It’s Unanimous: I am the Problem

If you’re wondering what’s a good way not to spend a Monday morning, I’ll give you an example: dealing with your dad’s doctor, when your dad has dementia and his doctor is also slipping.

My dad has a bunch of weight-related prescriptions, and because of his cognitive problems, I am now required to manage them for him. His doctor asked me to do it. My dad says we’re both crazy, because there is nothing wrong with him.

I have to put the pills in a special box once a week. The box has compartments, and each compartment is for a day and time of day. He gets his pills by mail, and they keep arriving late. His doctor prescribes once a year, and the mail pharmacy is supposed to send pills at regular intervals, but over and over, things arrive a long time after the last batch ran out.

His statin prescription ran out in December, and it took me about a week to get the doctor to phone a prescription in to a local pharmacy to fill in the gap.

Based on what I have experienced with nearly every other type of business in America, I just assumed that a prominent doctor at a major teaching hospital would have a mechanism for getting medication to his patients during the holidays. I guess that novel concept has not caught on locally. The doctor and key members of his staff went on vacation, all at once, and they didn’t forward patients to anyone in the interval.

I hope no one died.

I would think you would be likely to lose your most lucrative patients during a vacation, because the sickest ones would be most likely to die.

It went like this: I would call them. Whoever took the message would say they would get right on it. Nothing would happen. They would not call to explain. I would call again. They would explain why it was impossible to do anything. They would take another message, promising to do whatever could be done. Nothing would happen. They would not call to explain. I would call again…

The pharmacy called me today and said the doctor had failed to provide a “prior authorization,” whatever that is, so I had to call the doctor again. They said the doctor’s people would know exactly what to do (place your bets). I complained about the pill hiatus thing. They said the way to get the prescriptions to arrive on time was to order them about 15 business days before they needed to be in my dad’s (my) hands. Genius. The Nobel committee must hear about this.

I called his doctor, and I spoke to a woman who is in charge of prescriptions. She started saying she didn’t understand the prior authorization thing (bet lost), and when I told her the pharmacy lady had said she would know exactly what to do, she admitted she actually did know. Okay. Thanks for that (?). She tried to tell me the habitual delays were the pharmacy’s fault, because that was easier than doing her easy, 100% surprise-free job and fixing the problem. I pointed out that she could fix it by doing one of two things: a) shift the order dates back by 15 days, or b) have the doctor prescribe a few more pills than my dad needs. How obvious is that? She said she would talk to the doctor.

The doctor called later on. He is pushing 80, and he does not seem to understand things very well. He has a hard time listening. He prefers speaking. On top of that, he seems to have the physician ego. “I have an IQ of 120, and I got an A in Organic Chemistry, and I am rich, so be still while I deliver the word from on high.” He’s a nice enough guy, but I would guess he is not overly burdened with respect for my intellect.

He kept saying it would be an enormous task, keeping track of the dates of all his patients’ prescriptions. I did not know what to make of that. He has at least four people who work under him, and they have computers. One more relevant fact: they’re supposed to be experts at providing medical care. I think you can see where I’m going with this. It’s a simple job, it’s exactly the kind of thing people in their positions should be taking care of, they get paid a ton of money to do it, and they have technology which far exceeds the demands their work would place on it.

I gave up on making him understand that it was possible to write a prescription earlier instead of later. The learning curve was just too steep. I suggested he call a local pharmacy and order a small amount of each pill, and I would go pick it up. That way, there would be a supply of pills on reserve, and it would fill the gaps. Presumably, this would fix the problem permanently, because there is no issue with the amount of pills prescribed. The timing is what’s killing us. I can dump the manually obtained pills into the mail-order bottles when they arrive, and as far as the math goes, it will be exactly as if the doctor had started ordering pills sooner, except that if the prescriptions are ever discontinued, we will have a few pills left over.

Maybe I’ll take a handful of them and see if I can get my home blood pressure machine to throw an error.

He still didn’t get it. He kept saying the insurance company would not cooperate. He just assumed this was a deal breaker. I had to tell him we would pay for the pills ourselves.

It’s worth it. When a person has dementia, and their pills run out, it’s a major crisis. There is a lot of yelling and criticizing. Then you get to hear it again every day (at least once) until the pills come in, because the patient forgets. You get to call the doctor and be told it’s the pharmacy’s fault. You get to call the pharmacy and be told it’s the doctor’s fault. They all agree it’s partly your fault. You get to be put on hold a lot, because you’re not important. Important people wear scrubs.

I don’t care if the pills cost ten thousand dollars. I don’t care if I have to make fake pills using flour and food coloring. This WILL be done.

After I came up with this Einstein-level, Vizzini-boggling strategy, I had to give my dad the bad news: he was going to have to pay for some of his own pills. That was fun.

So far no one I’ve dealt with has taken even a tiny amount of responsibility, but all four have blamed me without hesitation. And they’re not even my pills! And I’m the only one who has done everything right.

I keep telling people I want the doctor to prescribe Xanax for my dad. So I can take it.

I was commenting on an Internet forum this weekend, and I said something that came as a revelation to me even as I was typing it: everyone I know is completely helpless. No one can turn a screw, change a tire, saw a piece of wood in half, get a prescription to arrive on time, connect anything to the Internet, put the batteries in the right way…you name it; they can’t do it. And unfortunately, they know I can. Because I have a special arcane method: I try.

Don’t tell anyone my secret. I’m thinking of patenting it.

I was talking to God about this, and I stopped myself short. I realized I was complaining about being more blessed than other people. It’s bad to be surrounded by people who can’t do a damned thing, but think how bad it would be to be one of them, always waiting for someone else to come and wipe up the mess.

I told God I was grateful to be a giver and lender instead of a taker and borrower. Not that I never take anything from people, but I’m glad I’m not part of the set of people who lose their minds when a breaker pops or some computer device has to be fixed (“TURN IT OFF AND ON. LOOK, SHUT UP. JUST DO IT”).”

It’s dangerous to start feeling essential, though. When you start believing other people are as helpless as they say they are, you will find they are happy to agree, and then you end up carrying everyone you know around on your back, like a mother possum lugging its young.

Here is some wisdom for you: when you choose to help people do things they say they can’t do for themselves, most of the time they will instantly feel entitled, and they will think there is nothing wrong with criticizing your charitable efforts as though you were being paid.

Here is some more wisdom: people who constantly ask you how to do things will not necessarily have any respect for your intelligence. People have almost no respect for me, but that doesn’t prevent them from asking me how to do things all the time. Figure that out if you can. I would point out the obvious inconsistency, but they wouldn’t respect me enough to think I was right.

I think everyone should hide away for a few days once in a while. Turn off the phone and pretend you’re dead. Then when you reappear, talk to people and find out how they solved their problems while you were gone. Sometimes you’ll find out they survived without you. If they ask where you were, just say you were “trapped near the inner circle of fault.”

I love Rip Torn.

Here is one of my favorite things to say: “They’ll get over it.” People try to burden you with their problems, or they try to manipulate you into doing things you shouldn’t have to do, and you choose not to comply. This upsets people. Say, “They’ll get over it.”

They do.

Not everything is your responsibility. The fact that someone else is upset by something you did or didn’t do is not necessarily important or even worthy of thought.

I remember having a drug addict come to me and demand help getting new housing. This person had refused treatment for years, she had lost her house, and she was about to lose her apartment. Like, the next day. She kept telling me she was going to be on the street, and this bad thing and that bad thing were going to happen to her unless someone gave her large amounts of money right away. I agreed completely! I said things like, “That’s probably right. That will be bad. What are you going to do?”

I don’t know if steam can actually come out of people’s ears, but I think I saw a little. Sometimes I wonder if I’m the only person on earth who responds to addicts rationally.

I can’t take that attitude with regard to a dementia sufferer’s medications, unfortunately.

We could look for a younger doctor who is more alert, but you know what they say about the devil you know and the devil you don’t. When a person hits 85, you don’t look for medical revolutionaries to turn his life upside-down and work miracles. You think about peace, comfort, safety, and a nice big TV.

I guess I feel better now. My dad has four different blood pressure pills. I have a blog.

What are the odds that the doctor will actually phone the pharmacy?

Think about something else, Steve. Think about something else.