Doc, the hip bone’s connected to the thigh bone
Agood doctor is a wonderful thing, a treasure, so much so that people often insist with vehemence that theirs is “the best doctor”.
We ’ re all proud of our doctors, and their feats of healing and boundless understanding. Many in South Africa, mostly black and poor, have never had the luxury of choosing a doctor. Any doctor. Popular support for national health insurance (NHI) feeds off the sense of injustice at a health set-up that is seen to deprive the majority of that most basic human right: the right to feel well.
But how did we get from there to a proposed scenario in which individuals will not be free to choose, and pay for, their own standard of medical care, under doctors they freely choose and who they can afford?
For me the most important question is my choice of doctor. Don’t offer me a free doctor, whatever you do. Who can trust a doctor who hasn ’ t mastered the dark arts of the invoice? I like my doctors to charge a decent amount yet maintain frugal rooms with the motoring magazines on a wicker table at least a year out of date. Nothing flashy.
I once had a doctor who tested my chest and concluded that I’d die within “24 months” unless I quit smoking. I’d chosen him at random, but also partly because he was named after one of South Africa ’ s first prime ministers. I wrongly assumed he ’ d have the diplomacy and tact to keep such alarming premonitions to his own learned self. But no. And so I was quickly in the market for a new doctor, where I fear an NHI-sanctioned set-up would have insisted I content myself with the “24 months ” prognosis. I’m prepared to pay for better medical news.
Another time I had a phlebitis in my calf, which sounds like one of your cattle just got bitten by a tsetse fly, but is more a vein infection. I sought out a doctor in Yeoville, which was back in the days when doctors in Yeoville were all Wits graduates and came from distinguished medical families, a lot of them.
Many visits later, Dr Aaron asked me how I had first come to know of him. It was with great shame that I explained his surname put him at the very start of the medical section of the old Johannesburg phone book, edition circa 1988. Would the NHI allow me the freedom to apply my tested scientific approach to finding my own doctor? I doubt it.
On his wall Dr Aaron had a photograph of himself with Joel Mervis, a former editor of the Sunday Times, and two other lawn bowlers alongside the bowling green. Although I didn’t know any editors of the Sunday Times back then, I presumed they wouldn’t hang round with idiots, and that my choice of doctor must have been entirely rational and well-founded.
After reading his cards in silence, Dr Aaron would look up over the thin frame of his glasses and say in his gravelly voice, “Still on the pots, boy? ” Irreplaceable bedside manner. Can the NHI give me that, where your doctor’s consulting room feels like a Prohibition-era speakeasy?
My next doctor, a long-time refugee from the old Yeoville, could lay some claim to being “the best doctor ”, with a manner distracted enough to suggest great genius. He had a unique way of conducting consultations, especially because he knew you usually hadn’t more than a seasonal upper respiratory tract infection. I spent one consultation helping him shift a desk so that he could find the missing pages of someone’s vitals report. During another, I helped him look for the electrode pad things that he was going to stick on my chest to test my heart.
On at least one visit to this doctor, he hardly looked up to announce: “There ’ s nothing I can do for you. Go home, rest and take a Dispirin if you want. ” Not a jot of sympathy. Admirable technique, and good doctoring. Instead of someone being paid by the hour, with no real interest in your health, dispensing rubbish, encouraging you to feel sorry for yourself.
Lately, I’ve given up on doctors. If it’s bad I go to a private fly-thru clinic. I did, not so long ago, and the young doctor asked me, “Are you married?’’ I said, um, no, and he said, “You ’ ll live longer because you won’t have a wife forcing you to go to the doctor all the time.”
Recently, I reached the conclusion that I’ll probably live beyond 100. To that end I will more than likely continue to avoid the doctors of my own choice, while still paying for the right to exercise that choice.
If I need a hip replacement, and it is conducted by a surgeon not of my choosing, please consult the files of the Sunday Times once I am under anaesthetic to confirm that it is the right hip that needs replacing. I repeat. Right hip. When you look at me, it’s the one on your left.