Every 6 months I visit Dr Rowe, “my” dermatologist. Dr Rowe is a retired medical officer from the military and a trained dermatologist who has been in Waco only two years. I was one of his very first patients, so he remembers me every 6 months when I visit him.

His office is not large, but there are enough chairs and sofas for about 15 people and this morning they are all occupied. I check in and am told that “you have some papers to fill out, to bring you up to date.”

I am given a clipboard and pen and the forms to read and “fill out”, a set of four sheets, double sided. I begin with examining what they already have recorded on me, which is everything but my blood type. I examine who is the “responsible party” (that’s me), the “primary insurer” (that’s United Health), and the “secondary insurer” (that’s no one) and for each paragraph I must indicate that I have read it and sign my name and date (below).

I’m not done: I am asked to acknowledge that I am having treatment—some people apparently don’t know why they are there, and that I have an insurance claim; that I have read all about “office policies”, which include privacy notes, cancellation requirements, “cosmetic retail”, payment plan, and future appointments. By signing below I acknowledge that have duly read all the fine print.

I am still not done. I must read PHI on “communication preferences” so that I can authorize disclosures to my son-in-law and accept telephone information on benign (non-cancerous) diagnosis. By signing below I agree with everything on the “financial policies” page. There, I declare that I will be responsible for any remaining balance that insurance does not pay, that it costs extra for a biopsy or examining “specimens” or for any blood work done at the “preferred lab”. Yes, and that I will pay $25 for any returned check. I sign below and think I am ready to give the papers back to the receptionist.

I notice one more: It is about “privacy practices,” a full sheet of information from the Compliance/Privacy Officer of U.S. Dermatology Partners. My friend there is “committed to your (my?) privacy” as long as I allow them to use information on: my treatment, payment, health care operations, appointment reminders, sign in sheet, treatment options, health-care related benefits and services, release of information to family/friends, marketing, disclosures required by law and breach notification. In other words, everything they can think of! They can send any or all of this information to “public health risk reporting”, “law enforcement”, “workers’ compensation” and, probably, the FBI. Coupled with this “use and disclose” agreement is a list of my rights: I may request restrictions, whatever that means, prohibit sale of health information—I know what that means—and  request confidential communications concerning my condition. I can also inspect and get copies of said information, amend and correct, receive an accounting statement (that is automatic), including a printed copy, and I have the right to complain (to the FBI?). They don’t mention my right to remain silent—I would probably need a lawyer for that.

Now I wait in the, (what else?) “waiting room” where there are two sofas, seven stuffed chairs—with people stuffed in them—and a table with coffee service available with a TV above it and some framed information on the wall. Each has something to do with Dr Rowe—one is a set of clothes pegs with a sign “Get to know Dr Rowe.” Apparently patients are to write little notes and attach them to clothes pins in the frame, although no one has done that, or they take them down every day. There are also two small lamp tables and a coffee table with medical magazines. I pick one up and read how to “freshen up your home,” “Think Zinc,” and about “WebMD.” One magazine has the names of all the medical services in Waco: there are 49 kinds of “physicians” listed, from Asthma to Weight Control and including 70 family medicine physicians, one of which, is ours.

There are only 3 dermatologists listed and that does not include Dr Rowe. Instead there are men like Dr Bang and the Epiphany Dermatology Center.

I glace at Dr O’Neill’s picture on a full page ad informing me that he is a plastic surgeon who will “perform” breast lift, hyposuction, tummy tuck, body contouring, brow lift, injectable filters, scar revision, as well as scores of other activities. He looks quite rich. Another ad is for a pain center and has a picture of a bear with the question “Can’t Bear the Pain?” Quite clever. There is an inside the cover ad for “substance abuse” with providers (not of abuse) like Alcoholic Anonymous, Bluebonnets Trails, Narcotics Anonymous and the “Targeted Abstinence Project.”

I have been reading and waiting for over 20 minutes before a technician calls me and asks the standard “How are you?” before being led to a large examining room. The technician asks me several questions, tells me to take off my shirt and that “Dr Rowe will see you shortly.”

I look around. The room is large and has a big chair in the center—it appears to resemble the electric chair I have seen in movies. That is where I will sit for Dr Rowe.

There is not much to do so I count the cupboards: 14 above and 11 below, as well as 11 drawers with labels like sodium bicarbonate, pillow cases, blankets, tape, sterile drapes, specimen cups and alcohol pads. There is a large red plastic container in the corner for HAZ waste, with an oxygen bottle by its side. There may be some connection.

The counter and room are spotless, one could say fastidious, and on the counter are tongue depressors, Microtouch gloves (5 boxes), medicine vials, and so on, all in a neat row. One gets the impression that every necessity is provided.

Dr Rowe and his assistant enter. I mention to him that I had taken off my shirt, but got cold and put it on again. The Dr understands and asks me to sit in the electric chair—he has his trusty little torch in his right hand. He places it to one side and begins to examine my head, arms, back and legs. Satisfied that there is work to do, he says “This is going to burn a bit” and begins. We have a nice conversation as he squirts nitrogen on to a number of spots on my head and arm, each of course “burning a bit.”

Within 5 minutes he is done and I am told to come back in 6 months. He “can’t believe” that I am 84 years old because I am in “good shape”, which probably means that I didn’t need a cane or walker to get to the electric chair.

I go to the checkout window, pay my $45 and get an appointment for March 5, 2018 at 9am. I pick up a brochure that reminds me to “follow the ABCDE’s of skin cancer”, that is, Asymmetry, Border, Color, Diameter, and Evolving. How about the DEF’s: Dripping, Effusing, and Foul (smelling)? That would get more attention.

I wasn’t “spotless”, but I didn’t get “skinned alive” either.

Waco, August 31, 2017