I have a friend who is about to have a baby. It’s her first baby, so understandably she’s very concerned and wants to take every precaution.
One of the things that she’s asked everyone who is going to be near her new-born is to get a vaccination. Specifically, she’s asked us to get a Tetanus, Diphtheria, and Pertussis (TDAP) vaccination.
Now, even though I am a male in my 50’s, I’ve never quite gotten around to actually getting anything approaching a family doctor. I’m generally healthy and on the very rare occasions when I’m in need of medical care, I just go down to some local clinic.
I figure that this will not be a big deal. I enter a clinic that just happens to be near my gym and go to check in. The receptionist looks up and asks me what I’m there for. I tell her that I would like to receive a TDAP vaccination. She narrows her eyes suspiciously at me and asks me why I need one. I explain that I have a pregnant friend who’s asking all of her friends to get this vaccination. She goes into the back. After a couple of minutes consultation, she comes back and tells me to take a seat.
I do, and after some small amount of time, I’m called back by the nurse. Once again, the nurse asks me why I want to get the TDAP. I’m not particularly surprised, because as anyone who has gone to a doctor’s office knows, repeating your story is fairly routine. It’s almost as if you’re undergoing police interrogation and they’re looking to trip you up on your story. So, again, I explain about the pregnant friend and her request.
After telling the story again, I fully expect the nurse to nod her head knowingly, whip out a shot, jam it into me, and I’ll be off on my way.
Instead, there’s a short pause and then she tells me that the doctor will need to talk to me. I’m shocked. What is there that is so controversial about someone getting a vaccination? Is there a TDAP underground black market? Do mature men often go out to get thrill vaccinations? I’m baffled.
The nurse leaves. After a couple of more minutes, the doctor comes in. Like me, he also is somewhere in his 50’s. He gives off a serious, no-nonsense air.
He sits down and says that he’s heard that I’ve requested to get a vaccination to support a pregnant friend. I confirm this to be true. He compliments me on being a good friend and how impressive it is that I’m taking time out of my day to address my friend’s concerns.
He then says…”However…”.
I hold my breath for a moment. However? What kind of however is this? Is the TDAP some $10,000 dose? Is it so rare that only certain people can get it?
“However, we are an emergency clinic and we can’t give vaccinations”.
WTF? I might have noticed the word emergency in the name, but I just thought (if I did indeed even think about it) that meant that they were qualified to address conditions that a normal clinic could not address. I in no way would have ever thought that meant they could only address emergencies. Is a broken leg an emergency? A fever? Where’s the line? I want to stress that there was nothing about the waiting room or anything else that made this look like it was only for emergencies. People were not running around shouting Stat!
There is a short awkward pause. And then, this very serious, no-nonsense doctor looked me straight in the eye and said, “I can’t give you a vaccination but I can give you a shot if you’ve cut yourself”.
Another awkward pause. “So, have you cut yourself?”
Now it’s my turn for an awkward pause. I’m not great at reading social cues, but was this serious, no-nonsense doctor asking me to tell him explicitly that I cut myself so that I can get the thing that I need done that he just praised me for coming to do?
I nod slowly. “Yes”.
The doctor’s eyes light up and he says immediately, “And where did you cut yourself?”
I’m still in a state of disbelief, so I’m talking very slowly now and am ending every statement like a question. “On my hand?”
He nods and asks, “And how did you cut yourself?”
Again, he’s giving me all kinds of non-verbal positive cues and asks, “And where on your hand did you cut yourself?”
And now I’m stuck. I have no cut on my hand. If I’d been a little bit quicker mentally, I would have pointed to the still visible scar that I got when I cut one of my fingers on a saw on a Boy Scout trip when I was ten years old. Instead, I literally just stare wordlessly at my hand willing for a cut to magically appear on it.
The doctor takes my hand and examines it. He notices on my wrist a slight discoloration. Maybe it was a long ago wart or something that flared up and disappeared, leaving only a faint trace of its existence. He points at it and asks, “Is this where you cut yourself?”
I’m sensing an end to this Kabuki theater. I say yes.
The doctor nods and then turns back to the keyboard and proceeds to merrily type away for some time. After he’s done, he turns to me and tells me that he needs to give me a tetanus shot because of my cut. He mentions, in an offhand manner, that he’ll be giving me the tetanus shot in the form of a TDAP vaccination. He then gets up and walks out.
Quickly the nurse comes back, gives me the shot, and I’m out the door within five minutes.
I’m still at a loss. I know people regularly bemoan the state of medical care in the US.
But seriously, did I just have to commit a minor act of medical fraud just so that I could get a vaccination that probably I was way long overdue for anyway?