Bureaucracy

Yesterday I got tangled up in the idiocy of the American health care system. The orthopedist ordered an MRI of my shoulder to try to figure out what is floating loose in there, and also to look for a tear she suspects because of the weakness of that arm. That was Sept. 19th. We both knew that my insurance company was going to put up a fight, and she told me that she would handle the appeal. On Sept 30th came the expected denial. The next step is something called a peer-to-peer between my doctor and one working for the insurance company. They are not actually peers - doctors working for insurance companies don't have to have any actual experience taking care of patients, and they are also not specialists in the field being discussed. As my appointment on Oct 14th approached, my assistant began trying to find out if the peer-to-peer had happened and if I was approved to have the MRI but she could not reach anyone. Usually if you are scheduled for something and it is not approved, they will call and cancel. When I didn't get that call, I figured I should show up, although I was skeptical. When I got there, the receptionist was pissed that nobody had called me, and sent an email to somebody about it, and then told me that they will call me when it's approved. So my shoulder and I remain in limbo. When I got to the office, I found a new client waiting for us to open. Just as I was starting his intake, an avalanche of increasingly frantic messages came pouring in from JD, who is usually pretty level headed. I told him I was in an intake, and he told me to interrupt it, an unusual request that tipped me off that something was seriously wrong. I left the client in my office and stepped out to call JD. "This guy has been stalking L. for months because she wouldn't go out with him," he said. "So I told him to back off and now he's sending me all these messages about how he's going to rape and kill her." He forwarded me some screenshots of messages filled with gruesome, sadistic detail. "I can't warn her, she's at work and not answering the phone, and I can't reach NYC 911 from here in Connecticut. Can you call?" I called 911, and relayed JD's message. Then I had to get back to the client. "My family is from Jamaica," he told me. As soon as I heard that, my mind started to fill in the rest of the story. I once assisted a Jamaican asylum seeker who was living at Sylvia's Place, testifying at his immigration case because to claim asylum he had to "prove" he was gay. "Jamaicans are very homophobic," he continued. "My mother calls me a battyman," he says. I cut him off as he is starting to explain. "I know what it means," I tell him. "I needed to get away so I went to the University of Albany." I ask him what he studied, "developmental psychology," he tells me. "But I work as a medical secretary." He is back home, living with his mother and brother. His mother tried to get him to pay the full amount of a bill they had agreed to split and when he refused his brother butted into the conversation, and before he knew it, his brother attacked him physically, taking his phone when he tried to record the attack. He tried to flee up the stairs. but in the scuffle the railing gave way and he fell to the bottom of the stairs, injuring his back. Even as he lay there injured, his brother continued to attack him so he ran, without his phone or his ID. He had come to me looking for advice about where to go. At 24, he is too old for the LGBTQ youth programs, so I explain the process of getting into Marsha's, which requires going to the adult men's intake first, and tell him to send me his shelter ID # when he gets it so I can get him an interview at Marsha's. This system doesn't make much sense - Marsha's was created in recognition of the fact that queer people are not safe in the mainstream shelters, yet people have to start out at one of the unsafe mainstream shelters to get into Marsha's.