First Things Last, or Running Up the Bill in the Shark Tank
	On 9 November 2020 I went to Northwestern Urgent Care in Evanston, Illinois, regarding constipation. I am a traveler, and travelers frequently suffer constipation. I paid 250 USD for an approximate 10-minute conversation with a technician who referred me to Northshore Hospital ER, also in Evanston. He said Urgent Care was not equipped to handle my ailment. Naturally, I began to wonder what they were equipped to handle if not constipation. A runny nose? Chapped lips? Bad breath? At Northshore I was met by a team of doctors and medical technicians who, rather than administer an enema for relief of constipation, proceeded with myriad tests, including a CT scan and a chest x-rays! (See detail below.) Their thoroughness paid off. Northshore ER ran up a bill of 9,233 USD. I was never apprised of costs or need to perform any of these procedures. While I am happy to say I survived them—I am a fairly hardy person—I am uncertain about surviving their financial impact! And while I fear the covid virus, I also fear the bill collector, who looks a lot like those robbed doctors with goat-bladder masks stuffed with straw and herbs who lanced buboes during the bubonic plague. After waiting some three hours thinly robed in a chilly hospital bed in ER while various tests were performed, I begged for the enema to be administered and, begrudgingly, it was done. It is of course what I came in for. My pulse, my blood pressure, my temperature, my lungs, all the internal organs revealed by the CT scan ... were fine. I guess the problem was this: doing the enema would end the whole show and billing would stop. For some reason, however, billing does not include listing the enema! Was it so far down on the hospital to-do list that it was forgotten? The most expensive items are the CT scan at 4,314 USD and the "ER Gen Classification" at 3,018 USD. The latter now makes me wonder: Does being classified now have a price? If not "classified," am I cheaper? What do you think, Orwell? From hospital records, here are the details: Emergency Dept Visit,l evel Iv - 99284 (CPT®) $319.00 Ct Abd & Pelvis; W/ Contrast - 74177 (CPT®) $298.00 X-ray Chest Single View - 71045 (CPT®) $30.00 URINALYSIS, AUTO, W/O SCOPE - 81003 (CPT®) $9.00 Hepatic Function Panel - 80076 (CPT®) $20.00 Auto Hemogram/plate/diff - 85025 (CPT®) $20.00 Metabolic Panel,basic Office Performed - 80048 (CPT®) $22.00 Assay Lipase - 83690 (CPT®) $16.00 Urine Culture, Colony Count - 87086 (CPT®) $16.00 RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION $339.00 CT SCAN - GENERAL CLASSIFICATION $4,314.00 EMERGENCY ROOM - GENERAL CLASSIFICATION $3,018.00 DRUGS REQUIRING SPECIFIC IDENTIFICATION - GENERAL $95.00 I finally screwed up my courage and insisted on leaving the hospital before other procedures were performed; I feared for my economic survival. Note: There was also an issue of not being able to pass urine, but that is often associated with constipation. Once the constipation is relieved, you are able to pass urine. But this baffles me: catheterization was performed before the enema was administered. There seemed to be a principle of "first things last" throughout this visit to ER. To state the obvious, I was being used to run up a very large bill; I was the ER "chump" Evanston. I might have better gone down to Walgreens on Chicago Avenue for a 3.99 USD enema kit. I have since done so for any future episodes. A few years back, with the same problem, I went to an NHS clinic in London and was out the door in a half hour cured—and with no charge! (This was before the American president Donald J. Trump shot off his mouth about what a "disaster" UK's NHS is, with the result that the UK added modest charges for Americans!) Similarly, some years ago in China I went to Shanghai International Medical Center and was treated there for under 200-hundred USD. As I said earlier, I am a frequent traveler; and travelers often face constipation issues because of diet, unavailability of restrooms, and so on! Seeking help in the USA, or Richard Sanderell's monster "Oo-Suh," for a fairly mild ailment, had I gone swimming in the shark tank? So it seemed. I am currently in Cherry Creek, Colorado, killing time while waiting to get out of Oo-Suh. But so far, no luck. Covid numbers are going up, not down, due to people who won't wear masks, won't maintain distance, always won't no matter what ... Today I was going shopping, walking down S. Colorado Street in Cherry Creek, when I came upon an "Urgent Care" facility. I had a panic attack. They were also offering covid testing. But not enemas or constipation counseling. I pulled myself together and crossed the street to King Sooper for a non-organic Kroger salad, pale, mealy tomatoes, and Oreo cookies. I think I will survive. Urgent Care, desperate people, Trump-19, utter despair. Why do this words go so well together? You figure it out while doing time in lockdown during the holidays. Cheery cheers from Cherry Creek!
	By Louis Martin