Inside the Little Plastic Castle

Yesterday I accompanied MyGuy to his colonoscopy. We entered a small room with a surgical bed, vitals station, the now-ubiquitous bedside computer, and a parking space for me. After he donned the hospital gown, nursing staff connected him to the vitals station, and started a saline drip. They wheeled him off to the procedure while I waited in the cubicle. I distracted myself with some Sherlock fanfic.

Suddenly the door was opening. An unfamiliar nurse was wheeling a complete stranger backwards into the space—I asked should I remove my husband’s clothing if someone else was using the room. She said, “Of course not, he will be putting them back on in a few minutes.” Seeing my puzzled face, she said, “Don’t you recognize him?” I was still stunned—who were these people? She swung the bed around so I could see his eyes. The estranged swirl of jamais vu vanished, and I saw his lovely face, his smile enhanced by recent doses of fentanyl and midazolam.

All went well, and 45 minutes later we were in the taxi back home. I’d read of the vu triplets—presque, déjà, jamais—in Catch-22 when I was a teenager, but this was my first experience of jamais vu.

Very disconcerting—have you experienced this?

In October I was diagnosed with squamous cell carcinoma on my nose. Last week I learned I also had basal cell carcinoma, while I was having it surgically removed. Good news! That’s it — don’t need drugs or chemo.

Back in 2020, I wore 3M Aura N9205+ masks I had on hand. Its interior nose wire is cushioned by gray foam. After a couple days I saw a little spot on my nose when I took the mask off: I assumed my twitchily-sensitive skin was reacting to the foam.

( Details of skin cancer diagnosis )

On 8 July, I got a cortisone shot in my middle finger, in hopes of warding off surgery for yet another trigger finger. The PT handed me an oval-8 splint to wear that would help the synovial sheath swelling to calm down.

In the mail today, I got a notice from my pharmacy benefit manager (PBM) one of four profit-making entities that I buy health care from. This EOB notice comprised six sheets of office paper, mailed flat in a 9"x12" catalog envelope with a custom window. On top was the single-sided cover sheet with my and their addresses (to fit the window) as well as a boxed definition of "explanation of benefits" (EOB).[note 1] Next was another single-sided sheet with that actual explanation (details below). Then there are four more pages printed both sides explaining how to appeal (in type too small for me to read). These six sheets were mailed unfolded in a catalog envelope from Connecticut (although Navitus is headquartered here in Madison). For personal mailings, six sheets folded in an envelope costs $0.74 — sending flat sheets increases the cost 230%. Commercial postage is less but too confusing for me to calculate.

In the end, the EOB informed me that I might need to pay $1.20 for the oval-8 splint — more than it cost to send me the notice.

I know that many, perhaps most EOBs document important (nay, oppressive) amounts of money. Yet and still, this system is borked.

Players in my health care team, or, places to duplicate info and mishandle data:

1. Health plan (we pay $890/month private insurance) https://www.deancare.com [note 2]
2. Clinic — almost all my care and equipment comes from staff who work for https://SSMHealth.com They get paid by 1, 5, and 6
3. Small mental health group, home to the "in-network" APNP who deals with my psych meds. https://madisonpsychiatricassociates.com Paid by 1, 5, and 6
4. Family-owned and -run pharmacy, which gets money from 1, 5, and 6 https://www.ipcrx.com/pharmacy-profiles/2018/neuhauser-pharmacy-madison-wi
5. Navitus the pharmacy benefits manager, https://medicarerx.navitus.com co-owned by SSMHealth and Costco. 1 pays them administrative fees to pay 2, 3, and 4
6. Medicare (US government insurance, $170 monthly deducted from our retirement checks) and the only non-profit. Pays most of the bills for 2, 3, 4, and 5.

Note 1: (I’m not going to attempt to spell out what an EOB is. A handful of places try to explain in plain language: https://www.carepartnersct.com/wellness/how-read-your-explanation-benefits-eob

Note 2: I’m super lucky that MyGuy spent 20 years working for #1; he does a great job analyzing the EOBs, among many other skills.

I adored Ann Patchett's early fiction — The Magician’s Assistant, The Patron Saint of Liars, Bel Canto, and Run. I was fascinated by the parallel experiences of reality gained from Lucy Grealy’s Autobiography of a Face in conversation with Patchett’s meditation on their friendship, Truth & Beauty.

But she fell off my radar. Then this outstanding 20,000 word essay fell into my eyes

These Precious Days in January 2021 Harper’s Magazine

It’s got a big twist, just like she enjoys writing in her novels. It takes its form from the current moment, so there’s lockdowns and air travel and Tom Hanks and more air travel. Along the way Ann encounters Hanks’ assistant Sooki. Ann recognizes that Sooki radiates beauty and competence, and offers her a place to stay during cancer treatment. In return, they develop a true friendship. It’s heartening to learn these magic moments can still lie ahead.

A few quotes: ( 400 words )

https://harpers.org/archive/2021/01/these-precious-days-ann-patchett-psilocybin-tom-hanks-sooki-raphael/

alternative backup

( I'm doing it now and it helps )

• excellent hearing in optimal conditions (cool)


• difficulty "hearing in noise" (yeah, that's why I was there)


• tinnitus (Checking just now at HearingLossHelp druglist (PDF), I'm taking three meds known to cause tinnitus in some people. Huh and


• Hyperacusis