Joan Called About Your Past Due Body

Yur body maintenance expires while you manage everyone else's healthcare; the system renames your triage as past due obligations you're failing to coordinate.

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Documentation, not confession.
Patterns preserved, details altered.
If it sounds familiar, it is. That's the point.
Language left intact. Adult themes unavoidable.
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Transcript

SPEAKER_00 0:01

Based on real exhaustion, details changed, privacy protected, patterns preserved. The phone rang at twelve fourteen PM on Wednesday, November 5th. You could see it was the doctor's office. Now you assumed it was the perfunctory confirmation call about your son's prescription refill. The call they don't usually make because, well, typically you find out they've done their job when the pharmacy texts you. So this call seemed a bit unusual. And you had about seven seconds of available brain cells to calculate whether answering it was worth it. So you answered. Her name was Joan. She worked somewhere inside the giant healthcare conglomerate that owns every doctor you've ever seen. One phone number and hundreds of offices. She wanted to coordinate with you on your outstanding healthcare needs. You thought to yourself, what the fuck does that even mean? But instead you replied, I'm sorry, what? She laughed nervously and explained that her records indicate that you were past due for a mammogram, a colonostcopy screening, a pap smear, your annual OBGYN physical, and a skin cancer screening. Oh, and you were also eligible for the shingles vaccine series. You had been for a few years now, apparently. Congratulations on being old enough. And while you're at it, there's a new pneumococcal pneumonia vaccine that they're recommending as well. This, of course, in addition to the annual flu shot that they recommend and whatever current flavor of COVID vaccine was available this week. But you thought about it. Past due, like a library book or like a bill, like something you forgot instead of something that just never fit into your calendar alongside your children's annual checkups or your mother's cardiology follow-ups, your father's diabetes monitoring, and of course the reminders that you send to your husband about his own physical that he'll probably miss anyway. All of that said, if you actually made and kept every annual appointment on time for yourself, your kids, your aging parents, and then at least reminded your husband about his, you would literally have weekly maintenance obligations. Who the hell has time for that? Anyway, back to Joan. It sounded like telemarketing, like Joan's entire job was making outbound calls to drum up appointments, cold calling about your body maintenance. But in the midst of Joan rambling on about your past due body bills, her mentioning the OBGYN triggered you to think about your IUD. The IUD that's supposed to last five years. But how many years had it been? Were you due to get a new one? Were you overdue? Oh my god, what was happening? It was probable at this point, honestly, that you didn't even need birth control at your age and you didn't have periods because of the IUD, so that was nice. But because you didn't have the periods, you didn't know if you then still needed the IUD. But so just to be sure, you asked Joan, when is my IUD up to be replaced anyway? Up to be replaced, like it's an air filter for the furnace. Every five years, she said. Great, when's that? January, she replied. Perfect timing, Joan. I'm so glad you called. No, last January, she sheepishly inserted. Oh my fuck, total astonishment. Last January? Like ten months ago? Oh. So obviously, in all of the visits that she just mentioned, the IUD replacement that you may or may not even need, but you were going to get just to be sure, and the OBGYN visit, which would be the annual, but apparently had far exceeded that annual. Well, whatever, those were your priorities. So you told Joan you need to replace your IUD, and that's the appointment that you want to make. Now I'm bringing this up because Joan said it not once, but twice. The first time she said very calmly, she explained that we weren't just talking about getting a new IUD. We need to have the current one taken out and the new one placed. And then later she circled back around and upgraded the language. This time it was IUD removal and placement of the new device. Very official, very clear. But as if you might have missed the part where there was already one in there, so that had to be taken out. Like the woman with 47 contact lenses layered on her eyeball, just quietly accumulating hardware until somebody finally noticed. Well, you told Joan you wanted to schedule both the annual exam and the IUD removal and placement. So yeah, I guess that's actually like three things. But anyway, Joan then goes on to explain that they can't actually do all of these things at the same time. Insurance protocols, she said. She doesn't extend understand it exactly, but something about mixing up preventative care with reproductive something or other, or I don't know, that's just what she said she was told to say. Ultimately, you think this all sounds pretty ridiculous because it doesn't sound really logical that the insurance company wants to pay for two separate appointments instead of just having everything done all in one visit. Like once you're up in the stirrups, can't we just get this done so we don't have to get into this position twice? Maybe rotate the tires, get an oil change or something while you're up there. I don't know, make it work. But no, that's not an option. Two separate appointments. Now that means two separate times away from work, probably two sets of paperwork. I don't know, whatever. Just do it, Joan. But then she asked, which appointment of those two you'd like to schedule first. Now, let's think about this. The IUD expired 10 months ago. We've just covered that, Joan. Now, you know that your eggs might be an older model and all, but they probably still have a few miles left of them. And who wants to test the odometer, right? So that damn papsmere's just gonna have to wait. You choose the IUD removal and placement as your first appointment. Get that thing taken care of, just to be sure. Joan then asks, what days or times were best for you? That question alone was hilarious. And because it wasn't as though you could say, like every Tuesday you're available no matter what, or every single day between this time and that time, you're just freeze bird. Because that doesn't happen. So rather than telling her about how impossible your schedule was, you just asked her what their first available appointment would be. That way, if it was far enough in advance, you know, you could work around the schedule, whatever. So here we go. Remember, this call just happened Wednesday, November 5th. The first availability Joan had was February 18th at 3.55 p.m. Mind you, not 3.45, not 4, 3.55. So basically they're calling you right after Halloween, soliciting your business. Your IUD expired 10 months ago, but now they can't see you for over three and a half months. What the actual hell? Why would you first ask what days or times are best when they don't even have any availability for over three months anyway? Why call about outstanding needs when your earliest solution is spring? Why pretend this is so urgent when their own calendar proves it's not? So you said February 18th is fine. You'll block it in your calendar, rearrange whatever conflicts come up between now and then find coverage for whoever, whatever handles it during the day, show up on time, even though I'm sure they'll run 40 minutes late if you're lucky. Now, while she had you on the line, you asked about scheduling that annual exam, you know, the one that couldn't be done at the same time anyway. Next availability for that, hmm. Friday, February 27th. Now, for this one, she had two options: 1110 a.m. or 350 p.m. No 355 that day. Someone beat you to it. So you choose the 1110 a.m. that day. But that basically means that you're going to have two trips to the same doctor that you have not seen in a frightfully long time within nine days. You're gonna have this Tuesday, February 18th at 3.55 p.m. for the IUD removal and placement, and then Friday, February 27th at 1110 a.m. for the annual exam. Now, because the office isn't close anymore, this is all sorts of wonky. Switching doctors, though, felt harder than just forgetting to have the appointment and you'll just make the drive. Joan is very pleased with your cooperation. Now she's confirmed both appointments and reminded you that they'll send confirmation emails. Oh, great, more emails. And you should arrive 15 minutes early to update your paperwork. Because of course there's paperwork. There's always paperwork. And they'd email you the same paperwork, probably for those two separate appointments. You'll complete it, and then you'll go up to the office on your scheduled day and time, and then you'll fill out more paperwork because the two systems can't talk to each other. Oh, and the vaccines she'd mentioned earlier, those can actually be done at your primary care provider's office, she told you so cheerfully. Yeah, the same office that you were just at last week with your son who was getting his sports physical. You don't need an appointment for those, she assured me. Just walk in whenever. Well, whenever, except for 12:30 to 1.30 when they break for lunch. Or maybe it was 12 to 1 or 1 to 2. I don't know. You know that they don't open until 9 a.m. and they close at 3:55 p.m. So that rent whenever window is pretty narrow anyway. Great. So you can get those vaccinations anytime. Just walk right in. And while you're at it, you could get that blood work done that you should have had done you when you were there last, but the lab had already closed. So they had to put that on your file too. And you still haven't gone to actually get those labs done because they were already closed when you went there last. And well, life. Joan then asked about any other appointments. The mammogram, the colonoscopy, the skincare screening. You couldn't schedule anything else at that time. Those were more homework projects you didn't have time to start, but now lived in your head as things that you were behind on. Thanks, Joan. You hung up. Her voice followed you back wherever you were doing before she called to coordinate your outstanding health care needs. The work deadline that was actually this week, not three months from now, the dog whose vet appointment was in 19 minutes, because you made sure he didn't miss his annual exams. And the partner, again, who still hadn't scheduled his own physical, but would mention feeling tired tonight, and you'd be expected to manage that concern with appropriate spousal worry. Your body is a maintenance project. Overdue maintenance. Maintenance that requires advanced scheduling, geographic logistics, time away from paid work, insurance protocol, compliance that makes no sense, and the ability to plan three months ahead while still handling everything else that happens in the next 13 weeks. They call it preventative care. Preventative. As in preventing future problems, as in responsible adulting, as in if something goes wrong later because you didn't take time for these appointments now, that's on you for not coordinating your outstanding healthcare needs. 10 months of expired reproductive maintenance you didn't even know about. Three and a half months to fit your body into their schedule, two trips across town in February, one at 3.55, the other one at 11.10. Don't ask me which one's which. Two blocks of time carved out for work, and hopefully out of whatever, whoever else needs you at exactly that same time. Two sets of paperwork. Your entire professional life spent working while your physical existence requires administrative coordinator that the insurance company won't let you even do at the same time. Past due. Outstanding needs. Coordinate. Evidence you can't manage your own health care, while, of course, managing everyone else's logistics, schedules, their needs, and somehow always get handled immediately while yours wait until apparently February. And whenever you finally make it to that lab for the blood work that's been waiting since forever, Joan was very helpful. Joan coordinated. Joan did her job. And somewhere there's a report saying that women miss preventative appointments more than men. They'll probably call it non-compliance. I call it proof that triage is a gendered skill. You'll do yours by showing up in February on time with your updated paperwork, having to have your body process through whatever modern medicine requires. And then you'll drive back across town to work, and nobody will know that you spent your morning. Be reminded that your health care is something you're behind on. Something that expired 10 months ago while you were handling everything else that couldn't wait. Outstanding needs. What gets named gets kept. What gets kept can't be erased. This is the silence tax.