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Why it isn't working · 25 July 05
It’s getting fairly close. I enjoy life over here. There are many pleasures that I did not have in the UK. I have found good friends, and a lifestyle that I enjoy. But it still isn’t working – it still isn’t right.
One thing keeps pulling me up. Everytime I ‘fail’ in american society, it boils down to one thing – I am not demanding enough. The question is – do I want to learn to be that demanding?
So yes, I have failed again. I didn’t walk into the ER and demand that they X-ray my jaw. To most other people, what I have just been through would constitute a fair comparison of the british/american health systems. I realise that this isn’t so.
I guess this is one of those obvious demonstrations. Systems work for the people who are meant to be in them. The american system didn’t work for me, but this is because I didn’t play it the way it is meant to be played.
My trip to the dentist is a demonstration of what I mean. I walked into the office and explained that I hadn’t seen a dentist in the US yet, but I’d had an accident, so could I join their practice and make an appointment please. The woman looked politely interested and vaguely concerned, and started looking through their appointment book. How about 4 weeks time, she suggested – we like to spend extra time with our new patients.
To me this was mindboggling. To expect me to wait 4 weeks when I had indicated the emergency of my situation? So I turned round to her and said – I have teeth that are cutting up my mouth, any chance of anything sooner? Oh, she said, would you like an emergency appointment then?!? How about next Tuesday?
The same principle held true for my visit to the ER, but I didn’t realise that in time. I had something very obvious wrong with me – a gaping wound in my jaw. However, several times I mentioned the severe pain in one side of my jaw. At first this was just ignored, but as it escalated and I pointed it out a few more times, I was offered painkillers. And yes, this fixed it – for then. 3 days later, it is pretty clear that my jaw is dislocated. I still can’t open my mouth over half an inch, move my mouth sideways or bring my teeth together – let alone eat food. To me it is mindboggling that they didn’t X-ray my mouth when I told them about the pain, or even just feel my jaw. But my roommate keeps pointing out that I didn’t ask them to.
Now for the comparison. I cannot, with total confidence, say that the British health system would have gone as far as identifying my dislocated jaw. However, what I can say is that I could now just go and walk straight back into casualty, and get it dealt with. So, the system would have worked for me, the initially undemanding person. However, if I do that here, it will cost me another round of co-pays. So I don’t know where to go. My doctor will take a few days to give me an appointment, then all I will get will be a referral. Who will I go to and how long will it take? I have no idea. Because I don’t know how to play this system…
An american wouldn’t have walked in there and expected to get fixed up. They would have walked in there and told the people how to fix them up. They would have demanded the plastic surgeon, the X-ray, all the things that they needed. And it would have worked.