Drama Fiction

 I know I had to be fired, Mr. Dues, but did he have to call the cops?

Yeah, yeah, still not sorry. How do I want to plead? Aren’t you the lawyer? Tell the judge...I don’t know. A reaction from the third vaccine affected my mental state. Better, call it an act of civil disobedience. Besides, I didn’t really hurt him. Gadget's lucky I didn’t have a Louisville slugger. Crybaby.

Well, I guess you want to hear the story. So, relax as best you can in here. Got a cigarette by any chance? I didn’t use to smoke trust me. But 2021 isn’t shaping up to be any better than ‘20 and memes only get you so far. It is? Who ever heard of a jail being smoke-free?

What’s this damn world coming to? Never mind that’ll take more time to answer than you and me got.

Yeah, I’m a brace-maker and prosthetist. Blood pressure through the roof but that’s healthcare for you. So, there I was at work, arguing with this old soldier. Because of HIPAA, we’ll call him Jake. He wanted a new prosthesis. That’s not an unreasonable request, you might say. They wear out. Over time, the patient’s residual limb shrinks so the leg doesn’t fit right anymore. Sensible right? Go tell it to the government.

The problem was his artificial leg was less than three years old. And I was the one that had to explain that to him. We could replace the socket-the part that fits around his residual limb. It was loose so that made sense. But the knee and foot functioned well and had to stay.

“So,” he said. “I saw this C-leg some guy’s playing sports with. Computerized knee. I want it.”

“And I want you to wear a mask correctly, but you don’t. I care about you, that’s all.”

“Damned things ‘bout as useless as Biden.”

If anything is useless, it’s arguing with people.

“About the knee.”

“It will cost us nineteen grand. We can’t take the risk it won’t be covered.”

“I was in the war,” he said. “Doesn’t that count for anything?”

“Not to your insurance.”

I knew he’d stayed stateside and trained the men at Parris Island. I’d heard it from his wife who comes in for her leg brace. We don’t know why they’re together but whatever. They come in separately. I think it’s so each can complain about the other. Anyway, the guy grabbed a handful of the candy my boss puts out. He probably doesn't need it, to be honest. It didn’t stop Jake though.

“Bastards,” he said.

 As if his amputation was war-related. It isn’t. In 1980 Jake took a dare to swim a canal at night. That would be fine except it was in some backwater ass town in Florida. In spring. During alligator mating season.

I assume he wasn’t sober at the time.

 His wife said he tells everyone at the local bar he stepped on a landmine.

No, sir, our patients don’t always do sensible things. Your clients too? Yeah, I know the feeling. Truthfully, I feel sorry for the guy. First of all, I’d lie too if I were him. And I can’t blame him for wanting a better, more natural leg. Patients see this high-tech stuff and they want it. My kid wants it, and he has strong limbs. Everyone shows me the wonderful advancements in prosthetics and my answer is: show me the real miracle. An insurance company that pays for it. Especially in our state. As usual, they kill the messenger.

“You got to get stronger,” I said. “You need to be fairly athletic to justify this thing. And there’s a reason you need to be that way. The weight of those components will tire you out. It will be hard for you to swing the prosthesis when you’re walking. You need to know the disadvantages. And there are plenty of them.”  

“Maybe if I had it I could dump this scooter.”

Which he got his insurance to pay for. A mistake because now they’ll question his strength and potential to use such a prosthesis. And who expects the layman to understand this stuff? I still wanted to hit him with the candy bowl. Shame it’s plastic.

Hey, you wanted me to tell the truth and I am. I have a love-hate relationship with my job, and this is the hate part. Anyway, Jake said, “I play basketball all the time.”

“E-sports don’t count,” I replied.

His eyes widened. “How do you know about that?”

“Your son told me. Look, here’s the reality. We’re getting killed on these audits. They could come back years later and ask for doctor’s clinicals, therapy notes, letters of medical necessity and God knows what else. If we don’t have the proper notes from the doctor and God that justifies a C-leg, they take our money back. Now if you want to sign an ABN-“

“I can’t afford to pay if they deny the prosthesis,” he said, slyly dropping his candy wrapper on my floor. “I’m not signing a financial form.’

“Well then, you can try the VA and get us a work order for what you’d like. But it’s too soon for your insurance to pay for a complete prosthesis. A socket replacement, yes. The rest, no.”

He stood and got into his scooter to leave. As I opened the door, he shouted back at me, "You got a signed baseball mitt from Babe Ruth, but you can’t afford to help a veteran out.”

“Yeah, you have a nice day too.” I turned back into the room to see he had swiped all our candy. I walked back out and stared at the baseball mitt. Some patient had given it to my boss and John had framed it. I shook my head, got the Clorox, and cleaned the room as instructed by the CDC. After, I opened up a letter from Suma insurance. It was over a kid that had a very bad start on life.

You tell me. What the fuck kind of rat bastard shakes a newborn?

That asshole should be-well never mind.

 Now she had something like Cerebral Palsy and autism. Means she needs braces to control her spasms and to walk halfway normal. Grandparents have custody and Grandma can barely walk herself. They’re probably living in subsidized housing if they’re lucky. And here was Suma auditing us over her leg braces for the love of God.

That’s assuming He exists. Sometimes I wonder.

The next patient came in. He was a young man who had been shot by a crazed girlfriend of all things. She's in prison and he's paralyzed on one side. Also, he didn’t believe in vaccines. Not that it bothers me, but I don’t want him to get sick.

Fine, it bothers me. He’s a good person that don’t deserve that.

Anyway, we had made him a long-leg brace with carbon fiber uprights, aluminum knee joints, and a sick purple and black design on the thigh and calf portions. To be honest I thought it was a thing of beauty. Unfortunately, his mother had other ideas. “Does he really need this thing?”

I wanted to cry but that would be weird. Instead, I asked what was wrong.

“He’s going to have a hard time putting it on. And it looks heavy.”

Great. If the family isn’t on board the patient wouldn’t be either. I took a couple of deep breaths and reminded myself she was most likely scared. Who could blame her? If it was my kid I would be freaked out too.

Or in prison if the police didn’t get to the crazed girlfriend before I did. But that’s another story.

“Brian,” I said. “I set it up so it will be really easy. Here. First I’ll put it on you, then you do it.”

“It hurts,” he said.

Mom threw up her hands. "Just wonderful."

“Not a problem. Let me go fix it.”

He showed me where it rubbed, and I took it in the back room. I reminded myself Mom probably needed someone to be upset at and I was elected. Then, I ground out the spots I’d marked. Now my arms itched from fiber dust but whatever. Then I put the brace on Brian and told him try it out. As he walked, I videotaped with my phone, trying not to scratch my arms.

“Watch him walk.” I showed the video to Mom. “See how stable his knee is now? Compare it to how he walked before. Brian, what do you think?”

“It feels good now,” he said. Then he stood in the parallel bars and swayed his hips side to side. “I think I can dance.”

Mom started smiling. I did too.

“And this is why we made you a longer brace. So, you can be more active. We want to see you dance at your wedding someday, right?” I hoped I wasn’t sounding like a used car salesman. I needed them to look past the brace and see what it was allowing him to do.

“Thank you,” Mom said, and gave me a hug. I was just thinking maybe there was a God when my boss walked in. I told him about Jake.

“He’ll get over it. You need to get the charts ready for billing. Crystal’s coming Monday. I'm seeing the accountant now.”

And I deserve a bonus but don’t see that happening.

 Be thankful. You could be considered non-essential.

Still, must be nice to take off whenever.

Our receptionist always calls in sick, even before this plague. Unpaid but it’s still annoying. Whatever the problem, she needs to figure it out. I was doing paperwork when the school called.

“Alex’s sick.”

“Please tell me it's not Covid.”

“We don’t think so but he’s throwing up.”

Yes, I’m getting to the point. I know all about your billable hours trust me. But I got to tell this thing my own way, okay? Now back to my kid. “It’s probably that stupid ADHD medication again. Makes him sick sometimes. But I’ll be there as soon as I can.” I was just texting my boss when this bald guy came in. He was about five foot six. His shirt’s buttons were fighting a losing battle to stay fastened across his stomach. He handed me a badge and remarked I wasn’t wearing mine.

An insurance representative. Wonderful. I reached into my wallet and pulled out my badge. “I put it away,” I said. “Got to go get my kid, he’s sick.” I gave him what I hoped was a winning smile. “I’m the only parent left so…”

“I have to do an office inspection,” he said, from behind his N95 mask. I wondered where the hell he got that from. I sure can’t find one, not for gold.

I texted my boss. Please come. Insurance inspection..

Do, you’re kidding.

John meant to say Sue. Stupid voice text and he never checks the spelling. I wish I were.

At warehouse. Bee there surely. Shortly. Great. He was probably fabricating something. Shortly could mean an hour from now. Meanwhile, Inspector Gadget was checking his watch. He said, “I need liability insurance, your warranty for patients-“

“On the wall,” I said.

He listed off a bunch of other papers he needed plus five patient charts. I took the notebook where we keep that stuff and shoved it at him through the window. “Here, have at it.” He raised his eyebrows. “Christ sakes I said my kid was sick. I don’t care, get what you want from there and I’ll copy it for your records. Better yet, come back on Monday.”

“Sorry, you know the rules. It’s business hours so I can come. Where’s his father? Can’t he pick him up?”

I gripped the desk, leaned through the reception's window and said, through my clenched teeth, “If it’s any business of yours the man’s deceased. Now, let’s get on with this.”

“Sorry,” he mumbled, sounding as sincere as Melania Trump talking to the common folk. I picked five patient charts at random and handed them over. He was so slow I wondered if he actually read above third-grade level. The phone rang.

Habla español?” a weak, old woman’s voice asked.

Un poco.” Somehow I managed to get her an appointment. God only knows for what, but I’d figure it out come lunes. And while I dragged up all my college Spanglish Gadget stared at me. It was unnerving with those beady little shark eyes just drilling holes into-

No, I’m not exaggerating. Anyway, I hung up the phone and turned back to him. “What else do you need?”

“I have to see your inventory.”

I showed him. He said, “I don’t see any of these carbon fiber AFOs you’ve billed us for.” As he said it I swear he licked his lips.

“We haven’t ordered those leg braces recently. They’re quite expensive and with this being a pandemic you know we’re keeping costs down.”

My cell phone rang. The school. “You really need to get your son.” You lousy no-account mother. Your son’s sick and yet you leave him here.

“Damn it I’m on my way.” I hung up knowing that wouldn’t go down well. But I didn’t know what else to do. My boss wasn’t here yet and Mr. Stupid was in no hurry to leave. In fact, he was writing extensive notes on our cost saving measures to not stock a rotten brace we hardly ever used. He turned, walked into the bathroom, and looked back at me. “You don’t have CDC warnings about washing your hands up here.”

“Our patients wouldn’t read them-“

“Sorry, have to document that. And what’s this ugly blue vase in here?”

Did he just call that vase ugly?

“I put it there. It used to be my dear departed grandmother’s. The woman was a saint.”

“She had poor taste,” he said. “Plus, what’s up with the single-ply toilet paper?”

“While we’re at it do you know what’s in poor taste?” I walked right up to him. I had to look slightly up but I didn’t care. “You coming here in the middle of a goddamned pandemic. Are you even vaccinated, you idiot?”

“That’s none of your-”

“It’s also in poor taste that you pay a goddamn claim and then audit us two years later. And then take our money because the prescribing doctor doesn’t write the right details in an order or his notes. Like we’re supposed to police them. You know half the time they don’t know what they want?”

He just stared at me, his little beady eyes dilating. I pulled off my mask to make sure I breathed on him. Shame I was vaccinated myself.

“It’s not their job to know all the prosthetic or orthotic components and what will work best for which patient. That’s why they don’t document it. They leave it for us to decide. That’s my job. And yet you don’t care about our clinicals. We follow the rules, dot our i’s but it seems you deny us for no good reason.”

Gadget pulled himself up as tall as he could. I hoped he wouldn’t pop a button and hit me in the stomach. He said, “We’re trying to prevent fraud.”

“What? You think we’re committing fraud. Yeah, when my boss and I are both driving old cars with more mileage than the earth has. When my clothes are obviously from the local outlet mall.” I looked down at the glue on my pants and back at Gadget. “Are you serious with this shit? What the hell is wrong with you people?”

“First of all, I’m just doing my job. Maybe,” I swear he leered at me. “You should do yours and learn to document properly.”

I looked down at the mask I held. Smiled. I wrapped it around my hand, pivoted, and smashed the glass the catcher’s mitt was in. Gadget’s eyes went wide, and his mouth opened.

“What the hell you doing?"

“Sweet justice,” I said as I hit him with the mitt. It made a lovely wap noise upside his sweaty scalp. He cried out. I slid my hand inside the old, soft leather, said, “Shame I only have one of these,” and smacked him again. Gadget ran but I was quicker. I finally cornered him against a shelf and went to town. It was like I was destroying every audit, Covid, every damned time my kid went into quarantine, every patient complaint. I destroyed anything that made me cry these last two years. I didn’t stop until someone grabbed my arm.

“What the hell is going on?”

My boss. Great. Gadget was cowering, hands over his head. He made these uh uh sounds like a toddler just denied candy in a checkout line.

“Umm. Kinda lost it, I guess.” I explained what happened. My boss just rubbed his eyes.

“Look,” he said. “I get it. But did you have to use the mitt?”

I handed it over. “I’m pretty sure it’s fake anyway. Wasn’t Babe a lefty?”

John just stared at the mitt, shook his head, and turned towards Gadget. There was a strange light in his eyes. I said, “well I reckon I’m fired. Can you let me get my kid before you call the cops?”

“’Fraid I can’t let this go,” John said. “But sure. Take your time. I’m in no hurry.’

“You’re just letting her leave?" Gadget shouted. “I’m suing!”

It was the wrong thing to say.

“Shut up you fat prick,” John said, and he smacked the guy himself with the mitt. Then he grabbed the N95 mask and pulled it as far back as it would go. I heard the snap against Gadget’s face as I walked away. Cervantes wrote Don Quixote in prison supposedly, and Martin Luther King wrote Letters from a Birmingham jail. Maybe it would be my turn now. I smiled, and headed out.

September 03, 2021 02:48

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Michele Duess
03:06 Sep 03, 2021

Author's note: The patients in this story are all fictional, as is the story itself. Sadly, the audits, insurance problems, and the narrator's frustration is not. Still, there are healthcare workers who have it far worse, and take more risks than I do. This is for all of us in the field, especially the front line workers.


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Beth Connor
16:06 Sep 03, 2021

Great story (although I felt frustrated alongside the narrator the whole time!) You illustrated a struggle that is all too common. Thank you for doing what you do.


Michele Duess
03:07 Sep 05, 2021

Thank you. I'm glad you liked the story.


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