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Last Updated: Wednesday, 21 June 2006, 10:03 GMT 11:03 UK
Washington diary: Body shock
By Matt Frei
BBC News, Washington

I have spent the past two weeks recovering from foot surgery and so I have had ample time to reflect on the marvels of (private) US health care and the misery of a body in decline.

Patient has his teeth examined by a dentist
Dental perfection means you are in for the long haul

By sheer coincidence my medical issues started as soon as I landed in the US four years ago.

Only 48 hours after getting off the plane in Washington I was seized by numbing pain in my upper jaw and rushed to a smart dental clinic near the White House.

I pointed to a throbbing molar and was puzzled to find the unusually monosyllabic nurse taking an X-ray of every single tooth in my mouth with quiet and unflinching determination.

She returned half an hour later with the maestro of the clinic who pinned 36 or so stamp sized X-rays on a back-lit board as if they were part of an avant-garde art project and then gave a PowerPoint presentation entitled something like "My vision for your mouth".

"What about the tooth that hurts?" I asked innocently.

"Thas juss the beginning," said Dr Harrison, a southern gent with a pencil-thin moustache arching over a blindingly white smile.

"We are gonna work together for three years to get everything in perfect order! An I promise, I won't have to see ya more than once a month."

The health industry had officially declared me fair game, easy prey

When the doctor had exited in a swoosh of fluttering white to "work with" the next patient, the nurse leant over as if in deep confidence and added: "You are SOOO lucky to be working with Dr Harrison! He is the beeeast!", making "best" sound like "beast".

I never returned after my root canal operation. I chose to become a dental fugitive, hounded every six weeks by increasingly urgent letters reminding me of the doctor's vision and my empty promises. I am certain that my mouth is on a blacklist somewhere.

Flatulent joints

Two months later the next chapter of bodily woes was opened. One day, out of the blue, without warning and for no apparent reason, my neck felt as if I had survived a garrotting.

I ventured into the hitherto unknown world of chiropractors.

Surgeon holds a scalpel
You can run but you can't hide from the surgeon's knife

Dr Schweinstein X-rayed everything above my shoulders and explained to me that - among other things - I had too much gas in my joints, which is why I would soon hear a flatulent noise as he took my neck into a half nelson.

As I contemplated the notion of farting joints, the chiropractor's fleshy hands fastened around my head, yanking it left and then right as if I was an extra in some martial arts movie. I heard the advertised noise and felt instantly better as the pain seeped away.

"Thank you, Dr Schweinstein," I said with genuine relief and admiration for the healing profession. "That will be it then?" I added for good measure, heading for the door.

The doctor fixed me with watery blue eyes.

"Actually," he intoned with a flat, yet authoritative voice, "this is just the prologue, you might say. What I have in mind for you is a two-year programme... a standard course of chiro-therapy to get your neck back in shape. The good news is: shouldn't need you here more than once a week! Your insurance should cover some, if not most of it."

The cost of this healing process to the uninsured would have been $150 a week. I wondered how the estimated 50m Americans who have no private medical insurance cope. They don't, of course.

But they weren't on my mind at this stage. I was planning another getaway. A fugitive from medicine... twice over.

Midlife crisis

Four months later I was reading the New York Times and my then seven-year-old son asked me: "Dad, why are you holding the newspaper like that?"

"Like what?"

"Like that... so far!" he said and stretched his little arms straight out.

Man has his eyesight tested
Perfect vision - just in one's dreams

I hadn't even noticed how my reading arm had got longer and longer.

So my eyes were next. At least the optician was a "walk-in". No appointments, no waiting room, no dog-eared copies of last month's Time Magazine and Yachting Monthly.

The verdict: long sighted.

"Why?" I asked the optician, whose name escapes me. "I have always had perfect vision!"

His nose crinkled and I knew I should have kept my mouth shut. No optician believes in perfect vision. It's presumptuous and it's not good for business.

"How old are you?" he asked.

"Forty-one," I replied.

"Ahhhhh," he said in a voice oozing pity, understanding and wisdom all coated in glee. "It's the age."

And with those three words my midlife crisis started.

The healthcare industry had officially declared me fair game, easy prey, a rich seam of never-ending profits.

I had hit rock bottom. What could be next?

I left the opticians and stumbled, diminished, into the glare of a Washington summer's day.

I walked down the road fingering my new glasses - frames so sleek, lenses so petite they were almost invisible - almost - when I felt my Blackberry buzz to life in my trouser pocket.

I put on my new specs clumsily, half enjoying this pompous new prop, and allowed them to slide professorially to the tip of my nose. I glanced down at the tiny screen. It was a joy to see so clearly.

An e-mail flashed up from someone called Kevin. I assumed it was work and clicked to open.

"Need Viagra, Cialis, Levitra?" Kevin asked. "We can help! You can perform!" It wasn't the Kevin I thought it was.

Metatarsal hell

I had hit rock-bottom. What could possibly be next? A few months later I got the answer: my feet.

I have always had feet so wide they defied even the most comfy Hush Puppies. To me, Birkenstocks felt like winkle-pickers.

Victoria Beckham sits in the crowd watching the English football team play
Fellow bunion sufferer Victoria Beckham opts for sensible boots

The pain was beginning to make me hobble and I was about to learn a new word: podiatry.

My podiatrist, a tower of a man who wears disconcertingly orange clogs with his blue surgical jump suit, eased me into the wonderful world of podiatry.

"No surgery, yet, Matt. Foot surgery is a serious business... we'll give you some orthotics first."

These specially moulded soles were the most expensive shoes I have ever bought and they didn't work. Six months later the pain was so bad that I had to go under the knife.

I would like to say that I have joined the hallowed order of the broken metatarsal, just in time for the World Cup.

Rooney, Beckham, Owen, Frei... even if I was nursing MY metatarsal on the sofa watching them test theirs on the pitch. But unfortunately I shared my pain with the other Beckham, not David, Victoria.

And it wasn't the metatarsal per se... it was metatarsal-related. I am talking about an excrescence of the bone resulting in a serious realignment of the toes. I am talking about a... bunion.

Posh Spice has one, a whopper that sticks out of her golden lace thong sandals like a raw pink golf ball. And I have two. One on each foot.

Hobbling hordes

"Bunion?" Isn't that what women get for wearing the wrong shoes?" a friend asked. True.

About 50% of American women get bunions, a statistic that didn't make me feel any better. I owe mine to my mother. Yes, they are hereditary and no, I have never worn stilettos.

"Bunion?" I asked the doctor. "Is there no fancier word? Something in Latin perhaps. Something complicated, more interesting?"

"Well, bunion is the ancient Greek word for turnip. Does that help?" the doctor with the orange clogs asked. (*)

No, it didn't.

The worst thing is that the surgery necessary to remove a "turnip" is long, complicated, painful and could end in failure.

It involves hobbling around for eight weeks with a surgical boot that could have been invented by a workshop of medieval torturers on attachment to the Ministry of Funny Walks.

I hit my low point last week. I was waiting in the surgery for my post operation check-up.

I was surrounded by middle-aged women wearing the same boot. My fellow patients. The hobbling regiment of hop-alongs.

A lady with a magenta rinse turned to me and said: "Honey, I feel so sorry for you. You are the wrong age and the wrong gender to have a bunionectomy!"

She recommended I check out an internet talk show called Life Beyond Bunions. I didn't know whether to feel flattered or flattened.


*bunion: medical condition known as hallux valgus. Origin early 18th century, unknown origin, perhaps Old French buignon, from buigne, bump on the head (Oxford English Dictionary)





MATT FREI'S WASHINGTON DIARY

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