical professional who had only just met me, bursting into his own office as if expecting to catch me fiddling with a knob located just above my left eye? OK, I was feeling a little dizzy, probably because I kept having the odd sensation that the examining table where I was sitting was moving. But impressive as it was, his split-second "brain portal" diagnosis would have been more convincing if I hadn't been coming to see him about a nagging cough.

"And by the way that doesn’t sound too good either," he said after my chest had heaved in several noisy convulsions.

But I was too stunned by all his mad-scientist palaver to say anything more than, "Do you really take my health insurance?"

"Universal coverage," he said, waving a medical chart at me.

"I don't think I have that one. My health insurance is very particular about what doctors it will pay for and which ones are out of network."

"No, no, I'm not talking about some faceless bureaucracy but the universe itself, which insures each and every one of us down to the last particle of our being. The key is not to interrupt the flow of Omega corpuscles. Now let's have a look-see at your chart!"

While he glanced at it, I nervously scouted the walls for a diploma of some kind. "Omega corpuscles" was the sort of answer I used to put on biology tests I hadn't studied for. The most I could come up with, though, was a certificate from the Gallifreyan Institute of Cosmic Studies, which sounded like a place for doctors who couldn’t get into real medical schools. Still, even one of those could manage to prescribe a simple antibiotic.

"Immunizations up to date – no history of plague –Aha! Now that's very curious. Would you mind stepping into my vehicle? It's parked just outside." In a sudden burst of impatience he'd flung the chart aside.

"But you haven't even listened to my lungs."

"On the contrary, I can hear them quite well from here."

"But your stethoscope –"

I had been semi-reassured to see one hanging on the wall near some of the other equipment you'd expect to find in a normal doctor's office: thermometer, blood pressure machine, and a large, revolving eye. But I was bothered by a few things, too, like his talk of listening to my lungs from afar and the way the blood pressure cuff seemed to be expanding and contracting on its own.

"Extra-sensory auditory calibration," he explained. "Every time you come here, the sound of your lungs leaves an impression in the fabric of space. So there's already an echo from your last visit –"

"Except this is my first one." Did he even bother with medical records at all? Next time I needed a physician I was going to hold out for a real referral.

"But what a puzzle this is turning out to be! If those weren't your lung impressions I just heard, I wonder whose chart it was I tossed on the floor. Must have you confused with someone from the other planet Earth. Unless –" he seemed to be struck by some medical insight, "No, but it couldn't be – but that would mean – no, no, they couldn't be back. They were banished several millennia ago by the High Council."

"To tell you the truth, doctor —" After some more hacking I recovered enough to continue. "I haven't decided if I'm coming back. Could you please stop with all the obscure medical jargon and say something in plain English?"

"Then in plain English: if you don't do exactly what I say, you only have 72 more seconds to live." I hadn't thought my cough was quite that serious, but he sounded pretty sure of his new diagnosis. And if he was right, there was no time for a second opinion. "Listen!" I thought this was for more lung sounds, but he went on to explain. "They're inter-galactic cyber-case-managers sent by the insurance company to drown us in unnecessary paperwork. And I do mean quite literally 'drown.' So I'm afraid we've got to hurry."

Inter-galactic cyber what? But feeling the examining table start rocking beneath me again, I decided to put off questions for now. And I soon saw who, if not exactly what, he meant. From one end of the hallway outside his office, a group of figures was advancing upon us in ominous lockstep. I would have thought they were nurses if it weren't for all the tentacles writhing up from under their starched uniforms.

At the opposite end was – of all things – a blue phone booth that looked as out of date as my doctor's bow tie. It hadn't been there when I arrived so I figured he must have brought it with him to spruce up the d├ęcor.

With the tentacles writhing closer, I was soon barreling down the hall like a runaway IV machine, trying to follow not just my doctor but also any signs I could find to the nearest "Emergency Exit."

"In here!" he shouted.

In where? There were no signs, just the blue box.

"But Doctor!" I cried out as a tentacle nearly lassoed my ankle. "I have my cell with me."

"There's no need to clone just yet. In here, I said!"

Maybe the plan was for us to make a 911 call to the creators of "The X-Files."

But the phone booth turned out to be his vehicle, parked in what I could only assume was his reserved "Doctors Only" space. Even cooler, though, was that the interior of his vehicle was fitted out with all sorts of advanced gadgetry and seemed to offer its own simple yet elegant solution to the problem of overcrowded hospital facilities: they just needed to be much bigger on the inside than they were on the outside. In fact, this one was so roomy inside and its walls were covered with so many buttons, levers, and blinking lights that all I could say was, "No way my insurance is going to pay for this!"

"Not to worry. So long as we've left the case managers in the inter-galactic dust, we can just bill it to the universe. Now which part of it do you want to see first?"

"How about a pharmacy?" I suggested while my lungs gave vent to more loud, unhealthy impressions. But he seemed to have picked up some kind of distress signal because we were off in another direction altogether.

"I'm not sure they had pharmacies in ancient Babylon, but we'll certainly look," he promised as he began adjusting the controls to set our course. "Now hang on tight because it's going to be a bumpy ride."

Universal health coverage, I sighed. It might be seriously flawed after all.