TRANSCRIPT
I’m going to share two vignettes that critique the American medical system.
In the first, maybe eight months ago, I was in New York City. I’m a guitar player, and I had switched to this little guitar that I loved. I fingerpick, so I used my fingers, and I especially use my thumb. Well, what happened was my thumb started getting so sore on my right hand, on my fingerpicking hand, and I found I couldn’t make a grip. I couldn’t hold on to things. I couldn’t open a can. I was like, what’s happening to me? Do I have arthritis?
So I went to my doctor, and my doctor thought I might have arthritis. But the first thing that he did was he prescribed me an anti-inflammatory medication. He said sometimes that can just blow it out; that can just take away the problem right away. So the first thing he did was give me pills, and he said come back in a week, or come back in two weeks, something like that, and we’ll see how it goes.
So I went home and I took this pill, basically for arthritis, kind of a high dose, and it did help when I took the pills. But as soon as I wasn’t taking the pills, it hurt again. And it made me think like, ooh, hmm, I don’t know. So I went back to the doctor, and he said, well, okay, so the problem’s still there. Maybe even it’s getting worse. So he referred me to an orthopedic surgeon.
So I went to the orthopedic surgeon, and the orthopedic surgeon looked in my hand. Oh, they did x-rays, ah, but all this expensive stuff. And he looked at it, he said, well, I—he looked at my x-rays. I don’t know if you have arthritis, but what you should do is go down to the physical therapist in this building, and they’ll make you a sort of hand brace that will keep your hands from being in a position where it will be likely to get hurt again.
So I went down, talked to the physical— but I asked him, I said, what do you think is causing these? It’s very hard to know. I said, you think it’s playing guitar? He just, probably not. It could be so many things. It could be just natural aging. But a lot of people get these kind of hand strains; they come on, there’s often not a real for them. We don’t know what it is, blah blah blah blah blah blah blah.
So I went down to the physical therapist. I said, are there any stretches I should do, anything like that? No, no, the bracelet probably fix it. Just have to wear it for a couple of months. So she made me this brace, and I have it right here. Straps on with Velcro. I had to wear a little sort of glove underneath it. I wore this religiously, this brace. I wore it every day. I wore it at night. I kept it nice and snug and tight, and I kept playing guitar, but a lot, a lot less. And I made sure definitely that I wore it when I played guitar, and I played a totally different style. I didn’t even use my thumb for fingerpicking when I was playing. I only ended up playing with my fingers, and I did a lot more strumming, so I didn’t put any strain on my thumb at all.
And I kept hoping that it would feel better, but it kind of didn’t. Oh, and I have one other thing to add. My doctor, she said, well, if it doesn’t work, we always have the surgery option. We can, you know, go in there and open it up, and you know, that can often relieve some of the strain. And I remember thinking, wait a second, I’m a guitar player. I don’t want them digging into my hand, literally digging into the tendons and the muscles and through the skin. That could permanently destroy my ability to play guitar. So I was like, uh-oh.
So I was wearing the brace, and one day I was walking in the street. It was winter; it’s about December. And I ran into a guy who’s a member of my community garden, who’s older than I am. He’s probably in his 60s, is my guess. I’m not really sure, but he saw me wearing the brace, and he said, what’s that? And I said, yeah, I have strain, strain in my thumb, and I can’t make a grip because—ah, yeah, I know what it is. It’s you’re playing too tight on the guitar.
I was like, well, I didn’t really trust him. He’s not a doctor, not a professional medical person. But I was like, well, I’ll just hear him out. He does play guitar, and he’s played guitar for a lot longer than I have. But he said, what you have to do is you have to stand up, put your arms back, and you have to do a stretch where you open your hands up really, really wide, really wide. He doesn’t do that a lot. Do it when you walk. Walk like you’re flying, just like you open up your arms like wings and stretch your hand like this, really behind you. And it’s like you open yourself up. It’s the exact opposite of getting in there tight and playing guitar just because I see you’re fingerpicking, because that can be really tight, especially with a small guitar like yours.
And I was like, you know, I have nothing to lose, so I tried it. Well, I swear to you, after doing that stretch for 15 minutes just while walking home, just stretching behind me, I felt something that I hadn’t felt in months. It was just some strange feeling of like aliveness in my hand, like there was like a buzzing in there. But it was a strange feeling that felt good. It actually felt good. And I was like, is it possible? If I started doing it more and more, and whenever I walked, I would stretch behind me. And you know where I was living in my apartment, I would stretch and stretch, and every day it started to feel better.
Well, within about three weeks, I stopped wearing the brace during the day. I just started wearing it at night because I was afraid sometimes I lie with my hand under my head and in strange positions, and I’d wake up all uncomfortable. So I wore it for another maybe two months just at night, in part because I was just afraid not to wear it because I’d become so accustomed to it. But I kept doing the stretches, kept doing the stretches. And then one day I took the leap, and I didn’t wear it at night. You know what? Woke up the next day, and it felt fine. And it’s been three months now, and complete use of my hand. My thumb is fine, my grip is good, and playing guitar is just fine.
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And I never did go back to that doctor.
So the second story happened three years ago. A friend who speaks Swahili invited me to go to Africa with her, to go to Kenya. So we went to Africa, and we traveled around really low budget, and we lived with her friends. We lived with her family members all around different parts of Kenya. We lived with several different tribes, and part of our time we spent at Lake Victoria, the largest freshwater tropical lake in the world. I forget, it’s like 80 degrees Fahrenheit, whatever that is in Celsius, 24, 25, 26 degrees Celsius. Wow, just gorgeous tropical lake borders Kenya, Uganda, and Tanzania, I believe.
I went swimming in there a bunch of times, had a great time, came home, and started feeling ill. Well, I’ve been taking malaria pills. I’d also had a yellow fever vaccine. I think I—what else did I have? A hepatitis vaccine. But I took malaria pills; they said they could have silenced some side effects. But I started feeling ill when I got home just a couple of weeks later, and it was in my throat. Like, I thought, well, maybe I’m stressed because I’ve just had a major journey across the other side of the world. I was there for several weeks, and so I waited, and it didn’t get well. And it was in a low part of my throat that I’d never felt sick before. So I waited; it didn’t go away after a couple weeks. So I went to my doctor, and the doctor wasn’t sure what I had and thought maybe I just had a sore throat, thought I had strep throat. But I was like, I know I—
Don’t have strep throat. I’ve had strep throat before; it feels totally different. They did a throat culture; it wasn’t strep throat. Well, then I tried to go back to my doctor again, but my doctor was out, so I went to a different place. I went to a primary care, an urgent care facility that took my insurance. Paid money, paid money for all this stuff, and explained my whole story of all the things that I went through in Africa, all my symptoms.
Let me ask you, you took malaria pills. She was, when you took those malaria pills in Africa, were you drinking a full cup of water with each pill? I thought that was a completely random question. I said sometimes, maybe sometimes I had half a glass. Remember, but I made sure I, you know, drank water. Chief, now you know what I think? Because those pills are large, they probably, a few of them got stuck in your throat for a while, and they burned your lower throat. So you have like a medication-caused esophagitis, and what you need to—
I was like, I don’t—she goes, no, no, just trust me on this. And I’ve seen this before; I think that’s what you have. So you need to take these other pills, a proton pump inhibitor, and I think it was like an upgraded version of Nexium for like gastroesophageal reflux disorder. But, uh, some strong stuff. She goes, I think it’ll help.
Well, I took it for a week or two. I did it. I went and bought the pills, paid her, and got a hundred and thirty-something dollar bill for seeing that doctor, even though I paid the $30 copay. My health insurance declined covering that doctor; it took me a year to work that out. But I took the pills, and they didn’t help the problem at all, except they had one side effect, and it was actually pretty amazing. I started spitting up stomach acid, and I thought, oh my god, I have gastroesophageal reflux disorder. I have GERD caused by these pills. Now, the interesting thing is these pills are actually supposed to cure that problem—a problem that I never actually had—but suddenly, as a result of taking those pills, I got it. So I eventually stopped taking them, and the spitting up stomach acid went away, and I was like, oh my god, what is it with these pills?
So I finally was able to get back to my primary care doctor, and I explained the problem again. Well, then I started having a high fever, and I was like, uh-oh. And then I got a rash on my legs, and I was like, oh my god. And now I was having bad headaches, and I was still having this problem in my throat, and it was really uncomfortable, and it hurt. It was hard to swallow; I couldn’t sing well.
When I said all this, I remember at the front desk of my doctor’s office, they saw in my chart that I’d been to Africa, and they were like, this was during the time of a big Ebola scare in West Africa. Well, they panicked, and they’re like, you have to wear a mask. They made me wear a mask in the waiting room, and then they got embarrassed; they didn’t want everyone in the waiting room to see that I was wearing a mask. So they put me in a back office wearing a mask, and I was like, yeah, but I was in East Africa. Kenya’s in East Africa; there’s no Ebola in East Africa. They’re like, you need to wear the mask until the doctor comes in. I was like, okay.
So the doctor came in, did all these tests on me while I was wearing a mask, even though I explained that I was nowhere near Ebola. But they were scared because they didn’t know what I had. Well, after I think this is like the third time I’d seen a doctor, I was like, can you just draw blood? Maybe there’s something in my blood. Well, they drew my blood, and everything was normal except for my eosinophils. I’d never heard of eosinophils; I didn’t know what they were, but there’s something related to white blood cells, and they said, ooh, these are high. It could be a lot of different things that are caused by it, but we should come back and check that in a week.
So I came back a week later, checked my eosinophils, and they were even higher. So the doctor said, well, it still could be a lot of different things; we don’t know what it is, but it’s probably not serious. Let’s give it one more week, come back, we’ll test your blood again, but it’s possible you have some sort of parasitic problem. It could be some parasites from Africa. So they did stool tests; they did all these. And by the way, I’m paying co-pays on all this, and I had Obamacare insurance. These doctors are charging an arm and a leg for each one of these visits.
Oh, they also—I forgot—they referred me to an ear, nose, and throat doctor so they could look down my throat. So they put a camera down me, and the doctor said, yeah, you actually do have some inflammation down there, but we don’t know what’s causing it. I was like, yeah, that was hundreds of dollars paid by my insurance—maybe eight, I don’t know, eight hundred dollars, something like that. I had to pay a $100 copay, something like that. So this is actually very expensive. This is now all that I’ve paid in medical expenses so far for this unknown problem, totaled the whole cost of my trip to Kenya because it wasn’t very expensive to go there. I got a cheap ticket, and we were mostly living with friends, and the food was not expensive, and we always traveled around by like the cheapest way. We traveled in like these vans that all the Africans use to get around Kenya.
So now it’s like this is becoming expensive and frustrating because they’re not finding anything. Well, I looked up eosinophils, throat problems, rash, high fever, headaches, and then I put in Kenya, and this thing called schistosomiasis came up. It’s a parasite; it lives in tropical waters, and it burrows in through your feet. It goes into your bloodstream, and then it goes into your liver, and it lives in your liver. All those symptoms could be explained by schistosomiasis. Now, for people that have it a long time, you can go blind; you can die. I was like, this is really serious. This is like something that could kill me, and it’s also extremely common in Kenya, and it’s very common in the waters of Lake Victoria. It comes through people, and then the people either pee or poo it out, and then it goes back into the water supply, and then it creates this larvae that lives in snails for a while, and then it hatches, and then it goes back into people, and it burrows through your feet. And I thought, oh my god, I think this is what I have.
So I went back and talked to my primary care doctor. I said, I think I have schistosomiasis. Can you give me a test for schistosomiasis? And the doctor was like, that’s beyond my ability to do anything about, but I think we should wait and just do wait until the result comes back from your tests with your eosinophils. I said, how about you just refer me to a tropical disease doctor? And he’s like, okay. So finally, he did that. I did a lot of research online, and I found a good tropical disease doctor on the Upper East Side at Mount Sinai. I went up there, paid, paid, paid all the co-pays, but I went and saw the tropical disease doctor, sat down, explained my story, explained my symptoms, and then I said to the tropical disease doctor—this guy was about my age—I said, you know, I think I have schistosomiasis. I’ve looked it up. He goes, yeah, pretty sure you have cysts. Oh, that’s simple. He’s like, well, we’ve got a really simple test for it, but I’m almost convinced you have it. So let me prescribe you the pills. They might be a little expensive with the copay; I think it cost me $92, the copay for the pills. He said it’s just two doses: you take one, and then you take one either a week or two weeks later. And he said, but I’ll get your results back by email; I’ll let you know.
It’ll just take a few days. If you do have it, just take the first dose of the pill, and then that’ll knock it out. And then the second dose will kill anything that’s left in you. He said it’s pretty simple.
So the test came back. Yeah, you do have cysts. Oh, really? Simple. So I had Chesto, took the pills. Oh, I felt like a drunk, like liquid metal. I felt horrible. Took the second dose, felt so ill, but all my symptoms were gone after that. I’ve got totally felt fine, felt totally well.
What was interesting, I started studying Sisto, and I realized there was a foundation. I believe it was somehow related to Jimmy Carter. But they go, sometimes whole villages are like 50 percent of the people in the villages all have schistosomiasis. So they’ll treat the entire village with this pill, and it’s been made since the 1970s.
So I was like, oh my god, that must be incredibly expensive until I realized, well actually in Kenya, you can get this pill for not a thousand dollars a dose, because that’s what my health insurance paid for. They paid a thousand. Oh, they paid $900, and I paid $92. That was more or less a thousand dollars for a dose of that medicine. 20 cents a dose in Africa, same exact medication, no different.
And I thought, wait a second, 20 cents a dose, and in America my insurance and I combined had to pay $1,000. So for the price that I paid for my treatment for schistosomiasis in Africa, you can treat five thousand people. And I thought, you know, I’m so glad that I got the treatment for it. Glad that I had health insurance also. But what is wrong with our healthcare system that you can treat in Africa with the same drug 5,000 people, and it’s not subsidized in Africa, by the way? That pill is not subsidized. It’s not expensive. It’s very simple and easy to produce, very cheap to produce. It’s that there’s major, major price inflation going on here. It’s all profit, profit, profit, profit.
So I thought, what if I hadn’t had health insurance? Well, you know, if I hadn’t had health insurance, the cheapest, smartest thing for me to do just been to flown back to Kenya, get another $500 ticket back to Kenya, go to any hospital there, describe my symptoms. They’d say, oh, you have schist. Oh, give the 20 cents for the pill, take it, and I could have had another vacation in Africa and gone around and seen. I probably could have gone into Tanzania and Uganda this time – and had a great time and learned about two new African countries, all for the price of just that pill in America.
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