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Injured Then Denied Medical Care by my HMO


     INTRODUCTION

     I have always been a healthy person who has always watched out for myself and I have always tried to be knowledgeable regarding medical science.  I did not study medicine, but I have taken several college courses in anatomy and physiology and I minored in organic + biochemistry.  In addition, I've always been very interested in all aspects of veterinary medicine as it relates to horses.  The few times I could, I attended and assisted  with surgical operations and I'm familiar with equine diagnostic procedures. By no means do I qualify as a veterinary assistant, but I can and have served as such in a minor capacity.


A SHORT SYNOPSIS OF THE INCIDENT 
     Many years ago, before I retired from aerospace, all I had was my company's poor health insurance program.  Earlier in my career, I worked for companies that had great health coverage, but as time went on, the doctors and hospitals started charging more and more and the employers started to feel the pinch as medical costs rose far beyond normal inflation.  Medical care became so expensive that companies began to look to HMO's to try to manage and limit costs.  This was great for the employers and it was more than great for the many HMO's out there, each paying their CEO's millions of dollars in salary, but real medical care got worse and worse for us employees.  All of a sudden we could no longer simply go to a doctor when we were sick, but we had to first get approval from the HMO and had to endure their many restrictions. While taking away real benefits, our employers presented us with a whole plethora of "choices."  The companies dishonestly tried to fool us with "choices" and these choices were so bewilderingly complex that it was impossible to make head or tail of them.  Only if you wanted to pay a huge and an impossibly large premium could you get the kind of medical coverage we used to have as standard.  

     This was the health care (as it was ironically called) in effect by the mid 1990's and it was also at this time, during a Civil War cavalry reenactment, that I was trampled by a wildly bucking horse and was injured.  I'll go into detail later, but for now let me say that this horse really and truly wanted me off of him and kept the bucking going for a long, long time.  Although I stayed on him for quite a long time, eventually my right foot became dislodged from its stirrup, I lost my balance and slid under the horse.  As I lay on the ground, the horse's rear hoof stepped on my right leg just above the ankle.  The immense pressure of being stepped on by the full weight of the horse damaged the tissues of my leg in a way I will describe later.  

     Before I go into all that, I want to interrupt the story and give you some historical background.  This diversion is necessary to explain what led up to everything.  Yes, I know, my diversions are long and boring, but background is important and I want to tell the whole story.  Everything in a person's life is a series of connections, each one interacting with the other and it is those connections, not always apparent at the time, that makes for a complete story.  At the risk of boring you, I'm going to include all these connections and I hope you find them interesting.


LEARNING ABOUT HORSES
and a little diversion from the main story


     It seems that each of us undergoes several metamorphosis as we go through life and with each metamorphosis we take on a different role and become a somewhat different person.  As we grow up and as time passes and as new and interesting things come to our attention, as our tastes change and especially as fate requires new things of us, we take on or are forced to take on all these different roles. We thus become different people while retaining our essential self with our associated memories and personality binding us into a single and sequential being.  I am no exception, I have, throughout my long life, assumed many roles and at many different times I've come to think of myself in many different ways.  Many people call these episodes in their lives "Periods."  This story is about one such period that I shall call "My Historical Immersion Period." I entered this period when several older periods and their associated interests intersected with a new and unexpected opportunity.

     My Historical Immersion began in earnest around 1983 when I discovered that I really liked horses and horseback riding.  It was at this time when I felt that I needed a new and fun thing to spend my time and money on.  It happened this way: my older sister and her family had recently purchased a mini ranch with a horse corral and and saddle room on the property.  They had 10 acres in what was then a very sparely populated and rural canyon in Southern California (Mohler Canyon) located in (what was then) the outskirts of Anaheim Hills, California. In those days, I used to visit my sister and her family quite often, even though it was a 200 mile, 4 hour drive down there.  
In my sister's corral was a fine looking horse (named Chocko) that belonged to a neighbor.  The horse was somewhat neglected and so got little of the exercise that horses crave.  Chocko was confined to its otherwise ample corral for days on end and, as I was to soon find out, desperately wanted a really long and hard, gallop.  

     On one of my first visits to see their new place, my Brother in Law, Fred, asked me if I'd like to take Chocko for a ride and give the horse some exercise.  I ignorantly assumed that Chocko was a slow and lazy barn horse and I'd be able to handle him with ease, so I eagerly said 'Yes I'd love to ride Chocko.'  As I've written before, "fools have more fun" and making assumptions about unknown horses is very foolish.  You might wonder why I was so eager to ride Chocko.  I had this strong, but latent interest in horses and horseback riding that had lain dormant for decades, but now was my big chance.  


MARINE CORPS TEACHES ME RIDING
     This interest began when I was about 13, around 1956.  My dad was a doctor at the little hospital the Marine Corps had on the Camp Pendleton and our quarters were up on a mesa just above the rodeo grounds with the Pendleton horse stables down the road a couple of miles further.  As part of their recreation programs, the Marines had horses and would give us kids riding lessons.  In addition to the lessons, there were guided trailrides that sometimes included a picnic cooked over an open campfire.  All this was during the "Golden Age of The Cowboy and Knights in Shining Armor" Movie Era.  In those movies and on our little black&white TV screens, there was plenty of very exciting and excellent horseback riding.  Back then, all us boys wanted to joust in Medieval Tournaments with lance and sword like Ivanhoe and Robin Hood, or ride across the purple sage and handle a six-gun like the Lone Ranger, Wild Bill Hickok the Cisco Kid and Roy Rogers.  Of course, Davy Crockett was another big hero of ours and he too rode horses.  Sadly, this era is long over and almost no men under 75 today ride horses because it is now almost exclusively a woman's hobby.

     Yes, thanks to the Marine Corps at Camp Pendleton I got an early exposure to horses and riding.  Through them I learned a lot about these wonderful creatures and their fascinating equipment (called 'tack').  At this early stage, my biggest disappointment and something that colored my later decisions regarding riding style was the bulky "Western" type saddle with its horn and long stirrups. I did not like for the stirrups to be so long.  I wanted the riding instructor to shorten my stirrups so I could get my butt off the saddle and coordinate my own motion with the motion of the horse, but the instructors always refused to shorten the stirrups for me.  The instructors thought it was important for me to learn to "sit deep in the saddle" and if the stirrups were short, "I'd be tossed off."  Well, that wasn't true, but that was "The Western Way" of riding and that was what I had to learn.  I also wanted to go fast, like they did in the movies, but they would only allow us to go at a walk and if I attempted to break into a "jog" (a slow trot), I'd get yelled at and told to slow down.  Very frustrating and it poisoned my mind against Western type riding.  (The so-called "Western saddle" is actually a slight variation of the Mexican stock saddle and perhaps it should be called a Mexican saddle)

     I might add that in 1968, when I was stationed on Guam, I rode my motorcycle all around the Island discovering things.  One place I discovered and I visited was a riding stable on the Southern end of the Island where I could go on guided trailrides through the volcanic highlands.  It was fun and scenic, but again the saddles were those "Western (Mexican) saddles" with their long stirrups and with their annoying "saddlehorns" that kept hitting me in the guts.  Again, we were kept to a frustratingly slow walk, so it wasn't as much fun as it could have been.  Those rides were enjoyable, but sailboating and snorkeling in the warm and clear waters of a big nearby coastal lagoon (Cocos Island Recreation area) was what I did most for fun.


 I apologize for the diversion, so now back to the story:

Mr. JOHN'S WILD RIDE

     So, my Brother-in-law got a saddle down from inside the tack room, grabbed a halter and bridle.  Fred called the halter "a bridle" but I corrected him and told him the pieces with the reigns and the bit was the bridle and what he had was the halter.  I astounded myself, how did I know what those things were called and how did I know the names of the saddle parts like the girth, the pommel and the cantle?  For a couple of minutes, I couldn't think why I knew these technical names, but then it occurred to me that I got it from the riding lessons from so many years previously.  Anyway, we got Chocko all saddled up and to my surprise, Fred simply wanted me to "have a good time" and left me to ride the horse all by myself over the miles and miles of trail that existed out there before all the huge housing developments made Mohler Canyon the dense urban jungle it is today.

     We all know what a wild ride Mr. Toad took with his motorcar.  Well, Mr. Toad's Wild Ride had nothing on the wild, wild, wild ride that Chocko took me on.  

Wild Rides are scary, but fun as I'm sure Mr. Toad would agree

     I had never, even on the wildest rollercoaster ride, been on such a ride before this.  One thing the Marines taught me was to never, ever hold on to the saddle horn while riding, but if necessary, grab a big hunk of the horse's mane.  This was the the best riding advice anyone ever gave me because if you hold on to the horn, the saddle will eventually start to slip and when it does, you will pull it over more and more as you more and more lose your balance.  Very quickly you and the saddle will end up under the horse, the horse will go berserk and you will probably be killed.  Grabbing a hunk of mane will keep you centered on the horse and you won't come off even under the wildest gallops.  I have always kept my horses' manes long and grabbing it has saved me from countless falls.  By the way, pulling on a horse's mane is entirely painless and most horses actually enjoy it.  They don't mind a bit if you pull out hairs to "thin the mane" while grooming and a "pulled mane" looks a lot better than if trimmed with a clipper.

     Anyway, Chocko took me on the Grand Tour of Mohler Canyon and ALL of its many long trails and we did it at a full gallop and in record time while I hung on his mane with my right hand and the reigns with my left hand, with my butt in the saddle and my feet in the stirrups.  

CHOCKO GETS ALL LATHERED UP

     When the horse had run off all of its cooped up frustrations and had throughly tired itself out, he finally came down to a walk and by that time we were somewhat less than a mile from the stable.  The horse was absolutely covered in foam from all the sweating he had done.  I knew what an overworked and lathered up horse looked like, but I had never seen one so throughly covered in foamy sweat as Chocko was.  I was concerned that I would receive some severe criticism for "abusing the horse."  Well, lord knows that I hadn't forced the horse to get all sweaty; in fact it was all I could do just to hold on for dear life.  No, he had done it to himself, BUT, to my surprise, Fred seemed unconcerned at the appearance of the horse and I didn't even have to make my prepared excuses or have to confess that I was such a green rider that I couldn't control the horse and keep him from working so hard.  Fred and I simply gave Chocko a quick bath and cleaned him up.  I truly believe that Chocko, after his little run, was as happy as a horse can possibly be as he took a nice roll on the ground and he eagerly went for the feed we tossed out for him.  Mr. John's Wild Ride did us both a world of good and made us both wildly happy.  

     Well, that did it, I was completely sold; my next major change in my life was to be a horseman.  Within a couple of months after returning home, I purchased my first horse (Ibn Shaw) and that started my long career with horses that lasts to this day.
 By the way my first horse, Ibn, was an "Anglo-Arab" which is a cross between a Thoroughbred and an Arabian.  He was small like an Arab and with the Arab's amazing endurance, but looked very much like a Thoroughbred in profile and lord knows, he was fast like a Thoroughbred.  Ibn was one of the fastest horses I've ever owned, big or small.
 


MY METAMORPHOSIS INTO A HORSEMAN
AND THE BEGINNING OF A LIFE OF WONDERFUL ADVENTURES

     After about a year of horse ownership, I was starting to get a bit bored just riding in an arena and around the property where I kept my horse.  I was seriously thinking of selling Ibn, but then I discovered that there was a Fox Hunting Club over in the Santa Ynez Valley and through a series of complex arrangements, I was able to ride with them and join the club.  What a thrill it was to go fox hunting on Winter weekends and ride after hounds across country at breakneck speeds and jump over whatever was in our way.  Other wonderful worlds of adventure opened up to me too.  In those days, the various clubs still put on race meets and we were all young enough to want to race.  In those days, there were still plenty of men who rode, and, in fact, the fast races were the men's races.


MY FIRST STEEPLE CHASE WIN

     I entered Ibn and myself in our first "steeplechase race" (the video is on this website as "Ibn's Race").  When I entered Ibn, me doing so was considered as a kind of a joke and everybody expected the little horse to come in last.  After an exciting four laps around the race track, taking all the jumps perfectly at a full gallop, Ibn beat a much larger racing Thoroughbred by a nose to take first place.  The Thoroughbreds owner was a famous race horse trainer and, let me tell you, he was angry that his big Thoroughbred got beat by my little Ibn.  I had never before and have never since, felt such an elation that I experienced on winning that race against all odds.  By the way, our revered 'Master of Foxhounds,' Brooks Firestone was there at the race and he was so impressed that he awarded me my scarlet coat and colors.  There's more, but that's for another story.  Another august and somewhat mysterious figure, John Boles, was there too, but again, that's another story.

     A couple of years after winning my first steeple chase race I had to retire Ibn.  He was still very fit and healthy, but because I just couldn't hold him back, he kept injuring the suspensory ligaments of his front legs.  I was such a fool, I knew that I had to ride Ibn more slowly and carefully, but it was nearly impossible to hold him back because he was so eager to go fast and jump over everything.  Like the damn fool that I am, I'd get tired of holding him back and just let him go.  Well, after he injuring himself again, I finally decided that I needed to give him to a wonderful woman I knew, a woman who just loved him and would take good care of him.  Some time later I bought a large ex-racehorse from Chris, my veterinary friend.  On a suggestion from a lady at my barn, I named the horse Samson because she said he looked like a Samson, so strong looking.  


MY "SHOTGUN" MARRIAGE TO CHESTER THE WONDER HORSE

     Samson was hot off the race track and more than just a little bit crazy.  He wasn't working out at first (later he worked out brilliantly) and so I decided I needed a second horse. The horse I looked at I really didn't want to buy, but only wanted to try him out.  When I trailered him off his owner's property to try him out, the horse got injured in my trailer.   When I got the horse to where I was taking him, I was horrified to see that he cut his right leg rather badly in my junky old trailer.  Fortunately my veterinary friend, Chris, was right there and sewed him up with many stitches and then tightly encased his whole leg in this huge, brightly colored bandage so the cut wouldn't open again.  The whole thing looked terrible and I was so ashamed that the horse had been injured in my junky old trailer.

     I didn't really want to buy the horse at the time, but because it was my fault the horse was injured, I was desperate to buy him before the owner could see the horse's cut leg.  With the horse hidden away in my trailer, I bargained for the horse.  The guy wanted too much money for the horse, but I was willing to pay anything to salvage my pride.  I was so eager to seal the deal for the horse, my hand shook a little when I handed him the check and I was so incredibly relieved when he took it and the deal with done without having to show him what I'd done to his horse.  With that big bandage on its leg, my friend Rick, who was there when Chris put the bandage on, said that I should call him "Chester" after the limping actor in the TV series "Gun Smoke," Chester Good.  People nearby said it was cruel to tease me that way, but I was rather delighted and the name stuck.  Chester became its name and I can truthfully say that Chester was the best and by far the most intelligent horse I ever owned.  I mean to tell you that Chester was spooky smart.  There is a whole lot more to the story of Chester, but I'll have to leave it for another time because this story is already too long.


MY CAREER AS A UNION CAVALRYMAN

     Back to the story:  After I'd been riding Chester for about a year and had discovered what a wonderful animal he really was, another wonderful opportunity presented itself.  I had the chance to join a rather elite Civil War Re-enacting group branding itself as the 7th Michigan Cavalry.  During the Civil War, the Michigan Cavalry brigade was a famous military unit that was under the command of "The Boy General," George Armstrong Custer. This brigade, which included the 7th Michigan Cavalry, really made a name for Custer because of their outstanding performance in battle.  This opportunity to join the cavalry was ideal, I have always been thrilled by the service that my mother's grandfather and my father's grandfather had performed while fighting for the Union under the American Flag and against the slave-holding Confederacy.  Ever since I was a little kid, I was a passionate Unionist and an anti-slavery proponent.  When I was little, I was thrilled to wear the Cub Scout uniform because it was Union Blue, but not happy about changing to the Boy Scout's khaki brown uniform.  Anyway, I bought all the uniforms worn by the Union cavalry, a 1858 .44 revolver, a Smith Carbine, the McClellan Saddle, an authentic cavalry bit and bridle, an M1860 saber and I had the perfect horse for it, my wonderful Chester.


Trooper John with his War Horse Chester
From a genuine "Tin Type" photograph
taken at a reenactment.


LOSS OF CHESTER
AND MY FAILURE TO REPLACE HIM

     I participated in some really big and impressive Civil War battle reenactments with the 7th Michigan Cavalry, adventures which I don't have the room to tell about right now, but, most importantly, I learned a lot about how it must have been being a soldier and cavalryman during the Civil War.  Chester did magnificently, he was not a bit afraid of the gunfire or even being next to the cannons when they went off and he wasn't afraid to ride hard into the line of "enemy" horses to "battle with our sabers."  Chester was also a wonderful peacemaker.  If two horses were tied side by side and were fighting with each other, I'd put Chester between them and he would keep the peace.  I won't say too much more, but after a wonderful few years of owning Chester, he was stolen and even to this day, decades later, it still breaks my heart when I think about it.  I never learned who took Chester and I never got Chester back.  Now, decades after Chester would have died of old age anyway, I still long to have him back.  Stealing him was the cruelest thing anyone ever did to me.  It is perhaps best that I should never find out who did this because, even today, I fear that my revenge would be terrible.  

     I tried and tried to find a replacement horse that could do all the things that Chester could do, but no horse could come anywhere close to him in talent, temperament and intelligence.  One horse I tried, and I was stupid of me to even try, was a very good looking Thoroughbred that I thought I could train to be a cavalry horse.  To say that I failed is a gross understatement.  There was just no way I could get the horse accustomed to gunfire.  loud noises, like shooting off its back, caused the horse to go berserk and go totally and dangerously out of control.  I really should not have spent so much time and energy trying to do the impossible with that horse.

REENACTING A FAMOUS SCENE FOR DAVY CROCKETT

     At some point after Chester was stolen and gone forever and while I was still trying to get the new horse trained (with no success), I had a wonderful opportunity to reenact one of Davy Crockett's most famous scenes for the very man that had played Davy Crockett when I was a boy.  Yes, I was to be part of a reenactment scene where Davy and his sidekick George Russell were to have a shootout with the big bad Mike Fink (a professional actor hired for the part) and his band of cutthroat "River Rats."  This scene was where Davy shot his flintlock at a target and put two bullets in the same hole to win the shooting contest.  My good friend Rob, who was also a friend of the Parkers and the architect for Fess Parker's new winery, was all duded up in his brother's buckskin "Mountain Man" outfit and armed with his brother's flintlock rifle, Rob was to play Davy Crockett.  I wore my 19th Century Civil War civilian clothes and carried my own flintlock rifle and played the part of George Russell.  A big crowd of spectators was assembled on the lawn at the winery with a huge group of little kids in coonskin caps waiting for us to arrive.  Davy and I came riding in on our horses with our flintlocks across the saddles, dismounted in front of the crowd and proceeded to perform the reenactment.  The whole reenactment went superbly and I was so proud and thrilled to do all these famous scenes with Fess Parker, the "real" Davy Crockett watching.




HOW I CAME TO BE UNDER MY HORSE
AND TRAMPLED

     When the reenactment was over, I was feeling relieved because my crazy horse had behaved himself and we had gotten through the day without incident, but then my own stupidity struck me, as it so often has.  A guy in the crowd came over and begged me to help out at a small Civil War reenactment scheduled for the afternoon at a historical house and grounds in Santa Barbara and to please bring my horse.  Like the fool that I am, I agreed to trailer down there and participate in the reenactment.  The guy at Fess Parker's place made it clear that they needed someone in a Union uniform and with a horse to give authenticity to the scene they were planning.  Somehow I felt it was my duty to represent the Union.

     Before the reenactment was to begin, I took myself and the horse to a secluded area, deep in the sagebrush, to get him used to me firing my revolver off his back.  I cocked the pistol and then I hesitated because I just knew that the horse would go crazy, but I planted myself firmly in the saddle and screwed up all the courage (foolish courage) I had and pulled the trigger.  Yep, the horse exploded and went into a wild bucking routine, but I stayed on for a long time while hoping I could ride it out.  A normally sane horse would have tired, but not this one, he really wanted me off of him and showed no sign of running out of buck. After the last of many of his jumps straight up in the air, I lost my right stirrup and when the horse came down again, I slid off on the right side and right under the horse.  While I was under the horse, it planted one of its rear hoofs on my right leg a couple inches above the ankle joint and then sprang off on its rear legs (much like a gazelle).  The details of what happened immediately afterwards with everybody looking for my lost, loaded revolver is an interesting story all in its own, but I'll only say that I was sick with fear that we wouldn't find the loaded revolver and that someday a kid would find it and blow his hand off while playing with it.  A really smart young woman ignored my instructions and found it where I least expected it to be.  Anyway, the result of all this was an injury to my lower right leg, but I was extremely fortunate because it could have been a lot worse.  A whole lot worse, way, way, way worse and I was aware just how incredibly lucky I had been.



MY CAVALRY UNIFORM SAVED ME

    At the time I was injured, I was wearing thick leather cavalry boots and the boots were stuffed with my thick wool cavalry uniform pants.  These two items distributed the extreme pressure of the horse's hoof so that neither my tibia, fibula or nor my ankle joint was broken.  The point of maximum pressure was in the connective tissue to the rear of my leg bones and a couple of inches above the ankle joint.  I was extremely fortunate that the pressure of the hoof and its iron horseshoe did not split and break open my skin.  To my own amazement, the area where the hoof had damaged my leg was pain free and completely numb but the rest of my leg and foot were fully functional and I had feeling everywhere else.  In other words, I was very shookup and in a mild state of shock, but not lame or even limping and, thank the gods, not in pain.


SUBSEQUENT DEVELOPMENTS

     As mentioned, I will not relate what happened next, but in the following days, my lower right leg above the ankle (where the hoof had mashed the tissues of my lower leg), there developed a dark colored patch of skin a bit smaller than a half dollar coin.  Over the next few days, this patch developed a hard crust, exactly the color and texture of dried beef jerky.  Since I had no pain, I was not lame and I was otherwise feeling fine, I did not seek a medical opinion regarding my injury.  Most people would have wanted to see a doctor at this point, but because of the expected difficulty with my HMO in getting an appointment and the subsequent long delay I'd encounter, I didn't bother.  The fact is, I thought the scab-like lesion was just that, a scab that would heal underneath and eventually fall off without incident.  It turned out that this dark, crusty lesion was much more than just a scab.

     What I didn't know was that the entire volume of tissue under this lesion, that is, all the connective tissue cells, extending from the surface of the beef-jerky like lesion to deep inside my leg, had been necrotized (killed) by the intense pressure of the hoof.  I had a lower leg full of dead (devitalized) tissue, and here's the lucky part: if the skin would have been torn open, the wound would have been open to infection.  If the wound would have become infected, I might very well have developed gas gangrene and may have even lost my lower right leg (or worse).  As it was my skin was intact and that prevented bacteria from entering into and infecting the dead tissues.  


I WAS LUCKY THIS TIME

Clostridium perfringens rods
under a 1000 power brightfield microscope and Gram stained


     A very nasty, but very common bacteria, Clostridium perfringens, loves to infect dead tissue cells, but they couldn't get in and that had the happy result of allowing my immune system's phagocytes free to gobble up and gradually eliminate all of my leg's devitalized cells.  Over several more days my immune system's phagocytes removed the killed cells, but while doing so, they created a large, deep void where the damaged cells once had been.  This void then filled with lymphatic fluid, all nice and infection-free.  The medical term for a fluid filled void such as I had is a SEROMA.  A seroma is exactly what developed on my lower right leg, but I didn't know I had one until later.

     I was satisfied to just let my injury take its course and heal as it might while assuming that the healing powers of my body would do its marvelous work and so it did.  I suspected nothing because there was no sign of infection, no pain, no signs of inflammation and, best of all, I was not lame.  Things went on like this for about two weeks before I noticed that the patch of dead skin was starting to get a mottled look to it, the dark circular area started to get paler looking patches within the darker matrix and the overall feel of the lesion was less rigid and was in fact softening.  It was looking and feeling less and less like a hunk of beef jerky.  I was thinking that perhaps the lesion might be getting ready to shed and when it did, I expected that there would be healthy skin under it.  This is not what was happening.  No.


THE DAM BURSTS

     It was a Sunday morning and I had just gotten out of the shower and toweling off my leg when, on rubbing the lesion, it split open.  The split wasn't just a minor crack, but a really large, thick, deep crack and it was gushing pink lymphatic fluid all over the bathroom floor in a manner that seriously alarmed me.  The gushing continued until there was a puddle on the floor, and was wetting my bath towel.  I finished drying and I looked closely at the crack and could see it was deep and inside the crack there was tissue that was the deep red color of raw meat and indeed, it looked like raw meat.  Accompanying this outflow of fluid was this, hard-to-describe smell; a kind of "animal smell," almost like fresh raw beef, only stronger.  It was a healthy smell, not the smell of infection or decay.  You may believe that all this really had me shook up and I wanted to get to the hospital ASAP to have a doctor look at my gushing wound.  I made a makeshift bandage by wadding up a bunch of toilet paper and stuffing it in my sock, using my sock to hold it in place.  The toilet paper soon filled up and the fluid started filling my shoe.

     The town's one and only hospital is only about a mile from my house, but too far to walk under the circumstances, so I drove to the hospital, parked my car and hurried into the emergency room.
There I was with this big open wound on my right leg and fluid dripping into my shoe, out of my shoe and on to the floor.  I mean, it looked BAD, but it just never occurred to me that I wouldn't be seen immediately.  


THE SISTERS OF MERCY AND THEIR CHRISTIAN COMPASSION

     Well, the Sisters of Mercy, who ran this Catholic hospital, had strict protocols regarding WHEN or even IF somebody would be admitted to receive emergency treatment.  The very first thing was not the welfare of the patient, oh no, oh hell no, it was to check if the injured had insurance.  So there I was, sitting at the desk with my leg gushing fluid into my shoe and spilling on to the floor and there I was making out all these forms.  When I had completed the forms and had handed the woman my insurance card, she then telephoned the HMO and talked with the ignorant HMO villain on the other end.  The woman was having a hard time describing my wound over the phone because she was obviously NOT a trained medical technician, just a front desk clerk.  She handed me the telephone and told me that the HMO villain wanted ME, yes, ME to explain to him the extent of my emergency.  


MY HMO IGNORANTLY DENIES ME COVERAGE
STUPID CATHOLIC HOSPITAL REFUSES ME THE E.R
.

     Over the phone I described the wound and what it was doing, but I got a strong impression that the person I was talking to didn't have the least understanding of what I was telling him.  Perhaps I shouldn't have used any multisyllabic words since he was so stupid.  Finally, when I had completed my description of my open, gushing wound, the villain told me, and I quote: "it doesn't sound that serious and I'm not going to approve you seeing the emergency doctor."  I was stunned, I was absolutely stunned, I was literally dumbfounded and didn't know what to say.  I had barely ever used my company's HMO, and when I really needed it, this cheap bastard didn't want to spend the company's money for me to enter the ER.  That was bad enough, but the stupid Catholic hospital receptionist didn't have the sympathy or intelligence to seek a second opinion from someone who might have known more about injuries and bleeding.  This witch, this throughly incompetent person at the desk then said, and I quote: "without the HMO's approval, I can't admit you and you will have to leave."  


LOOSING MY RELIGION

     I was stunned, I was dumbfounded, I was hurt both physically and emotionally, I felt defeated and alone, I just didn't know what to say.  I drove myself back home and after I had recovered a bit, I started to think a little more clearly.  You know, my late parents had been devout Catholics (although we didn't always feast on 'Feast Days') and I grew up believing in the Catholic Church.  As a child, I was sent to Parochial Schools and I went to mass every week (sometimes daily), but now, feeling rejected by this Catholic hospital, I wanted nothing more to do with that or any other brand of foolish superstitious religion.  This example of "Christian Charity" violently shocked me into the realization that it was all a fake and all those robes and the nun's habits, the priests collars and their "vestments," the rosary beads, crucifixes and threats of hell were just a cruel con and a hoax.  Even the talk of Heaven, a place of infinite, unending boredom, forever and ever praising and groveling before this egomaniacal god, was every bit like being stuck in a church service that never ended, I genuinely dreaded to go there.  All this skepticism was something I had deeply suspected since the 6th grade, but I didn't have the courage to admit it, even to myself, until that moment.*

*(Perhaps the nuns had done too good a job and had taught me too well regarding the social philosophies of Jesus and when I saw their practical application so egregiously misused at this "Christian" hospital, my reaction was strong.  No, I could never make myself believe in the supernatural, even as a child, but I was at least an "Ethnic Christian," trained in the Jesus social philosophy.)


BEING MY OWN SURGEON

     Once home, I knew I was on my own, so I got out my personal copy of a veterinary manual used by professionals for treating sick, injured and wounded horses. I knew that if I was going to be helped, I had to help myself.  I found the chapter relevant to my injury and then proceeded to treat myself as I have seen similar wounds treated on horses. I knew that it is important to remove dead tissue from around a wound (called debriding) so that it doesn't get infected and become a medium for dangerous bacterial growth.  I also knew that it is very important to pack a wound with medicated dressing so that the wound "heals from the inside out" without closing prematurely.  I knew that this wound was much too large to stitch closed and would have to "heal by second intension" and that closing the wound prematurely should not be done anyway.  

     After the "Sunday Disaster," on the following Monday, I called up and got an appointment with my "in network" GP.  Over a week later, I finally got to see the GP.  I was used to dealing with veterinarians who do everything for a sick or hurt animal, stitches, operations, colic treatments, eye injuries, injections, X rays, the works and so I expected this doctor to be able to at least advise me on my wound. When I showed the GP the wound and what I had done for myself, to my surprise and consternation, the guy threw up his hands and in a shocked voice said, and I quote: "I can't treat that, you will have to go to a wound specialist, I'll make you an emergency appointment for tomorrow."  Yeah, now that I was healing, my injury was now "an emergency" yeah, an emergency, not like it was when I spoke to that cursed HMO bastard while my leg's fluid was dripping on the ER's floor.

     Finally, finally, finally, here was someone who recognized that I had a serious injury that needed specialized care, but by this time, I had already operated on myself and my treatment was well advanced.  All I really wanted was for the "wound specialist" to examine my injury and confirm that I had treated myself correctly, BUT if NOT, I wanted him to do whatever was necessary to do it right.  Actually, I was pretty confident that I had done a good job because the wound was already slowly, slowly closing, all without the least sign of infection or inflammation.  Still, I wanted an expert's opinion.  I described all I had done for myself, including (1): debriding the thick dead skin around the opening of the hole (I used a very sharp, sterilized Exacto blade and the tissue, being dead, was removed painlessly) and (2): how I had packed the wound with medicated dressing to prevent premature closure.

     To my great satisfaction, the "wound doctor" said, and I quote: "well, you've done everything I could have done, only don't pack the wound with cloth soaked in Betadine; Betadine is harsh on human tissues, here, pack it with this," upon which he handed me a bottle of medicated wound packing that I have to this day. I was somewhat flattered that the Doc thought I'd done a professional job and that I was competent enough to continue treatment under my own expert care.  However, I was a bit surprised that he didn't want to do any follow up himself, but left all future treatment in my hands.  By the way, the doctor confided in me that, "in the trade," they called the area where my injury was, "The Golden Zone" because healing there is so slow, but the healing is almost always uneventful.  Expensive follow up appointments, that most people demand, are basically just for reassurance.  Fortunately for my HMO's CEO's big salary, I was confident enough in my own expertise that I didn't need (or get) any follow up appointments.

     Such was the state of American Medicine then and it has only gotten worse. Thank the gods for the Internet and all those good medical web sites and thank the gods for my veterinary manual and my ability to understand it.  While I'm at it, thank the gods for the anatomy class I took and the very sharp Exacto blade I knew how to use.


POST SCRIP

          If anybody is wondering what happened to the horse that injured me, after another year of working with that dangerous animal, I suddenly blew up and in a fit of long simmering anger (actually rage), I gave it away (for free) to a genuine horse expert, the legendary David Wendler, saying: "take it now or I will trailer it right over to the vet's and have the animal immediately euthanized."  By god I meant it!  Wendler couldn't believe I'd just give him such a beautiful looking animal for free, but I repeated that he should take horse or I would have it immediately killed.  Later I sent him the horse's papers and a letter signing ownership over to him.  Wendler had his staff work with the horse for an additional year and then sold it at a high price to a rich lawyer (and excellent rider) down in Los Angeles.  For two years or so, the horse worked out well for its new owner, except one day it was running down a hill on a ranch about 30 miles from here and at full speed, more or less out of control (per usual), but at the bottom of the hill there was a bog of quicksand.  The front legs of this fool horse immediately sank in the wet sand and the horse flipped over lengthwise, breaking its neck and mercifully killing itself.  The rider was thrown forward head first and landed some distance away, but was not badly hurt.  Sometimes fate is kind.


CONCLUSION

     In this United States of America of ours, we desperately NEED Single Payer, Medicare For All, REAL FIRST WORLD health care.  We need to get rid of these dozens and dozens of billionaire run HMOs that take tons of our money, but deliver little or no health care in return.  All the money is going into hundreds of bank accounts of this massively duplicated and criminally inefficient system of health care denial and it is high time this immoral system was ended, but because the "health" industry is so economically powerful, so omnipotently powerful and has our political system in its evil and unassailable clutches, I am afraid that it will never happen without some kind of violent revolution.  In this country it can't happen without the ultra, ultra wealthy and powerful CEO's having their heads chopped off a la our own version of "The French Revolution."  I think this is exactly why this Luigi guy is such a folk hero to so many people.



THE END

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