Day 09 – Simplicity vs. clarity, Part 1

Marie and I spent much of today doing paperwork and calling doctors and labs to arrange for two of the tests still needed to get the “baseline data” about the cancer.

After redoing one form, then making a redo phone call, I said, “Wow!  How complex this process is when you need data beyond what you can get with a stethoscope and an x-ray!”

We were experiencing our health care system at its best, and its worst.  Best, because we have yet to encounter a person who is ill-tempered or seems not to care, or doesn’t seem to know what’s going on.  Worst, because of the myriad of forms needed for referral, authorization, privacy protection, verification, and etc.  Making phone calls to connect doctors with labs, labs with the insurance company, and waiting for return calls and following up to see if it was done.  One doctor we called is in our insurance network but the hospital where he would do the test is not.   Try another doctor, another hospital.  Fragmented elements of a system leave many dots to be connected, and by me the patient — at least at this point.

Getting in line for services requires me to speak up.  For example, after looking at some test reports faxed to a doctor’s office, the receptionist said to me on the phone, “Thank you for the test results.  Dr. ___ will look at the results and determine how serious it is before he schedules your test at the hospital.”

I replied, “May I vote for how serious it is?  Last week I was diagnosed with esophageal cancer and my oncologist and surgeon are both waiting for this test before they proceed with treatment for me.  I vote for this as serious!”

She heard me, “I’ll certainly note that on your records, Norm!”

Marie and I both commented on the purpose of Dr. Oz’s book, “You, The Smart Patient” to encourage us to take effective control of our health care.  Great idea, Dr. Oz, but it’s so complex with ailments like I have!  My personal file folder, to keep track of all this, has expanded to an inch thick, after only one week.

Medical care was much simpler back in 1918, in eastern Idaho, when my Grandpa William Wood was treated for stomach cancer, the year he died at age 44.  I don’t know anything about the kind of treatment he received, nor does my dad, who was only 3 years old when his own dad passed away.  But, I’m certain that his doctors didn’t have access to an endoscopy unit to put down his throat, one with a micro-sized Olympus digital camera at the end. I’m very sure they couldn’t see grandpa’s stomach in living color on a monitor, and then get an instant printout of it.  Neither was the kind of chemotherapy we have now available.  Simple techniques that were available during World War I didn’t help Grandpa.

One of Oliver Wendell Holmes’ most famous quotes says something like this (at least this version of it)…

“I would not give a fig for the simplicity on this side of complexity, but I would give my life for the simplicity on the other side of complexity.”

But simple vs. complex isn’t the real issue for me — clarifying my current complexity is the issue.

“The most important goal of effective communication is clarity. Clarity is not the same as simplicity.  Complexity can be made to appear clear by effective organization and presentation and need not be reduced to meaningless ‘bite-sized’ chunks of data, as simplification usually does. Clarity refers to the focus on one particular message or goal at a time, rather than attempting to accomplish too much at once. Simplicity is often responsible for the ‘dumbing’ of information rather than the illumination of it.”

– Michael Hoffman

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I realize that as I proceed with treatment, my life will soon become more complex, but I won’t give a fig, or my life, for the easy drug of simplicity.   I will try my best to illuminate and clarify complex information, rather than be comforted by near-side simplicity.  I’ll work through it, with the help of others, on the far side.  In the end I’m grateful that this is not my Grandpa’s medicine.