A little more than a week before, it begins: The relentless, automated voicemails, text messages, and emails, are all hounding with reminders of your upcoming appointment. Login to the portal to confirm! Login to the portal to confirm! Login to the portal to confirm! …

This is the worst time for this. I don’t have the time. I’m already under enough stress. I have so many things going on. My sleep’s all over the clock. I’ve not been feeling great. Medicine to keep an old man’s blood pressure in some acceptable range have side effects, the worst of which can be a numbness or ennui that can really interfere with getting anything done; without it, though? Withdrawl symptoms of headaches, ringing in the ears, … Insurance is such that that they’ve mapped out one pill per day, and without the doctor’s say so, there’s no renewal. I’ll ration some here and there, tracking the effects, balancing the numbers, and making sure I can get through any periods of uncertainty or turmoil.

Login to the portal to confirm! Login to the portal to confirm!

Checking in at the window, “Oh, you have just one form to complete today.” Great… What is it? Nothing medical, just financials: You agree that you’re liable for whatever insurance won’t cover. That’s a reminder in the back of my head that there’s an outstanding bill or two with their lab since, even though an order for lab work propagates across the suite from the doctor’s office to the lab, billing and insurance information somehow does not. I can’t deal with them right now – too much going on. Besides, I was up all night doing other work and had a meal overnight that I shouldn’t have prior to lab work. Great.

So irritating… so no surprise: “Huh. Your blood pressure is elevated. Let’s test it again… and again in a few minutes… and maybe again. And how about lab work?”

“Not today, but I’ll schedule it.”

“Really?”

“Yes.”

“They’re right across the hall, so …”

“Yes, I know.”

“And the meds?”

“As I’ve told you before, (again and again and again,) the symptoms include…”

“So there’s a negative feedback loop, a disincentive to taking the meds?”

This time maybe he’s hearing me.

“I want to see you back in 4-6 weeks.”

At the checkout window, “We typically do 2-4 weeks.”

“4 is not even good. I have stuff going on and things have to be sorted out before I come back here.”

“Right, so here’s a date in 4 weeks.”

“Fine.” Process robots. I’ll reschedule it later…

“Now, let’s schedule you for your next physical. The general rule is no sooner than a year-and-a-day. How does this date work for you?” She stares at me, expressionless – maybe blinks once or twice.

I’m dumbfounded… “Fine, that’s great,” I say, finishing the thouht silently, “Robot.”

I stopped at a coffee shop on the way home, sat outside quietly in the sun, and breathed – just that. I called my wife to relay the status and story. I’ll have to negotiate with her calendar to pick a day I can go back for lab work. And during my call with her, I missed another: The message? “Hi! I’m so-and-so from the doctor’s office. I’m calling to help you schedule those lab tests…”

What’s the escaple from the stress of satisfying the system that requires you to keep your blood pressure within some statistically acceptable range, knowing that you won’t get the medicine they’ve got you hooked on if you don’t and you won’t be able to afford it if you can’t work through everything else?

Laugh, I guess, and enjoy a quiet cup of coffee.