Adventures in Phlebotomy

Every three months, I need to get my blood drawn, to make sure I’m taking the right amount of thyroid medication. My doctor doesn’t do labwork in his office, so I usually go down the street from me, to a little lab on Fifth, over a toy store full of spaldeens and those dollar squirt guns that break as soon as you get them home, and down the hall from someone’s business office. The people in the office have put up a sign that reads, “NO. THIS IS NOT THE LAB.” You can feel their annoyance leaching into the ancient, grubby, hardware store tiles on the floor. Generally, the people who work in the lab also seem perpetually irritated and defeated. I blame fluorescent lighting.

Today, however, I had the friendliest tech I’ve ever met at the lab. She didn’t have a name tag, and it’s not customary to introduce yourself before you let someone drive a needle into your arm and siphon out three or four tubes of blood. That’s weird, isn’t it? Anyway, I’ll call her the Tech.

The Tech smiled when I produced every form of ID, my insurance card, and my credit card immediately. I’m very nervous at the lab, always, and generally eager to show people that I’m a straight-A student. It’s one of my most unsettling qualities — that, and playing with my hair constantly.

She typed in my info, and made copies of things, and then she handed me a form to sign. At the top, it said:

Dear Patient,

Your insurance company will be billed for applicable charges for today’s service. By signing this form, you agree that any remaining balance due as the patient’s responsibility will be charged to your credit card. Should there be any remaining balance after your credit card is charged, [the lab] will bill you and you will be responsible for paying these remaining charges.

The agreed maximum amount to be charged to your credit card for [lab’s] services today for the above-referenced requisition number is:

$1,712.00

I must’ve made a face, because she said, somewhat apologetically, “That’s what we’re charging your insurance.”

“Jesus!” I said. “Sorry. But I’m really glad I have insurance.”

She nodded. “Can you imagine? And you know, a lot of people don’t.”

“Through no fault of their own,” I agreed, warming to my favorite topic.

“Imagine paying that whole thing, though, yourself.” She motioned for me to come around the desk to the patient rooms, where rows of leather seats with one extended arm each were separated by curtains.

“It’s expensive. But then, so’s health insurance. I pay for my own, and it’s a lot.”

She wrapped a rubber tourniquet around my arm. It popped off once, and she grabbed it with gloved hands and made a secure knot. At this point in the blood collection, I always want to bolt. It feels very wrong to just let someone tie off your limbs like that, as if there were a medical procedure where you agreed to let someone put you in a tiny box and lock the lid for awhile.

“Oh, you do pay for it yourself? How much do you pay?”

I told her, and she looked at me in honest shock. “Is that just for you?” she asked, swabbing off my arm with alcohol. I always give them my left arm, because it’s got my only decent vein. You can tell, because it’s got one little scar where the needle always goes in at the lab. Hubleys have small, roll-y veins. “Or for you and your husband?”

“It’s my medical and both of our dental.”

“But see, if you didn’t pay that, you could save that money every month,” she said, sliding the needle in so I barely felt it. “You’d have thousands of dollars at the end of the year. You have to think about whether it’s worth it.”

“But if I didn’t have it, I’d be giving you $1,712 dollars right this minute. It adds up. The second you don’t have insurance is when you get into an accident.” I tried not to look at my arm. It always makes me dizzy to see the blood go, and then I have the urge to be like, Hey, that’s mine! Give it back! and run out of the lab, clutching the tubes to my chest.

“Don’t I know it,” she said. “My husband needs prostate surgery, but I have to tell him we can’t do it. I can’t put him on my insurance right now, and it’s $60,000 for that surgery.”

I felt a record scratch. This was not a theoretical conversation anymore. She gently uncurled my hand a little, so the blood would flow into the tube more easily, and held it open so I couldn’t make a nervous fist.

“You know, when Obama became president,” she went on. “Everyone said he would fix it. And maybe he has fixed it. I don’t know. I’m waiting to see. But I tell everyone, none of these people care about you or know about you. I’m not holding my breath, either way.”

I actually do think Obama cares about people. I think it’s the major difference between him and Mitt Romney. But I didn’t think it was time for my pitch. How do you tell a person whose husband can’t have surgery that they should just trust the president? You don’t.

“Well,” I said. “I can see that. It is true that no one making these decisions has ever had a conversation like the one we’re having right now.”

“That’s true,” she said. “But on the other hand, if you can afford to pay that in insurance every month, you are rich!”

She didn’t say it meanly at all, but I felt, for a minute, like I’d driven up to claim my food stamps in a Mercedes, while people outside begged for change. I laughed nervously and said something like, “Right?” Which was the wrong thing to say.

“OK, my dear, you’re done.” She put a Band-Aid over the gauze on my arm. I could already tell it wouldn’t bruise. “Take care of yourself.”

She sounded like she meant it. I said thank you, you too, and left, feeling like I should say something about her husband, but not knowing what.

On the street, outside the cheap toy store, an ageless hippie with shiny graying hair smiled at me with saucer eyes and said, “Good morning! It’s a great day!” I smiled back, and scurried along, before she could recruit me to her cause, whatever it might be.