Imps

I have an Imp in my life. She is the right size, though the bleached blonde hair and dancing blue eyes, instead of bat wings and tiny horns, tend to mask her Impish nature. However, when it comes to mischief and the determination to being the center of attention, no Imp is her better. Which makes perfect sense. Why shouldn’t a near endless flurry of pure joy, boundless curiosity, and fearless adventurism be the center of attention? A touch of the mischief just comes with the territory.

A couple of weeks ago, a small lump appeared in the middle of my Imp’s little tummy. It was coy, sometimes noticeable and sometimes not. Every adult in her life immediately moved right up to the edge of panic and hovered there. Her Doctor insisted there was no real reason to worry. Our Imp was eating and sleeping well, never complaining of feeling bad, or showing any sign of being in pain. Still, he couldn’t say what the lump was was, only what is wasn’t. And what it wasn’t was a (rather common place) hernia. He scheduled an ultrasound for several days later, allowing that it could be canceled depending on what he learned from further research and conferring with other doctors.

Ultrasounds are moderately expensive tests on toddlers, and the Imp is among the many in our country whose family can only afford health insurance that comes with a crippling high deductible. Which puts one in a weird state of mind, hoping that any looming medical bills remain as “out of pocket” expenses. Such could easily drive us into a financial hole so deep that climbing out would take several years, as happened with a cancer scare a few years ago. (One of the contributing factors to us being in Bradenton these last two summers.) But chewing through the deductible to actually get insurance support would mean entering that place from where the panic wells. Perhaps the Doctor would come up with something, and the ultrasound could be canceled.

The several days passed and the Doctor could not find any explanation for the lump that would negate the need for an ultrasound. So the Imp, accompanied by Mom, headed off to the hospital. Apparently ultrasounds are common procedures for those who ended up having reason to fear the worst. My little Imp was the healthiest one in the room. It was a thought that brought a deep ache to the heart and allowed the panic to edge in a bit closer. Why should fate smile upon those I love when so many, so deeply loved by others, dwell in the valley of the Shadow?

At the end of the test, the technician was nothing but encouraging. According to him, had the test shown anything of real concern, the radiologist overseeing the procedure would have admitted the Imp to the hospital forthwith. That she was sent home to await the diagnosis was a a positive omen. But, once again, though they got a bunch of “good” pictures no one would say for sure what this thing was, or even what it wasn’t. The panic edged away a bit, but it didn’t disappear.

Two days later came word, and the panic died. The Imp has a hernia after all, it just isn’t a very common one. Surprisingly, while spreading the good news to family, we found out my Sister was born with the exact same kind of hernia and has had it all of her life. Surgery was never required nor has the condition done her any harm. Good news made even better, but it seems there is still some room for debate. Word has it general anesthesia and invasive surgery have already been broached by the professionals.

When one climbs aboard an airplane the professionalism of those flying is assumed. There is good reason for the assumption since the crew, as the saying goes “will be the first ones in the hole.” They have skin in the game, and those in the back of the plane ride along on the crews determination to end the day in one piece. But it is difficult to make that assumption of the medical profession in the US.

Our medical industry is a profit center, not a health center. It would be far more lucrative for that industry if the Imp undergoes surgery rather than just going about her life. A stay in the hospital, specialists and drugs, doctors and nurses…what do you guess - $10,000 - $20,000? And the thing is, if something goes terribly wrong, no one in the operating room “will be the first one in the hole”. In fact, they will get paid anyway. Will they “feel bad?" Sure. They are human beings after all. But they have likely “felt bad” before, and will “feel bad” again. In the mean time they have student loans to pay off, mortgages to meet, and dinner to put on the table. American’s ratio of health care returned for dollars spent is the worst in the first world. Ours is also the only one based on making a profit rather than making people well. Are the two connected? Many insist not. Indeed, some insist that "market forces" will make for the best health care. I suspect (if you will forgive the pun) they are whistling past the grave yard.

It would be nice to think that we, as a people, have earned better than that. Maybe, much like a chain can be no stronger than its weakest link, a nation can’t rise above the level of its average collective wisdom. It is starting to look like this is the best we can do, the wisest we will ever be. This generation of America is never going to fix its health care system. We have reached the limit of our collective wisdom.

My hope is that such is a generational thing. There is a whole new generation of Imps out there. One of them owns a big part of my heart. She is fine. And my belief is she, and they, are going to be much wiser than we.

Assuming we let them live that long.