(The new consolidated Army-Navy complex at Bethesda, home of the Walter Reed National Military Medical Center. The iconic tower where Secretary of Defense James V Forestal attempted to fly in in the center. US Government rendering.)

Ya know, I actually had an appointment with an orthopod Doc here in Arlington for yesterday- Sheila the nice lady at Commonwealth Orthopedics got it for me, but I had to cancel when I could not get a referral from my medical insurance people.

The Doc was available, and right down the road. They told me to get the piece of paper and they would be happy to see me.

Well, that led straight into the looking glass world. I tried to get a referral out of TriCare Prime, the contractor who won the contract to supervise military health care for the North East region, but no dice. They told me to contact my Primary Care Physician. I vaguely recall having got a letter about that very matter, and I think there was an actual active duty doc on the Bethesda campus who got tagged with ministering to my health needs.

I think the letter is in a folder at the office. I was not in a position to get there and find out who that might be, so I called Walter Reed (the new name for the consolidated campus at Bethesda now that the venerable Army facility is closed). The nice lady on the phone said they had absolutely no idea who “my” physician might be, so, I was left with a short list of options: either pay out of pocket for 100% or go to the place to which I had been assigned for care.

I steeled myself to go to the Bethesda ER yesterday morning. I rose early and tottered to the computer to rail about young Frenchmen of the Radical Islamic persuasion, and then headed out into the world.

It was an exciting walk down the corridor to the elevator, across the ice-slick marble of the foyer Big Pink, and over some ominously tall curbs to get to the Bluesmobile. Once I had scrunched myself into the car, I was as powerful (or more so) than my fellow motorists, and rush hour traffic was- well- rush hour on the Beltway. But not bad.

I missed the big security exercise on the sprawling campus, which has metamorphosed into a mega facility with dozens of new buildings with the consolidation of Army and Navy medical resources in the capital. Across the road is a Metro stop and the National Institutes of Health, center of gravity for all Government medical research.

It is impressive.

I got through the gate and motored around the campus. Emergency Services was located just where it used to be, though, and dismounting from the Police Car went as well as could be expected.

I was prepared to bitch my way through the whole process, but the ER on a Wednesday morning, 0800, was silent, with me being the first customer. No day laborers or long-suffering and status-ambivalent families waiting for basic health services. It still took a long time- I suspect they are not 100% manned during the hours in mid-week when people are not doing unsafe things.

In Room Two, I received periodic visits from a Corpsman, a couple Navy Nurses, commissioned officers, and my several devices beeped and chirped to keep me connected to the external world.

The Corpsman had some spectacular ink on his left arm- a Caduceus with an improbably bright red rose- and he took me on periodic excursions.

While I was being wheeled around, I saw a lovely young lady in a headscarf with deep set dark eyes in a wheelchair, waiting for her turn with the X-ray machine. She was emaciated. Cancer, I thought, or something nasty, and so young. Her young husband, a massive healthy young man, pushed her chair stoically. I was wheeled past as she took off her robe to go into the room with the big machine. She wore no bra under her think t-shirt and her chest was sunken around the pinpoints of her nipples. She made me very sad, that this should happen to someone so young and so pretty.

In the end, the very attractive dark-eyed Resident Army Physician reported that the X-rays did not indicate fracture. “That is good,” she said, and I agreed.

I waited quietly for another couple hours until she came back to inform me the subsequent review by the orthopods was complete. They can ship the Xrays around the hospital digitally these days, a cool feature, and their opinion was that surgery was not indicated. This was the same department who scoped the same knee years ago, to mixed results, so the news was good.

The Lieutenant came in to give me the discharge package, which contained a referral to the physical therapy clinic, now filled up with digital camouflage, both deep blue and desert sand versions. The Doc said: “get there early, since parking and participation are better before 0730.”

I thanked her- sincerely- for her service, and asked the Doc how I was supposed to walk from General Patient Parking, about a mile from the clinic, since that is what the problem is, and really, the reason I had not visited the campus before. We agreed there are mysteries that best left to the people who have to deal with BRAC-05 consolidation issues rather than semi-ambulatory retirees.

I was feeling pretty good when I got home, though highly stressed. I napped for a while and woke long enough to clear the office e-mail stream and called my son to ask for help over the weekend to clear some of the wreckage I cannot currently manage. The call went to voicemail, but he returned it on the way home.

I was propped in an unlikely position in my comfy brown chair, leg up. The phone was across the room, of course, and in the course of scrambling to answer, felt the knee go slightly past the maximum load-bearing point and went down for the 4th time.

Bright white light of pain in two parts: the first being the collapse, and then the impact on the rug. Lying on the floor, I looked at the sharp edges on the brass footstool in front of my chair, and contemplated what that might feel like impacting my temple.

Isn’t that how the famous actor William Holden went to the afterlife? Crap, I have to child-proof the house, I thought. Something to work on later, I reasoned, if I could get back up.

Two steps forward, one back.

i assume this will get better. Certainly hope so.

I was prepared to be mad with military medicine, but it actually was good care and the people who delivered it were responsive and professional. There just are not enough resources or professionals to make it fast or convenient.

But it is what it is. Walter Reed is a military microcosm of the larger health care system. We are all going to have to get used to that.

Copyright 2012 Vic Socotra
www.vicsocotra.com