Wednesday, September 27, 2017

SBD

After graduation, five weeks of the program remained, which we spent seeing patients and training our replacements.

During those weeks, I applied for health insurance through Covered California, which was harder than I thought it would be. Fortunately, there are actual human beings who are willing to stay on the phone with you for the entire process, which in my case was more than an hour. There were some ins and outs I would never have figured out on my own that had a big effect on how much my monthly premiums will be: $1.35 versus $600. (It turned out that the correct thing to do was to say that I didn’t have health insurance and that my health insurance would be ending on such-and-such date in September, only one of which was true.)

I estimated that I will have “medium” use of doctors and other health services, and “low” use of prescriptions, but I asked my helper what would happen if I was diagnosed with a horrible kind of cancer or got in a car accident two weeks after selecting my health plan. She said I would be SOL: that you get the care your plan provides and no more. When the next open enrollment period comes along, you can choose a different plan, and if you’re still alive at that point, then you can have your cancer treated.

Accordingly, I hit the back button a few times to estimate that I will have “high” use of doctors, and found that I could still choose the exact same plan at the exact same cost, so I went back yet again to see what would happen if I have “very high” use of services, and again nothing changed, so I am Kaiser’s newest member, and a very happy one. (At least, I was very happy until I realized that I have to spend $6300 before they start covering much of anything. Now I’m mildly happy.)

Once this was finally done, I realized that needing to apply for my own health insurance had been a minor source of worry ever since I learned I was losing my job, which was in January of 2016. Being done with this application and knowing that I would have health insurance after my internship ended was a huge relief.

Somewhere along in here, I decided to pursue interventional radiology for Hammett—radiation treatment for his hyperthyroidism, which is 95 percent effective. This happens at UC Davis and would have cost about $2500, but I figured it would rather quickly pay for itself in labwork and visits to the vet that wouldn’t need to happen, and medication that wouldn’t need to be purchased. Plus, instead of paying his cat sitter $30 a day, I could ask one of my neighbors to feed him when I’m away, since there wouldn’t be the need to administer medication, if all went well.

In the end, I decided not to do this, because an elevated thyroid can mask kidney problems, and therefore can actually be a treatment option when the cat develops kidney issues. If radiation has been used to set the cat’s thyroid permanently at a certain level, that option disappears.

One of our assignments in the final weeks of the program was to update the information sheets we were given for our hospital units last September, or write new ones as needed. This forced me to read the sheet for my main unit, which caused me to discover that there is a daily interdisciplinary rounds meeting! At a time when I could attend! So I went to it for the very first and very last time in mid-August.

I confessed this to Jodie, who said, “You hadn’t read it?” I told her it was extremely long (like possibly more than four pages—I’m the Donald Trump of chaplains) and she said that’s because the person who originally wrote it was a CPE student from a few years ago who was a Ph.D. who didn’t like to visit patients very much but loved to do research. She told me to feel free to edit as I saw fit, so it is now less than two pages of extremely interesting information.

Last year, I was oriented by two different chaplains. I can’t remember anything about one of them or what she showed me except that she didn’t seem very friendly, which I found surprising. As for the other, I seem to recall that we spent less than half an hour together, but that struck me as more than enough, due to his frequent bursts of foul-smelling flatulence. Maybe he had chosen his breakfast and lunch unwisely on that particular day, but I remember thinking that if this was the norm for him, his unit was probably pretty happy that his year with them was finally ending.

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