07 Aug Washington DC — Dr Romeo & the Great Benin Scare

Beware and take heed of the Bight of Benin. There’s one come out where forty went in.

Good advice from an old sea chantey.

As easy as Peggy is to get along with, she must have offended somebody. Or, maybe, she was just far, far away from the twisting corridors of power and unable to protect herself, but the day came when the Peace Corps announced they were transferring her to Benin.

Now I don’t want to use the word Hellhole, and I’m not going to use it about Benin. After all, I’ve never been there. But the Peace Corps does send people to places Princess Cruises won’t take you, and I had my opinions. So had the British sailors who’d actually been there.

And it wasn’t just us, people in Botswana were suspicious of Benin as well. As far as Batswana are concerned, any place north of the Zambezi is wild and dangerous. If a Motswana has business in Zambia, or Congo, or Rwanda, he’ll tell everybody he’s going to Africa and they’ll nod and admonish him to be careful. Africa is a scary place.

The only thing stopping Peggy and me from going to Benin was the note in my medical records about the heart condition I didn’t have. That note hadn’t stopped us from coming to Botswana because Botswana is right across the border from South Africa, and South Africa knows hearts. South Africa is where the world’s very first heart transplant took place. Benin is across the border from Nigeria, and going into Nigeria for healthcare isn’t the same as heading into the country that produced Christiaan Barnard.

The note about the heart condition I didn’t have came about when a doctor decided I needed to run on a treadmill. For reasons that were never made clear, running on a treadmill involved eating greasy food. The treadmill people directed me to the perfect greasy-spoon restaurant and I scarfed a load of bacon and hash browns and buttered toast and the chef’s famous three-egg omelet fried up in lard. Having medical people send you out for a breakfast like that is like having your priest refer you to a brothel. But, what the Good Lord hath provided, let no man cast aside.

After I’d blotted my lips and belched a satisfied belch, I headed back to the treadmill. But they wouldn’t let me into the room. Somebody inside there had had a banana. Not being a treadmill professional, I wasn’t clear what a banana was, but I had my suspicions. No more than five minutes later, a group of concerned people in scrubs wheeled past with a gurney.

I’d watched enough emergency-room dramas to know that medical people are supposed to shove gurneys briskly down hospital corridors while holding a bag of plasma in the air and yelling color-coded medical words. They weren’t supposed to be pushing the gurney in a sedate sort of way. And whoever was on the gurney wasn’t supposed to have a sheet pulled over his face. It interferes with the breathing. So you can understand why the treadmill nurse, who probably hadn’t noticed a telltale blip on a heart monitor a few minutes before, was a little edgy about whatever blips showed up on mine. And why she escorted me off the treadmill before it was even fully cranked up.

By the time Peg and I headed to Africa, the note from that terrified nurse had been lurking in my file long enough for everybody involved to realize it was an overstatement. Life rocked along, the note remained, and nobody cared. Then, somebody did care: a mysterious somebody named Dr Romeo who resided in the wilds of Virginia. Or, maybe, Maryland. Or DC,

Google as I might, review the correspondence in my email files as I would, I could never discover where Dr Romeo lived, or went to med school, or how long he’d been in practice, or what his specialty might have been. I couldn’t even track down his first name. In fact, I’m not even sure Dr Romeo was a he. He might have been a he but, whichever restroom he (or she) used, Dr Romeo was the person who got to decide whether the arteries connected to my heart were unclogged enough to accompany Peggy to Benin.

As it happened, a couple of weeks earlier the best heart specialist in all of Botswana had examined those very arteries with an ultrasound machine, and he wrote a long, professional letter explaining that they were clean as a whistle. I passed it along, accompanied by a cover letter pointing out that he wasn’t only the best heart specialist in all of Botswana, he was heart-specialist-to-the-president. But Dr Romeo was unmoved. He (or she) wanted me to have another treadmill test.

Only this test wouldn’t involve eating greasy food. It would involve having atomic radiation injected into my body while the people examining me cowered behind a lead-lined wall. The fact that nobody in Botswana even gave treadmill tests didn’t seem to concern Dr Romeo.

You might think that, as the physician assigned to my case, he would have wanted to examine me himself. But if you think such a thing it’s because you don’t have a lot of experience with Federal healthcare. All contacts with Dr Romeo were mediated through his (perhaps, her) spokesnurse.

The woman had a lot of letters after her name, FSHP FNP MPH and, for all I know, Dame Commander of the Order of the Garter. If I needed to communicate with Dr Romeo, I emailed her. From time to time, I imagined, she’d browse through the emails from all the patients Dr Romeo never saw, and trot the ones she thought worth his attention down the hall to his (or her) office.

Sometime later, she’d gather up his pronouncements, paraphrase whatever she thought he meant, send them to us and, presto-digito, medicine accomplished. This process must have proved too nimble because it wasn’t long before we were ordered to send our concerns to a person in an entirely different Federal agency whom, I presume, did not reside within trotting distance of either Spokesnurse, FSHP FNP MPH and, potentially DCOG, or of Dr Romeo.

The job of the Third Federal Person was to forward the emails she deemed worthy to the spokesnurse, whose job it was to decide which of those qualified for the doctor’s attention. When the rulings came back, the nurse would transmit whatever it was she thought Doctor Romeo meant to the Third Federal Person, who’d paraphrase what she imagined the nurse meant, to the people who’d written the emails. This put us patients at three degrees of separation from the person responsible for making our healthcare decisions.

If you’ve been following this website it might have occurred to you, it certainly occurred to me, that I had the ear of the Chinese ambassador. And if I needed to get a message to Xi Jinping, he could have conveyed it for me. Which meant I had a more intimate relationship with the Emperor of Red China than I did with the doctor who was supposed to know enough about my health to decide where I could, or could not, live. I don’t want to jump into hasty generalizations here, but this kind of thing might be what gives Federal healthcare a bad name.

It also occurred to me that all I had to do to get out of moving to Benin was to not have atomic radiation injected into my body and run on a treadmill and, le voilà, Peggy and I would be stuck in Botswana, one of the truly great places on earth.