Moans, Groans and Stones

Moans, Groans and Stones

By

Leo de Natale

Illustrations by Vince Giovannucci

She was a twenty-year-old, acne ridden woman who had Biafrin-thin skinniness. Like so many lemmings her age, she had the obligatory nose ring pierced through her left nostril and dagger-shaped chest tattoo emanating somewhere below her sternum and ending just below the throat. She also had a sleeve tattoo and was in her Goth mode: black blouse, pants and fingernails. “Tedi” was her name and she had arrived at Dr. Finkelstein’s dental office. She was due for an annual teeth cleaning.

As usual, she clutched her beloved cell phone. Her generation treats the phones as a body appendage. You go nowhere without the devices being in hand or within reach. It’s similar to eating at a restaurant and watching a family of four seated at a table, each member staring at a phone instead of a menu. Interpersonal communication is minimal – pass the fucking butter and don’t grease up my phone.

The dental hygienist Judy seats Tedi in an examination chair.  Tedi climbs into the chair but maintains a death grip on her phone as a bib is placed around her neck.

“Please put down the cell phone , Tedi,”  Judy says. “I’ll be cleaning your teeth.”

“Like, you know, can you give me a sec?” Tedi replies. “I’m expecting a wicked important text.”

She then holds her phone at arm’s length and thumbs a brief message. Judy is not pleased, especially after the phone rings. “Oh, I forgot to turn off the ringer.” No apology. Tedi sits there with her ear buds attached and listening to Goth Rock band Sex Gang Children while tartar is removed from her lower incisors.

Such devo behavior transcends all professions, all occupations. Ophthalmologists, dermatologists, gynecologists all witness Gen-Xers demonstrating generational boorishness. One gynecologist reported a patient keeping phone in hand during a pelvic examination. The coarsening of society allows poor manners to become acceptable. Lack of etiquette. Sad stuff.

The disconnection between and among us has no boundaries.

For example, Joey Angini tried contacting his new internet server, Ethernet, after his emails vanished into cyberspace. It was caused by an internet glitch. Angini, age 46, considered himself computer savvy but couldn’t retrieve his data and was forced to call the obligatory toll free number. He’d had similar experiences but never imagined how daunting this issue could be. He called the number and was greeted with a familiar recording: “Welcome to Ethernet. For English press 1,”. A voice speaking Spanish repeated the prompt – numero “dos”. He had entered a jungle known as the telephone tree.

“For account balance or to pay an outstanding bill, press 1, account information press 2, technical press 3; for any other matters press 4 or stay on the line.”  The process lasted five minutes.

Joey pressed 3. A message stated “Due to the high call volume, response time may be delayed. You are currently caller number six.” Fifteen minutes later, a voice with an unmistakably thick accent. He’d heard this many times.

“Hello, my name is Chuck (yeah, sure). With whom do I have the pleasure of speaking with?” Chuck asked.

“It’s Joey Angini, Chuck,” he replied.

Joey was certain the voice had a Filipino patois.  He felt like asking “How’s the weather in Manila today?” but proceeded to explain the nature of his call.  Lost email.  Business account. Important correspondence.  Need retrieval ASAP.

“No worries, Jo-Ay,” Chuck said. “We can fix your problem, but I’m at the company’s assignment center.  I’ll have to connect you to tech support.”

Thirty minutes had now transpired.  He was placed on hold for another fifteen.  At last, a he heard a woman’s voice.  She said her name was “Cherry” – they’re usually assigned American names- and the accent was definitely Asian.

“Hello, Jo-Ay. This is Cheree,” she said. “How can I help you?”

He repeated his conversation he’d had with Chuck. Cherry listed the repetitive questions: name, email address, home address, telephone number. She then checked his account to determine if he’d paid for the monthly service contract fee. He hadn’t and was informed he’d have to purchase the service –only $15.99 per month!- and then provided her his credit card information. Another 20 minutes passed. I don’t fucking believe this he thought. I’ve been on the telephone for more than one hour!

After the transaction was completed, Cherry told Joey he was “all set”.

“Let me transfer you our tech support line, Jo-Ay,” she said. “Eet’s been a pleasure talking to you.  Good bye, stay safe and have a good day.”

“Wait a second, Cherry,” Joey said. “I thought you were tech support.”

“ No, no, Jo-Ay.  I here to process your payment for services.  I send you to tech support now.”

So this is how it goes, Joey mused. There’s layer upon layer of foreign speaking support staff, This experience is becoming more labyrinthian. How many more trolls will I be subjected to before I retrieve my emails? He waited. Twenty minutes later, a man called Milos with an Eastern European accent spoke.

“Before we get started Milos, what country are you calling from” Charles asked.

“Romania, Jo-Eee,” he replied.  “ Have you been to my country?”

“No, but Milos, can we just solve my problem?” Joey said. “I’ve been on the phone with Ethernet for about two hours.”

“No Worries, Jo-Eee, ”  Milos replied.

That phrase, No Worries,  had become laboriously hackneyed.  It was as bad as the verbal crutches “Like” and “Ya’ know”, voice upgliding and vocal fry. Speaking skills were becoming an endangered species but at least Joey could understand Milos’ conversation.

Once again, Joey, had to repeat his email address, telephone number, etc.

Milos used a remote access program and navigated through the iPhone settings.  In some cases, technology was truly amazing and helpful.  He zipped through the various program files, found the error and quickly recovered his emails.

Charles thanked him, uttered several platitudes and, after 3+ hours, hung up the phone. This was my penance for today, he mused.

Meanwhile, another techno-crisis is unfolding across town.

          “Aarrgh! I can’t stand this,” yelled Annie Stutman. “I’ve been on the goddamned phone with Jet Blue for two hours!”

Jet Blue:”Like we’re really sorry but, like we’re wicked understaffed “

Annie was a stay-at-home mom. She had three teenage sons, a husband who was a big shot lawyer and two labradoodles, Bowie and Newmi, who many times ran the show. She was a petite, perky woman with blonde hair and gray eyes who was also a lawyer but had professionally burnt out after her children were born. She realized there was more to life than juggling a career and family.

Her particular frustration that day was the walking-through-mud experience so many people were experiencing.  Her father, a centenarian living in California, was now in hospice and she desperately needed to book a flight ASAP.   Like so many Americans, she was being engulfed with a techno-cyber monster that is wreaking havoc on her life.

She went online to purchase tickets, but a systems glitch was blocking her attempts. She was forced to telephone the airline company and therein lay the rub. Just like our friend Joey, the experience was as follows: a computer-generated voice answers and provided options – English press 1, Spanish press 2; she was then prompted to press buttons to reach various departments, In Annie’s case, she was trying to place a reservation. Fifteen minutes became thirty and she was benumbed by the canned, tasteless music interspersed with the message, “We apologize for the delay. Your call is important to us. An agent will be with you shortly”.

The reality appears to be there are more people – especially the Gen-Xers who don’t want to work. That’s where the shortage lies, she said to herself. Despite the long waiting time she finally obtained her ticket and would be flying to San Francisco the following day. Whew!

Several miles away from Annie, Stefan Gregson, an active 62-year- old, had returned from Wegman’s supermarket and knew something was afoot. A hard working blue collar type, he had a good job as a foreman at a long haul trucking business. It was his day off and he’d been food shopping.

He was minding his business when somewhere along the jams, jellies and coffee aisle he suddenly felt a distinct pain in his lower right abdomen. The discomfort began to escalate while passing the frozen pizza section. Uh-oh, he thought, here we go again. The telltale pain and its location provided an instant diagnosis: another bout of renal calculi, aka kidney stones. He had been told they eventually would reappear.

          Gregson had sustained an attack three years ago.  The pain was severe but not debilitating.  He’d driven to his urologist, Dr. Franklin Quid, whose staff performed an ultrasound. 

          “Yup, you have a stone, Stefan,” Quid said.  “It’s banging on your ureter’s door.  I’m giving you a prescription for pain killers.  That should tide you over.  I want you to drink four glasses of water daily.  Hopefully you’ll pass the stone but if the scan shows  you have a veritable quarry in that right kidney. Multiple stones.  If it’s any consolation, most people in your age group have them.  They’re the silent enemy.”

          “Gee Dr. Quid, what is the prognosis?” Stefan asked.

          “Tough to say but if you pass this boulder your kidneys may be quiet,” Quid replied. “But I want to monitor you for the next six months,” Quid replied.

           About two days later and much agony, Stefan’s stone passed.  He felt immediate relief.  That was then. This latest episode at the supermarket, however, was a different story.  The pain had intensified.  There was no mistaking his self-diagnosis.

By the time he arrived home, Stefan was nearly bowled over with the discomfort. He immediately telephoned Dr. Quid’s office and then swallowed two Tylenol Extra Strength anti-inflammatory pills. He quickly angered by the way modern medicine is parsed out. There’s a format that’s familiar with doctors’ patients, or “customers” as they’re more frequently known.

          “You have reached Boston Urology Associates,”  the automaton  voice declared. “If this is a medical emergency, hang up and call 911.  For prescription referrals, press one, to schedule an appointment, press two, for all other matters press three or stay on the line.”

          Gone are the days when a human being answered the phone.  Missing is the ability to speak directly with the physician.  Medicine has devolved into a hierarchy where it’s impossible to reach the big cheese.  After waiting five, ten, fifteen minutes a telephone receptionist answers.  Stefan recited the usual check down: name, date of birth, telephone number and then explained the problem: the kidney stone from hell.

“I’m sorry, Mr. Gregson, but Dr. Quid’s physician’s assistant Julie is seeing patients right now,” the operator said. “I’ll email her and place this on a high priority. In fact Suzy, our nurse practitioner, may be calling you.”

          So there’s  now a hierarchy.  Stefan was subjected to two strata of personnel before Quid becomes involved.  The reason?  Most MDs are on a gerbil wheel.  Fifteen minutes max for patient encounters. 

The more “customers”, the more insurance submissions. As actor Charles Grodin tells Robert De Niro in the film, Midnight Run, “It’s all about the fucking money, Jack!”

          We’re all meat on the hoof thought Stefan.

          Julie finally called Stefan with her sing-songy syrupy sweet voice.    He found her obsequiousness annoying.

“Hi Stefan, it’s Julie,” she said. “I’m sorry you’ve had to wait. You’ve got something going on here, huh? I’d like to perform a CAT scan today.  If that’s not possible,  we’ll have to wait until tomorrow. Sorry.”

“Well, what am I supposed to do?” Stefan replied. “This pain is becoming intolerable.”

“Well, if it’s that bad, drive to our Emergency Room,” she said. “I can call and prioritize you and there’d be no sitting in the waiting room.”

“Fine, my wife Katey will drive me there,” he responded.

Pushing through rush hour traffic, Stefan finally arrived at the hospital.  He was indeed fast-tracked but it’s the usual protocol: front desk “Your name, date of birth, address.  A visit to the triage room where some twenty-something nurse asks the same questions and takes vitals: blood pressure, temperature, medication lists and case history.  Stefan avoided the return to the waiting room and was ushered on to a hospital bed. He stripped naked and donned the obligatory Johnny gown.   The pain in his right flank was pulsating.

Another nurse arrives.  Name, date of birth, address, etc.  Another case history is taken.

“Well, Mr. Gregson, Dr. Quid has emailed us your information,” she said. “We’re going to send you to radiology for a CAT scan and find out what’s going on, ok?”

“Yes, yes,” he said. “Listen, can you give me  pain medication?  The stone is rolling and I’m not talking about the rock group.”

Thirty minutes later, Stefan is wheeled into the radiology department.  The CAT scan room door is opened and he is placed on to a bed.  The scan begins and a robotic voice repeatedly drones, “Breathe in. Hold. Breathe out.”  A whirling noise begins and in less than two minutes the procedure is complete.

He returns to his ER room and waits. And waits. Emergency rooms are controlled chaos. Doctors, nurses, technicians and support personnel hustle back and forth. All are in Covid protocol and masked. Most patients miss the good old days when they could see the faces of those who are tending to them. Much like the abhorrent telephone trees, the depersonalization with masks is a metaphor for the changes in health care delivery. The nurses inserting IV lines and performing various preliminary tests become faceless.

The attending physician finally arrived at Stefan’s room.

“Well, Stefan, you’ve got one big stone lodged in your right kidney,” he said. “In fact, it’s huge – 9 mm in length. You’ll never be able to pass that sucker. If it stays, it’ll eventually cause a serious infection and, of course, excruciating pain. I’ll be sending my report to Dr. Quid”.

Nine millimeters.  My God, that’s the size of pencil eraser thought Stefan.  It’s like a Yellowstone boulder wedged inside me. I can just imagine what the pain will be like. 

Dr. Quid’s staff scheduled emergency surgery for the following day.  He was released and returned home and was told to call an ambulance if he sustained a severe attack during the night.

The following day, Stefan is at the hospital; surgery was scheduled for 2:15 pm.  He had observed the cardinal rules of nothing to eat or drink after midnight.  As usual, there’s the terminal waiting.  After disrobing and again donning the johnny gown, he was wheeled into a pre-operation room.  The staff asked for his name, birth date; in fact at every point during the procedure line the same  two questions were repeated.  Why don’t I just have that info stamped on my forehead?

          Dressed in scrubs, Quid arrived, oh so cheerful over yet another stone crushing adventure.  He uttered the minimal pleasantries and left saying, “I’ll see you in the OR, Stef.”

          Eventually, Stefan was carted on to a corridor, transported by elevator, and arrived at the brightly lighted operating room.  He slid on to the table and awaited the happy juice express.  Everyone has the same experience.  The anesthesiologist appears and  chats  with staff and patient alike.  Stefan remembered starting to ask how long before the drug would take effect, but, as we all do, he slipped into unconsciousness before finishing the sentence.

          The next thing he slightly remembers is a nurse calling his name.  He was in the recovery room and, true to form he had no memory of the first a 30 minutes post surgery.  It happens to everyone.  That’s why they say “don’t make any important life decisions after surgery……………….”

          The flank pain continues due to  a temporary plastic stent tube Quid inserted that drains urine from the kidney to the bladder.  Josef is on the production line of old people with plumbing problems.  Apart from making a lot of money, why do people specialize in urology?

          Urologists work with geezers suffering from bum prostates, kidney stones and various diseases affecting the urinary system.  They daily stare at wizened old penises and shrunken scrotums.  He images Quid’s wife saying, “Hi, Honey, how was your day???”

          Despite the hassles he’d experienced with today’s health system, Stefan appreciated the good care received.  He, Joey and Annie can remember when communication problems weren’t complicated and realize how the rules have changed.

          Tedi the Goth and her beloved cell phone unfortunately haven’t a clue.  Like, it is indeed a brave new world, ya know?.