Five years ago I had a pacemaker “inserted” and three years ago when we moved from Duncanville to Waco I needed to find a “new” cardiologist. We also had to find other doctors—our “general practitioner” (GP), who would refer us to the specialists we would eventually visit Our son-in-law helped us find the GP, who gave us the names of, in addition to the cardiologist, a urologist, ophthalmologist and dermatologist. (No, I found the latter all by myself.) My wife “found” the same GP as I did, but also “needed” an ENT specialist ( called by an unpronounceable name), and an audiologist, but her main consultation s have been with oncologists in Houston every six months. We also wanted to “find” a dentist—not hard to do in Waco—they lay around like Easter eggs in a small lawn.

The cardiologist I was referred to is one of eleven who work out of the “Waco Cardiology Associates” in a building that was once a large box store. The ENT, audiologist, urologist and a lab are in the same building, so it is very convenient.

Every year or so I have to have an “echocardiogram” to see if my heart is echoing properly. Affiliated with the appointment is often an EKG as well. The “echo” is read by taping about 6 patches to my general chest and side area, each having a metal bump that a wire is attached to. The wires run to a electronic device that, when the technician turns it on, sounds like a washing machine with a heavy load. Some sort of gel is applied to the skin area of the patches which are “ripped off” when the echo is finished. It takes only about 15 minutes and the readings are sent to my cardiologist, whom I will see the next week.

The next week I also have to have my pacemaker tested as well, even though I send quarterly reports by means of an electronic home device connected to the telephone. The pacemaker test is to make sure it is working properly and the technician can read how often it is working—in my case about 40 to 50 percent of the time for two of the “chambers.” I’m in the care of the pacemaker technician for about 20 minutes. I don’t know exactly what she does, except hanging a cord around my neck with a metallic device resembling an I-phone, which is placed over the pacemaker. She fiddles with the computer and monitor and scowls a lot, but in the end she ays that every thing looks “very good” and gives me a schedule for home monitoring.

I am then taken to a small holding pen to await the cardiologist. On three of the four walls are large posters with cut-out hearts, labeling the different chambers, valves , and pistons. A number of diseases and abnormalities are spelled out in some detail. The pictures don’t actually bleed, but they look like they should. They are not pictures for the “faint hearted.”

I expect to wait, but a nurse soon comes in with her trusty computer and asks me if I am OK—dizziness, fainting, black outs, weakness, aches, pains and so on? I say “no” to each. She takes my pulse and blood pressure and is happy with them. She informs we that I have “not given her much work.” I am truly sorry, but what can I do?

Fifteen minutes later the cardiologist comes in. He puts on his stethoscope before he even sits down and he tells me to “breathe in and out deeply” while he tries a number of different positions on my back, and then “breathe normally” when he listens to the front part of me. He feels my ankles and then looks at his computer.

The lab reports on cholesterol, liver, and so on are “very good” so he turns to the “echo” report and he finds that over the last three years my heart has gotten progressively “a little weaker, but not a concern.” He is, however, concerned enough to order a stress test for me in a couple of weeks. There is not much else to be done except read the various reports. “After all,” he says, “you are 84,” surely implying that I am lucky to be alive and it will be to my benefit to stay that way. They could “run me in the cath lab” and see if the arteries are OK, but “at your age or anyone over 80, ”I leave it up to the patient.” So we will wait on the stress test but in the meantime “I’ll see you in a year.”

We did have a bit of small talk. I found out he knew our GP, whom he had been called to assist recently when the GP had a heart attack. “Maybe you will see him at the Y more often now,” was the cardiologist’s comment. We talked a bit about pain and I quoted C.S. Lewis that “pain is God’s megaphone” and he seemed to like that. He also knows our son-in-law, who is a doctor in Waco and I found that three of his children go to the same school as our grandchildren. Upon leaving he assured me to “call him if there was anything I needed help on.” Of course, we all know that it is all but impossible to call a doctor and talk to him or her. Instead, we get a phone message saying “if this is an emergency call 911” or we are given a number to punch if we speak only Spanish, a different number if we are someone important, like a doctor, another number if we are inquiring about a bill, still another for appointments, and so on, up to about 9, which says “punch this number if you want to hear all this again,” or something like that.

I didn’t have the “heart” to tell my doctor that he talked way too fast for me to remember hardly a thing that he told me.

To conclude, the doctor gives me a form to take to the check-out woman, who schedules me for the stress test and says, “your co-pay will be $45.” The whole visit has taken me 2 hours, so at $22.50 an hour, that’s not bad. However, I’m sure more bills will be coming—our insurance company will not “cover” the extras—they have no heart.

August 24, 2017