 |
Pelicans are cool, but they are so
numerous her in La Paz, that they
come to seem like sea gulls; we
shoo them off every chance we
get. See the giant white stain in
corner of our dinghy floor? |
And I waved back, just to emphasize how happy I am, and
how great this is.
I wrote that, just weeks ago. I was relishing the joy
of doing laundry on the foredeck, basking in the warm air of paradise as I
stomped on clothes in a bucket of cool soapy water.
The joy was short-lived.
A few days ago I was at it again, stomping, stomping. But
then I reached into the bucket to pull a piece of clothing from the bottom
and…I don’t know. It happened quickly, my pinky finger on my left hand caught
something and I felt a small tweak or snap. When I pulled my hand up, it hurt a
bit, but worse, my little finger just felt odd, a combined numbness and
stretched feeling.
And it looked odd too. The very tip hung limp. I could
easily lift it with my other hand, rotating that tiny joint so that my finger
was straight, but as soon as I let go that tip would just fall down again.
I played with it a bit and decided I must have ripped a tendon off the top of
the little bone at the tip of my finger.
I went below to consult Dr. Google and right away it was
clear that my diagnosis was spot-on: I had ripped the tendon off the top of the
little bone at the tip of my finger. The injury is called mallet finger.
Treatment rarely involves surgery, a splint for eight weeks is the indicated
approach. I made a splint. That was the end of it.
Until it made me think about my healthcare
decision-making process as an out-of-country cruiser. First, though we do carry international health insurance, our deductible is $10K per person; we are
self-insured for the small stuff like mallet finger. Seeing a doctor for this
injury would be easy and cheap, not even an appointment would be
necessary. If indicated, an x-ray would be more of a hassle, probably a
referral and more walking and waiting, but I wouldn't expect the total cost to
exceed $40US.
So those were my options for care. I decided
not to seek care. I think my decision is primarily due to the fact that
the information I found online seems to align perfectly with my
injury, the treatment approach seems universal, and I don't feel like taking
the time to visit a clinic and then an x-ray lab.
But I want to contrast this with the approach I may have
taken in our old life, complete with a steady income and employer-based
health insurance coverage. Let's put me at home with this injury, it happens
during a Saturday of yard work. Ice would have been so easy to get out of the
freezer that I would have likely done that first. Then, without a thought to
inquiring online, I'd have driven myself to nearby urgent care. I'd flash my
insurance card, fill out forms, see a doctor or P.A., get in the queue for an
x-ray, watch a nurse put a $25 splint on my finger, and then get sent
home--with a prescription for pain medication I probably would not have filled.
All totally appropriate, and with a more certain
diagnosis and a smaller risk that a rare complication went undiscovered.
Old life or new, the out-of-pocket expenses would be about the same.
In our current, very-low-income life, every dollar
spent moves us closer to the end of our travels, so maybe my decision
making in this case is just a matter of $40US looming larger than it otherwise
would. (Yet I know that if one of the girls suffered the same injury, I
wouldn't think twice before bringing them in.) But whatever the
reason, and whether it's foolish or prideful, I appreciate the self-sufficient
approach, I embrace it.
Back in my Washington, DC professional life, I remember
several times over a decade, returning to work after missing a day because a cold
or flu had knocked me out. Invariably, throughout that first day back, one or
two coworkers would ask if I'd been to the doctor. "No, of course
not," I'd reply, "it's just a cold--maybe the flu--just had
to wait for the fever to break."
"I had that last week, my doctor gave me an
antibiotic that just knocked it out."
The whole over-proscribed-antibiotics issue aside, I
couldn't understand the knee-jerk response to seek medical care for something
minor. The last thing I want when feeling sick in bed is to leave the bed to
visit a doctor's office. But I think that mentality is pervasive in a system in
which there is an almost complete disconnect between health care seekers and
the market that sets prices for that care.
But I digress. The worst part about my injury isn't
the care, it's typing. I’m a writer, I type constantly. And my
self-splinted left pinky finger can no longer manage its important job on the
<SHIFT> key and the letter <a.> (It's in charge of
the <q> too, but I’m not a big user of the letter <q.>)
Fortunately, I’m not a quitter. I will quietly suck it up and learn to type
quickly with my temporary disability. Damn, that was three q’s.
--MR
 |
Here are Eleanor and Frances with the 256-foot yacht Venus.
It's owned by Laurene Powell, wife of the late Steve Jobs.
Jobs commissioned this boat, but it wasn't finished until
almost a year after he died. It cost $250 million. The
quality of the photo is terrible because I didn't have my
camera with me when we saw this, only a second-generation
iPhone from 2008, kind of appropriate actually. |
 |
This is Frances in her berth with Stella, a dog we sat for a couple
days while the owner was in Cabo. She is a nice dog, a former
La Paz stray they picked up a couple months back. But she must
have been beaten by some guy with a 35mm camera in her street
dog life because we couldn't get her to look at the camera
for anything. |
