I haven’t had great luck with doctors. So when it comes to managing my mild asthma, I’ve tried to avoid them by waiting until my inhaler runs out, realizing I don’t have any refills left on the prescription, and booking a same-day appointment at urgent care. Recently, I realized this wasn’t the best way to treat a medical condition that could kill me, so I logged into Cigna.com and found a real-life MD who could help.
This is my story.
I left work on Friday afternoon and walked a few blocks north to the doctor’s office. I’d had a cold recently and was still a little wheezy, so I figured the doctor would listen to my lungs, give me albuterol, and I’d be back at the office in about 30 minutes.
When I walked into the waiting room, the first thing I noticed was a big green sign that said “THROW AWAY YOUR TRASH!!!”. When I see a sign like this, I assume that either the area is prone to a recurring problem that causes significant distress OR a person who works there is unhinged. I kept an open mind and headed to the desk to check in.
The woman behind the desk handed me an iPad to complete the required paperwork. “We reset the password this morning and nobody can remember it,” she told me. “Have a seat and I’ll tell you the password once it comes back to me.”
“Did you write it down?” I asked, trying to be helpful.
“No,” she said. “But it’s in my head somewhere.”
I sat in a chair and she sat on her desk, eyes closed and brow furrowed. Ten minutes later, she opened her eyes and logged into the iPad on the first try. “Don’t forget to take a few selfies so the doctor knows who you are.” I took two pictures without asking questions.
A different woman led me back to an examination room, and I sat down on the paper-covered table. She handed me what looked like a small strip of white paper. “The doctor only trusts temperatures taken in the armpit,” she said. “Some people think it’s weird, but that’s just him.” I placed the paper in my left armpit, waited five minutes, and then removed it and handed it back to her. “He’ll be with you soon,” she said. “It’s been a busy day.”
Minutes later, a short man with an all-black outfit, wire-rimmed glasses, and a deeply pockmarked face walked in. “I’m Dr. S,” he said. “And you’d be prettier if your face was more symmetrical.”
I didn’t disagree.
“I only say this because — ” he paused, pulled up my selfie on his iPad, and handed me a mirror. “I can tell just by looking at you that you have a sinus infection, and you’re seriously ill. Very, very ill.” He pointed to the center of my right cheek. “Look how droopy this side is,” he said, comparing it to my left cheek. “It’s full of infection.”
“I think my face just looks like this,” I said. “I’ve never been super photogenic.”
“We can change your face,” he said. “Watch.” He pulled on purple latex gloves and grabbed my head, tipping my face down and sideways so my right cheek was parallel to the floor. “I’ve been working in this city for 25 years,” he said. “I see people like you all the time — smart people — Salesforce, Google, Facebook, all of them.” He was ranting by this point, and it was hard to keep up. “But not one of you knows how to blow your nose correctly.” He pressed his thumb on the skin above my right sinus cavity. “BLOW,” he said. I paused, feeling shy. “Just do it,” he said. So I blew my nose into his gloves, and he repeated the process for the left side.
We moved on to questions.
“Have you had a cough?” He asked. “A little, but not too bad,” I answered. “I’m more concerned about the wheez — ”
He cut me off. “Do you ever see animals with four legs coughing?” he asked. “Like dogs, have you ever in your life seen a dog cough?”
I was bent at the waist and my head was still in his hands. I nodded, pretty confident that I’d seen a dog cough.
He pulled me back up to a seated position. “Dogs never cough,” he said. “It’s because their heads face down and the toilets in their skulls drain the right direction.”
“Interesting,” I said.
“Your head is a toilet,” he told me. “A toilet that drains the wrong way because you’re a human. It goes back into your throat. The mucus in your head is dirtier than the plaque on your teeth. Think about it.”
“Are you religious?” he asked.
“Not really,” I replied.
“That’s good,” he said. “It means you’re not being controlled. Do you think God has an anus?”
“I’m not sure,” I said.
“Me either, he replied. “But anyways, the benefit of religion is that when people pray, they put their head on the ground, like a dog.”
“And that’s good for … drainage?” I offered.
“Exactly,” he said. “You should always cough upside down, like a dog or a religious person. And, you should do it at least four times a day, even if you don’t need to.”
“I’ll try,” I said.
He moved on to the next question. “Do you ever use a Neti pot?” he asked.
“Yes!” I said, relieved. “I use one almost every day.”
“Have you ever seen a monkey use a Neti pot?” he fired back, peering at me over his glasses.
“I don’t think they’re that advanced yet,” I answered.
He ignored my joke and paused a few beats. “Would you stick a Neti pot up your ass?”
I blushed. He smiled at me kindly. “If you wouldn’t stick something in your ass, don’t stick it in your nose,” he said. “But if you really want to, you can use a vibrator on your face, to help with drainage. But it needs to be a small vibrator — really small. Okay?”
“Okay,” I said.
He walked behind me and placed his stethoscope over my sweater. “Breathe,” he instructed. I took several deep breaths. He whipped around, yanked open a notebook, and drew a simple graph with a sloped line. “This is normal people breathing,” he said. Neither axis was labeled. He pressed his pen into the page and drew a thick flat line. “This is you,” he said, staring at me gravely. “Your right lung isn’t working. You have a terrible infection and you’re extremely ill.”
“I actually feel mostly okay,” I said. “I was diagnosed with asthma as an adult, so I’m still learning how to manage it.”
“Have you ever in your life seen an old person with asthma?” he asked.
“I don’t think so,” I said, knowing by now that this was the answer he wanted. “Is that because they’re all dead?”
He laughed. “Don’t be silly,” he said. “Old people don’t have asthma because they took antibiotics all the time when they were kids. They constantly took antibiotics, and now they’re the healthiest people.”
“But I thought — ” I tried to say.
“Me, I take antibiotics six or seven times a year and I never get sick,” he said. “You have to ignore all the fake news out there.”
“Wow, how interesting,” I said.
“Fake news is a big problem,” he said. “Like in this city, you can’t even wear a red hat without people getting upset. Is that freedom of expression?”
I shook my head.
He returned to his notebook and drew a face. The left cheek was round like a clown and the right cheek was shrunken like a witch. I realized it was me. He circled the right cheek, drew an arrow, and wrote “THIS PART IS GREEN!!!” It became clear that he’d written the sign in the waiting room.
“If you cut your toe would you wait for it to turn green and fall off before taking antibiotics?” he asked.
I shook my head again.
“Exactly,” he said. “You need at least ten days of antibiotics immediately, and I’ll throw in an inhaler for your fake news asthma.”
“Thanks,” I said.
“See you in six weeks,” he replied.