Slim

“We get there, and who the hell cares how.”

… was a saying of one of my teenage whodunnit heroes, Peter Cheney’s Irish sleuth Slim Callaghan. It became a mantra throughout the years I spent in the quest to get cataracts removed by SA public health.

This is my health care story. It is a rear view mirror at what passed for my life long health care strategy. Once I was out of the corporate world (not by choice) I knew I was lost to the world of ‘sick notes’ and medical aid forever. I knew I could not afford doctors, nor could a I afford public health care. I could not afford private doctors, and I could not afford the time for public health care. Public health care can be summed up a “wait half a day to tell a doctor you have flu”. That half day skull had dangerous text stencilled in capitals across its forehead:

“Missed income”.

My strategy was truly simple:

Stay out of hospital, avoid doctors at (literally) all cost, until 65. After that, health care is free.

It worked well until in my sixties. For forty years, from twenty to sixty, I hardly saw a doctor. Then, inflammation hit. I am sure boozing had a lot to do with that. Most of my adult years were lived through apartheid, and apartheid frankly drove me nuts. Dr Ike Kumalo can say “apartheid was better” all he likes, but to me he is merely childishly seeking attention. He can’t be serious. It may be true that the current dispensation is utterly useless, but at least it is our collective fault. We all have to fix it.

I was not alone, boozing apartheid away. I almost equate the struggles: booze and aparthied were “equi-struggle”. Many of us overdid booze for years, only to found we miraculously dried up once apartheid was booted into history. Having said that, I had periods of up to eight years throughout my life during which I never imbibed. I would say it averaged out 50-50, booze years vs dry years. Maybe in the end, we just outgrew booze.

For me, there was another unwritten law:

Musicians can’t get sick.

Not in small bands. In big bands or orchestras, where reading was the thing, it didn’t matter. We simply booked a ‘dep’ (sometime to deputise for us). S/he was a functionary, just had to read, play and leave. Jazz is like that, too. The mantra is “we all know what we are doing”.

But in a small, rehearsed, non-reading band (which became the norm for many years), It was not about that. I have been in bands that rehearse a single phrase ten times. To a jazzer, that is crazy: just get the damn thing right. In these small bands, “depping” was very challenging. You might get a few chords scrawled on a crumpled piece of paper, if you were lucky. But, since a lot of this work was ‘covering’ music heard on the radio, most deps had learnt a song - somewhat. Still, Working in a four piece can get special, and it can be hard for another to fit in.

So, if you could stand, you climbed onstage. In a half century of performing, I lost a single solitary performance to sickness. That one time “If you can stand” did not apply. If I could have, I would have, but I had “taken the count”. The other thing was, if you don’t get up there, you don’t get paid. It’s a dead simple system.

Booze and Medicine

It took a lot of booze to harm me, and tiny bits of medicine to half kill me. A grain sized pill can fell a big man. It takes half a bottle of whiskey or more to do the same. A quarter of a century ago, or more, a doctor asked “Can you remember what you drank yesterday?” “Yes, a six pack of beer, two bottles of red wine, and half a bottle of whiskey” I rapped promptly back. “And, the day before yesterday?”. I rapped out “the same”. She quietened a little, and prompted “and the day before that?”. I said “No, that was different: a six pack, a bottle of red, a bottle of white, and three quarters of a bottle of whiskey”.

She stared at me silently for a while. Then (sternly or sadly, I was not quite sure), she said:

“You are going to die.”

it worked. I went home, passed the ‘boozerie’ without a glance, and forgot booze. Cold turkey. It was one of the easiest things I ever did. It was just so sensible. Habits are weird. I could never really work out why or how I came to be such an overboard “steady consumer”. It just creeps up. I didn’t think about it. If Dr Pippa McDonald had not issued her rather solemn prognosis, I would never have kicked it.

I did not, entirely. I became an Occasional Drinker. The Occasions could be birthdays, public holidays. They dwindled down to Christmas, New Year and Easter, and then stopped altoghether. I don’t even remember when. Life has been better since I did, except for … medicine.

The Percentages

In the same way that I averaged 50-50 in drinking vs dry days, so have I had around 50% success from each of private and public health care. If I have to score my health care experiences as good vs botched, this is how it looks:

Private

Public

The Score

As you can see from the tables, the quality of experience with both private and public health has been varied. Part Two goes into how I rated.

Shoutouts

Small town and rural clinics win hands down cheerful care. The experience is overwhelmingly positive, willing and caring. Villages can do only so much, no matter whether one goes private or public, and clinics are almost medicine-only. There are ‘doctor days’ but stitches fractures and serious illness gets one sent to a bigger centre. I have really fond memories of care received in Touwsranten (Hoekwil) and Sedgefield, where I am now. As for hospitals, I imagine George Hospital is as good as they get.

Helen Joseph Hospital is huge, tatty, old a little dingy, and it is a mystery how it even functions. Ghandi was rumoured to have said

Good systems are not enough. You need good people, too.

Helen Joseph does deserve some sort of shoutout. It appears to me overwhelmingly rudderless, completely lacking in visible authority or manangement, and you can cut the doctor-nurse atmosphere with a knife. They hate one another.

It is a massive building, and for all its faults, it keeps running, and the surgery I had, even though it took them two attempts, returned most quality of life. The hospital looked like my scary “Patient O’Higgins’s Last Op” fears on admission were justified, but I survived and have flourished. Admittedly it was Tough Love. But talent must lurk there, or it crash. Their computer recording is vestigial, the place has hundreds of PCs in throughout, spotless but unused. The food for some of my stay was truly tragic until that caterer (a definite ‘bakkie brigade’ apointee) was fired.

By contrast, the so-called District Six Community Day Clinic in Cape Town was literally a waste of time. After spending from 07h30 until 17h30 there I remained untreated, unseen, and was turfed out by a cleaner, who kindly suggested “maybe come tomorrow”. Earlier, after I arrived there, a man who proudly identified as ‘I’m a Coloured’, told me even more proudly

’not only whites got systems. We got systems too.’

He was right. They had systems, but theirs were boneheadedly stupid. An old saying comes to mind:

It is better to be thought a fool, than to open your mouth and remove all doubt.