In an plot device usually only reserved sitcoms...and my life...the Universe once again played the ironic timing ploy.

Because I'm used to this I usually know how to handle these situations.

But this time, well, I was in way over my head. If I did the wrong thing it's too late to undo it. But I'm curious to know if I handled it okay or if I should have said or done something differently.

Okay, here goes.

I'm going to meander off course a minute. Okay a few minutes. Buildup to the sitcom plot device and rant about the medical community all that. You can skip ahead if you want to get to the ironic plot device in a sitcom part.

So, I'm having a health issue. It's been going on for over a year. I saw my doctor about it last year. This is no small thing considering I have no health insurance. Doctor appointments are not cheap. So in the last two years I have seen a doctor twice: Once for this issue and once when I broke my thumb. And, when I broke my thumb I was in Michigan and went to a walk-in clinic. So I've sought medical attention from my doctor once in the two years. She is aware of my unemployed/soon-to-be-homeless/no health insurance "situation" and, while not crazy about me not having my usual check-ups, she is sympathetic and understanding, she knows I normally take care of myself and it's not a reflection on anything other than my employment and financial situation.

Right. So. I was in tremendous pain last year, to the point that even vicodin leftover from my foot surgery wasn't helping. There were also some other disconcerting symptoms I'm not going to disclose publicly. So I broke down and spent the money on a doctor visit. After a (very) thorough exam, my doctor thought I pulled some muscles which was causing the pain and the other issues were stress and sleeplessness related. Among others, the term chronic fatigue was used.

Okay, so, I've tried really, really hard to sleep at least 4 or 5 hours every night. It's not easy. But I make it my mission. And eventually I started to feel a little better. Not great, still having aches and pains, but at least not doubled over on the floor in agony. And the other symptoms abated, so I thought, "This is why I love my doctor. She's good. No drugs, no tests, no chastisement for not getting in sooner, just a pat on the back and a prescription to get more sleep."

Right.

Well, over the summer the pains returned. Still unemployed, still skint, still without health insurance, I did not seek medical assistance. Then last week some very disturbing symptoms sprang up, and I was fairly certain it was all related in one big morass of a health issue.

So I called my doctor's office to ask for advice. It was effectively the same thing I saw her for last year, and the prescription was: Sleep. But combined with these other symptoms I was concerned, to say the least. I was equally concerned about the cost of the office visit.

And here's my high-on-horse rant about healthcare. Why is it so difficult to get a price quote for anything medical related? I understand that sometimes an office visit leads to other tests/exams and it's difficult to predict the necessity of those tests/exams. But shouldn't an office visit be a) a standard fee and b) easily quotable/findable by anyone who works in said doctor's office? And for that matter, shouldn't urine/blood tests cost the same, or at least cost the same in tiers? I understand some urine/blood tests are more involved than others, and cost more, I get that, but, the cost doesn't fluctuate like stocks or gold, right? The cost is the cost, right? So why is it so difficult, even impossible, to get a quote for the cost before embarking on the exam? If I can't afford the office visit and/or subsequent tests/exams, I'm not going to have them done.

And before you get up on a high horse about health being a precious commodity, citing that you can't put a price on health, let me ask you this: When was the last time you went to a doctor's office or medical facility and did not see a notice clearly posted (in at least two places) that payment in full is expected at time of treatment, including co-pays. You can put a price on health.

Yes. "They" expect payment at time of treatment, and that's fair. But isn't it equally fair for patients to know what to expect in the way of cost? In most states there are laws requiring car mechanics to provide a detailed summary and cost of repairs before doing the work. And if, for instance, while they are aligning the tires they discover a bad wheel bearing, they are required to call and revise the estimate/cost before replacing the wheel bearing. If the mechanic fails to provide details and an estimate and does the work without consent (usually written) of the cost, the consumer is not required to pay. These are standard, basic, consumer protection laws.

And yet, there are no such laws regarding healthcare.

I'm all for capitalism. And I understand that a doctor affiliated with a world renowned major medical research facility is going to cost more than a doctor who has a small office behind the Sip and Curl Salon in Podunk. I understand that. I also understand that a specialist who has spent years of extended education and training treating very specific and complex issues is going to have a high fee attached to their service. I get that. I even applaud that. Yes, really. If a doctor went to the time, trouble and effort to advance their skills beyond the usual doctoral studies, then yes, they should charge more for their services. I'm totally okay with that.

However. They, or their office, should be able to tell any patient, any patient, the cost of a visit/exam before the patient shows up for their appointment.

I had this issue when I had health insurance, and honestly, it was worse. I got so much runaround about codes, and deductibles, and copays, and caps, and out-of-pocket, and out-of-formula, and blah blah blah, that I was always, yes, always, the monkey in the middle of the doctors/treatment facilities and the insurance company. I never, not once, got a straight answer on what a treatment or exam or test would cost me. Hence the over $25,000 in out-of-pocket costs I incurred over a two year period with my foot issues. Much of that was physical therapy expense that my insurance company said was covered, but several months into physical therapy, ooops! surprise! nope, that "type" of physical therapy wasn't fully covered and I had to pay thousands of dollars in out-of-pocket expense that I could not afford and never in a million years would have had done if I'd known I was going to have to pay that much for it. I fought that battle for 14 months, making payments all-the-while, calling the insurance company two or three times a week for help resolving the dispute, or, even, just an explanation why they told me it was covered and then, well after the expense was incurred, they refused to pay. I never got an answer other than, "it's not included in your deductible" and "it's out of formula." Why they couldn't/didn't tell me this beforehand, and yes, I inquired ahead of time about my cost, remains a mystery.

Honestly, it's a lot easier when you don't have health insurance. You're no long a monkey in the middle, a pawn or a cash cow. Yes, my healthcare is expensive, but, since all of my expenses are out-of-pocket there's no waiting and wondering what the bill is going to be.

I have learned something about the medical community: When you don't have that magic golden ticket in the form of a health insurance card, you are a) an anomaly and b) viewed with disdain, contempt and a little fear.

I triple dog dare you to call your doctor's office and ask them what an office visit will cost without health insurance. Go ahead, try it.

If, after being put on hold at least four times, you are connected with someone who knows what the fee for an exam is, you will be given a list of disclaimers about additional fees that cannot be quoted until the doctor completes the exam. The takeaway is, "The fee is $125 with a discount for cash payment, but, be prepared to have a lot more cash on hand because that's just to get you in the exam room and into a paper gown."

I've been going to the same doctor for several years. She is expensive. I know there are less expensive doctors. But. I like her. I trust her. She's good. Really good. And she's a decent human being, too. Smart, kind, compassionate, reassuring, funny, aware and chock full of information she's happy to share. Every time I see her I learn at least one new thing. I count her among the rare few good things and good people in my life. If I believed in blessings she'd be near the top of the list. So that's why I continue to see her.

Until two years ago, I had health insurance and was in the monkey-in-the-middle situation where I never had a clue what I was going to have to pay for my doctor visits. I tried, oh how I tried, to ask and get a handle the fees, but it was so complicated and inconsistent that I finally gave up and just opened the wallet and handed over my cash, debit and credit cards and let them take whatever they wanted. (This isn't my doctor's fault.) So, even after years of seeing the same doctor, I really didn't have a clue what an office visit costs. Sad, isn't it? Not right, is it?

You know what's more sad and not right? The way I'm treated by the front line artillery squadron when I call for an appointment. Here's a transcript of the call I made last week (we'll listen in after all the press one, press three, press five, press one again automated response stuff):

"Good morning, Fancy Schmancy Impressive Hospital Doctors' Office," a woman oozing with charm, professionalism and pleasantness cooed. Like if Miss Moneypenny had a twin who worked as a receptionist at posh hotel.

"Hi, my name is Tricia McMillian. I'm a patient of doctor M's. I'd like to make an appointment, but before I do so I need to know the cost."

"Hello, Ms. McMillian! We haven't seen you for a while!" she seemed genuinely happy to hear from me. "Certainly, Ms. McMillian, let me just check a few things for you, what insurance do you have, now? Still the Blue Cross, is it?"

"Um, no. I don't have health insurance."

"Oh. I see." Notable change in attitude. Abrupt click to hold and informative canned medical tips.

After at least five minutes on hold she returned.

"(audible exasperated sigh) Awright, how do you intend to pay for your exam?" She morphed from smooth, professional, slight air of sex Miss Moneypenny's twin to Jenny from the Block.

"Cash, erm, well, debit card."

"Not check or credit card?"

"Well, erm, I mean, I guess that depends on the cost..."

(mimicking me) "Well, I mean, I guess that depends on how you intend to pay."

I was totally knocked off guard by her attitude. I mean, I understand that I'm in the minority in their office. Most of their patients have health insurance and open wallets. And apparently I was asking an out of the ordinary question. But I've been going there for years. I know the people who work there. I once helped two of them figure out an Adobe Acrobat issue. I took them sugar-free Halloween and holiday treats and a swutting baby gift to one of them, for crying out loud. Had I not been so surprised at her attitude I would have had more presence of mind to react in ways other than a chastised school girl.

"It's just that, erm, until I know the cost I can't really say how I'll pay. I hope to pay with cash or debit card, but if it's really expensive I'll have to use a credit card."

"What's really expensive to you?"

I kid you not. She said, "What's really expensive to you?" And she was not joking.

Yes. She went there. We were firmly in, "If you have to ask, you can't afford it" attitude territory.

And to an extent, that's true. If you have to ask what doctor's exam is going to cost, you probably cannot afford it. However, in the interest of savvy consumerism, doing some price comparison shopping is always, always advised. Were this not my doctor, my doctor whom I trust, respect and like and with whom I have a long term history, I would have ended this phone call. I would have hung up with an incensed hurrumph long ago and already be on the phone with at least two other doctors. But, this is my doctor and she already saw me for this issue last year, and I really don't want to see anyone else, and, my pride and self-esteem are already nonexistent. I live in a state of constant humility. In terms of my dignity I can't be wounded any deeper.

For the record, I am sad and disappointed about this, though. I expected more from my doctor's office. The compassion and respect my doctor gives to her patients is obviously not reflected in the frontline phone staff. Or, at least not when dealing with swamp-bottom feeders like me who don't have health insurance. When I had health insurance the call and desk staff were all oozing with kindness and a helpful, professional demeanor, offering assistance for things I didn't even need. "Do you need a doctor's note for work? How about a care info sheet? Here's a list of websites we like to offer our patients." They tripped over themselves to help me and to be friendly and kind, like they'd just been to some customer service seminar.

The abrupt change in attitude happened the second I said I no longer have health insurance. And keep in mind, they made a shitload, oh yes, I said it, shitload of money off me and my health insurance. Yes, I know, they didn't pocket all of the money they charged, I understand it's expensive to maintain a physician's office. I know that. But. My out-of-pocket expense for office visits alone was thousands of dollars, probably around $9,000 over just the three-year period before, during and after my foot injury and surgery. And that was "just" 20% of the total cost my doctor's office billed and received payment for, the insurance company paid another 80%. So, I'm not "just" some Janey Comelately off the street who wants to see the doctor and has no insurance or payment history with said doctor's office. I'm a former cash cow who undoubtedly paid the equivalent of at least one front desk worker's salary.

I expect that sort of behavior at a fancy department store, for instance. The once "preferred customer" the sales people coddled and fell over themselves helping suddenly has a drop in her expendable income and starts actually inquiring about cost, comparing prices. Money is suddenly an issue and just as suddenly the sales team couldn't possibly care less about their previously preferred customer. And they abruptly start giving her the if "you have to ask you can't afford it" cold shoulder treatment.

I finally said, "Erm, well, I guess anything over $250 will have to go on a credit card."

I heard a bunch of clickity clack typing on a keyboard, then the click to hold and canned health tip info. No, "Hmmm, I'm going to have to put you on hold another minute..." Just a click and then the pre-recorded audio telling me more about prostate exams than any woman needs to know. (Yeeesh, I thought pap smears were bad...)

Then she clicked back and sounded like she was reading a script, "Okay, without insurance an office visit costs $125. But Dr. M sometimes gives a cash discount so if you can come up with cash it might be less than that. But remember, that's just the office visit. Any other tests or treatments will be additional. As you are aware, we offer premium state of the art healthcare. If you are having difficulty paying for healthcare perhaps you might want to look into more affordable healthcare options for your routine health care."

Oh yes, she did. She went there. From my perspective, the perspective of someone who's been unemployed for two years, has no money and is about to be homeless, this was an unnecessary kick in the already painfully self-conscious ass. I understand that sort of attitude when the situation at hand is along the lines of, "As you are aware, Saks Fifth Avenue offers premium designer fashion. Perhaps you should be checking out the Blue Light clearance bin at K-Mart." Price snobbery is the accepted norm in retail, but when did that norm seep into healthcare? When did a health insurance card at the doctor's office become equivalent to a platinum preferred card at Neiman's? Don't answer that.*

Also integral to my state of mind at this point is my mother. Yes. My mother. My mother is Scottish. And unfortunately, she is prone to behavior that happens to be cliché stereotype Scot. I'm 90% certain her thriftiness has nothing to do with where her DNA originated, but, there's a 10% margin of doubt that has embarrassed me since I was old enough to understand the whole "thrifty" and "Scottish" thing. My mother is just a savvy consumer, I tell myself. She's not cheap. (Truly, she's not cheap or stingy. She always tips well, overtips, actually, and she buys lovely gifts for people, and she doesn't buy anything that's inferior quality, like 1-ply no-brand toilet paper or cheese food instead of real cheese.) But. She always, always throws in the, "...and we'll be paying cash, today" card when dealing with sales people. And for some reason when she speaks this phrase she inflects it with Maggie Smith accent. I think it might be her way of exerting authority, or a way of trying to bring some class to this low-brow haggling transaction, or maybe it's just nerves. Whatever the reason, she sounds like a haughty, superior dowager. And she is completely, utterly unaware that she's affecting a Maggie Smith accent. "No, no we won't need financing on the toaster. We'll be paying cash today." And then gives a knowing look at the sales person, the knowing look that says, "and you swutting well better give 'us' a discount for paying cash or we'll march straight over to your competitor who will be more than happy to honor your sale price and give us a discount for cash. I am prepared to walk out the door right now if you don't cough up at least a 10% discount for paying with cash." When I was young I thought everyone did this, that negotiating a discount for paying with cash was standard consumer practice, including affecting a Maggie Smith accent, and that every sales person, in every store, selling anything, knew the universal knowing look and accepted the Maggie Smith accented cash discount gauntlet.

When I got older and realized my mother is a) from a bygone era and b) an embarrassing cliché stereotype, I started refusing to go shopping with her. I began to realize that certain sales people around town recognized my mother and didn't seem exactly happy to see her coming. Some of them would preempt her "...and we'll be paying cash today" look by beating her to it in their sales schpeel. At then end of their pitch they'd say, "And of course we're always happy to offer a discount if you'll be paying with cash today." This is where I first learned about phony smiles and passive aggression, so in hindsight those were valuable experiences. But embarrassing nonetheless. Discovering that your mother has a reputation as a cash discount ball buster all over town is not exactly a pleasant experience for a child. Or an adult.

When my dad was sick and the local pharmacy had to special order a prescription from a boutique drug manufacturer across the country, the pharmacist said, "Now, I'm not sure we'll be able to offer your mother the usual cash discount on this because it's special order. You might want to okay that with your mother." That was just a few years ago. I was an adult. Getting medicine for my gravely ill father. And the pharmacist was so aware and afraid of my mother's "cash discount" threat that he wanted me, an adult, to call my mother and okay it with her before he ordered the medicine for my seriously ill father. He wouldn't even let me use my cell phone. Instead, he dialed my mother's cell phone number on the pharmacy phone, put it on speaker and handed me the phone - and listened while I explained the situation to her, that the pharmacist might not be able to offer a cash discount on the special order prescription that was being flown in from 2,000 miles away. I was instantly reduced to a 10-year-old child, incapable of properly procuring a prescription for my father. My mother, who was at my father's side in the hospital at the time, knew that she was on speaker and the pharmacist was listening and said, in her Maggie Smith voice, "Well, your father needs it, we'll just have to pay whatever they're going to charge us. (pause) But make sure he gives you a few of those coupons for free Tylenol." Okay, to be fair, before you judge my mother, yes, we knew my dad was sick but we didn't know he was dying. So, you know, in the moment it didn't seem like such a big deal to negotiate a couple of free bottles of Tylenol in lieu of the usual cash discount. Embarrassing, but not a big deal. But it's moments like those that the 10% margin of doubt nags at me. Maybe there is something in her ancestral DNA that makes her that way. Which means there's a chance I might end up "that way." 

So when the snarky receptionist at my doctor's office said there might be a cash discount available, it sent me straight to a complicated emotional place. Yes, I need and want any discount I can get and I'm grateful for any price reduction. But. The term "cash discount" triggers some very deeply rooted issues in me. Any shred of dignity I was clinging to was squashed. She said, "Sometimes Doctor M gives a discount for paying cash." I heard, "Yes, you cheapass Scot, we'll give you a cash discount, wouldn't want you to get your kilt in a twist, now would we?" So. Yeah. I was not exactly in a sound, healthy or stable frame of mind.

And let me reiterate: I would not have remotely considered going to any doctor if I wasn't worried, really, genuinely concerned, about this health issue. I'm in a lot of prolonged pain and I have a few disconcerting symptoms that warrant valid concern. The sort of symptoms that, when you tell someone, anyone, the response is always, "(look of shocked worry) You need to see a doctor. That's not normal. That can be serious. Don't let that go. Really, don't mess around with that. (stern look of 'I'm serious about this, go to a doctor, now')"

So.

You know. I was kind of in a situation. And really wanted to see my doctor. And I'd like to say, "Money doesn't matter when it comes to your health!" But money does matter. A lot. Apparently a lot more than I realized.

Yadda yadda yadda I finally got a quote and made an appointment. To say my reception at the front desk was chilly is a gross understatement. I used to be greeted with smiles and news from the office and even the gal from the back billing area would come up and say hello. This time I was greeted with an abrupt, dismissive, no eye contact, "Just your insurance information has changed, right? Everything else is still the same?"

"Yes, everything else is the same."

Pointing toward a sign taped over the counter, she said, "And you are aware of our payment policy." It was a question inflected as a statement. As in, "I presume you can read, and the sign clearly states payment in full is expected at time of treatment, so consider yourself schooled on our payment policy."

"Yes, yes, I am aware. I am also aware that there may be a discount for cash payment." Oh crap. I said that out loud. In front of a room full of people. Oh crap. I've turned into my mother and there are witnesses.

Insert: Years of issues with my mother playing out in my head;
Insert: "Well, that's it, I've turned into my mother" sigh of resignation;
Insert: "Really, does everyone in the waiting room need to know I don't have health insurance and that I'm paying with cash and want a cash discount? Because if they do need to know, I think there's an elderly gentleman in the corner who didn't quite hear all of this conversation so why don't you just speak a little louder, and hey, why not mention why I'm here, too? I'm sure all of these people pausing from their game of Angry Birds and looking over here at the woman who doesn't have health insurance would just love to know the gory details of the health issue that would bring someone with no health insurance and wanting a cash discount on her healthcare into the doctor's office."
Insert: Let it go, let it go, just let it go and don't say anything or they'll make you see a "special" doctor and you really cannot afford a "special" doctor or the "special" medication they'll mandate.

Finally the receptionist found whatever note she needed to refer to about the cash discount and said, "That'll depend on how the doctor writes it up. Have a seat. We'll call you when the doctor is ready for you." End of conversation. I had been schooled.

And I had to slink into the waiting room where all the other patients suddenly got very, very busy with their smartphones or extremely interested in brochures about Shingles vaccinations. Okay, maybe that was my insecurity and imagination taking charge of the situation. But. Still. I'm sure I noticed a few furtive glances. This is not the sort of place where people who do not have health insurance hang out. I truly was a K-Mart Blue Light clearance bin shopper in the couture velvet rope area of Saks. I'm pretty sure it was pretty obvious. But. Whatever. I didn't feel well, I had some scary symptoms and in a few minutes I'd be alone in a room with my doctor whom I trust, respect and adore and everything would be okay.

I did have to have a couple in-office tests but my doctor "forgot" to add them on my payment sheet. See? I told you she's great. Truly, she's a fantastic doctor and an even more fantastic human being. Worth all of the nonsense I dealt with prior to the appointment.


Unfortunately she's concerned about the symptoms and the preliminary exam and test results. So. She wanted me to have a CT. She knows I don't have money for a CT and so she told me about this incredible site called Leslie's List. If you're not in Chicago or Dallas, I am truly sorry you don't have this unbelievable service, but hopefully the idea will catch on and it will become a nationwide phenomenon, a true reform and revolution in healthcare.

Imagine this: A site where a patient can compare prices for prescriptions and exams. Which means, (bwa ha ha) the price for exams and prescriptions is made public. No, really? Is that possible? How can it be? Medical exam and prescription prices are trade secrets! The public isn't supposed to know the huge disparity in charges for the same tests and medications! My God, if the general public is allowed to shop and compare exam and medication prices, why, they'll, they'll, they'll be empowered! They'll be savvy and they won't just accept whatever price we ask them to pay!! They'll have, gulp, choices!!! We can't have that!!!

Get this: The prices for the exam I needed ranged from $278 - $3,211. Same exam. Same equipment involved. Same process. Same everything. That's quite a range in price, isn't it? Yep. It is. Holy price gouge. Holy we've been had. Holy crap. I expected some range in price, but I figured they'd all be within a couple hundred dollars of each other.

No. Not even close. $278 - $3,211 and everything in between. In the old days, days when I had health insurance and just went to the treatment/exam places in my doctor's hospital, I just did as I was told, went where I was told, and assumed with my health insurance the cost elsewhere wouldn't vary that much. And maybe, with health insurance, it doesn't vary. Now that I'm in the "no health insurance" "I'm paying cash for everything" legion, there may be some difference in costs. I don't have to take anything but price into consideration. And so, my eyes are now open. I'm starting to realize there is some freedom in not having health insurance. And if/when I ever do get health insurance again...there's no going back to the old way. Thanks to Leslie's List the medical price gouge cat is out of the bag. I'm really scared the site will be shut down, I'm sure some of the healthcare providers are fighting this, but I really hope there's some sort of Freedom of Information Act provision for this information that will allow the site to continue and spread to other cities. Empowerment and emancipation. They're beautiful things.

I called three of the providers on the list. I admit, I was kind of afraid of the lowest cost place, but, I called them anyway. And guess what? They were the nicest, most helpful and accommodating of the places I called. They had a long waiting time for an appointment, but when I told them why I needed the exam they had me speak with a triage nurse who said she'd find a way to get me in sooner. I went to the place and guess what? It's not some scary back alley clinic type of place. It's perfectly sterile and professional and the people who work there are super friendly and helpful. Oh, and by the way, it's in the same building as some of the city's most hoity toity doctors, surgeons and dentists. Just sayin'.


And now we get to the sitcom ironic plot device.

Okay, so my test required me to completely disrobe and wear a gown. The nurse was very nice and escorted me straight back to the changing room.  The place does mammograms, and by the queue of women waiting wearing a gown on top and regular clothes on the bottom I presumed most of them were there for mammograms. Because I was having a different exam there was no wait for me! The nurse waited for me to change into the gown. (Which, by the way, was in a little vacuum hermetically sealed bag and when I opened it out popped a heavy-weight, real cloth garment with strings that weren't frayed or knotted beyond use, and ample room for coverage and comfort. Sanitizing, modesty and comfort? At the cheapest place in town?! Wow!) So I didn't pay much attention to the women sitting and waiting in their mammogram gowns.

The exam went okay, I mean, it didn't hurt or anything and the technician and nurse were super nice and I even got to take home a CD of my CT. Yeah, swag. Go figure.

When I went back to the changing room it was even more full of women in gowns reading magazines or looking at their smartphones. All the changing rooms were full, including the one where I had my stuff locked up. (Guys, maybe you don't know this, inside the inner sanctum of mammography/imaging centers there's usually an antechamber with chairs and magazines and sometimes a TV. Adjacent to it are little changing rooms with lockers where you change into your gown and lock up your clothes and purse, then take the key with you, then you sit around with a bunch of other half-naked women wearing gowns and holding locker keys waiting for their exams. Sometimes there's conversation but usually everyone just tries to mind their own business and avoid eye contact. I presume it's the same for men except it's a bunch of guys sitting around in gowns with ESPN on the TV instead a bunch of women with Lifetime on the TV.)

There were no chairs left so I had to stand there, naked except for my socks and the gown, and wait for the specific changing room where my stuff was locked up. Naturally the woman in "my" changing room was taking a stupendously long time. And no one was called for their exam, so no chairs freed up, and there was no television, and I had nothing but the locker key to busy myself with...and I was trying to avoid eye-contact but it was difficult because I was standing and everyone else was sitting...and did I mention I was completely naked except for my socks and the exam gown? Everyone else was at least wearing skirts/pants and shoes. Not me, the gown was nice enough, as exam gowns go, but it didn't hide my stupid ridiculously long and cartoonishly white legs and arms. And remember, I'm not feeling well. And I'm having some, um, symptoms. Not exactly my finest hour.

And then...I noticed one of the women noticing me.

Oh crap.

Who is the last person you want to run into in a situation like this? Dozens of people and types of people come to mind, I'm sure, but really, think about it, who do you absolutely not want to see you in this situation?

Perhaps the executive managing director of the department you spent two months and five interviews with and just got the rejection call last week? Yeah. That'd be an embarrassing person to run into in this situation, wouldn't it? Yeah. That's kind of sitcomical, isn't it? Yeah, that's my life(?). There, she was, in her executive managing director glory. The woman who put me through five in-person interviews, including one requiring a trip to New York with her to meet the rest of her team, the woman who courted me and dangled carrots in front of me for two months, put me through several phone interviews/conference calls with her team, the woman who called and emailed me evenings and weekends to "touch base and make sure I knew I was still a top candidate and that the process was gaining momentum and wanted to make sure I felt the same way and wasn't seeking other offers," the woman who then had her minion call me to let me know she chose another candidate instead of me.

Yeah. That woman. Her. She was sitting there half-naked looking up at me amidst a room full of half-naked women in exam gowns. And I was just standing there, all naked except for my socks and the gown, standing there unable to do anything because there was no place to sit and some woman was taking an inordinate amount of time in "my" changing room.

Once we made eye contact there was no going back. I mean, what do you do? You have to acknowledge each other, right? A nod, something, right?

I could not think of what the appropriate acknowledgement would be if I ran into her in any situation. "Hi, nice to see you again. Thanks for the opportunity to interview for a job I really wanted. I'm glad you found a good fit for your team, even if it wasn't me, even though I really wanted that job, even though you pestered me night and day for two months and made me jump through hoops so far and above the normal call of interview duty that I'm pretty sure you violated your company's code of ethical conduct. Really, great to see you again. I hope the person you chose instead of me is working out okay." Yeah, probably not the right words.

Then add in the weirdness of the waiting room situation and I mean, come on, really, Universe? You really did this to me? And to her, for that matter?

Cripes. It was awkward for me, but then as I thought about how awkward it must be for her I felt even more awkward, awkward for her, and, awkward for me, I mean, good grief, what does one do or say in this situation? They don't tell you how to handle this situation in business school or etiquette classes or ethics seminars. No one ever mentions that you might want to prepare yourself for the possibility, that, while standing naked in the changing room of an exam center, you may run into an executive director of a major corporation who recently interviewed and rejected you. At least no one ever mentioned that possibility to me.

I'm 100% certain I am the last person she wants to run into while sitting half-naked waiting for a mammogram. Or, ever, for that matter. She knows I'm crushed that I didn't get the job, and she knows I know she was the one who made the final decision. If I was her I would not want to run into me anywhere. At least not while it's still so recent, so fresh. The wound of rejection hasn't even had time to scab over and there I was, standing there before her, naked except for socks and a stupid exam gown. I'm still shedding tears over not getting that job, for crying out loud (literally). I'm still going over every detail of every interview and conversation trying to piece together when I made my fatal misstep. I'm  still thinking she was a spineless coward for not calling me herself, for making her assistant make the rejection phone call. And there she was, half-naked in an exam room full of other half naked women, looking up from her Blackberry at me. And there I was. Stupidly overlong and overly white legs and arms made even more obvious by the stupid exam gown and socks.

Humiliation and irony, thy names are Trillian.

We just kind of nodded at each other. I think I managed a smile. That was my intention, anyway. "Just nod and smile, nod and smile. What the swutting Belgium is taking that woman so long in my changing room? Nod and smile, nod and smile." She nodded but didn't smile at me and then went back to her Blackberry. Whew. Okay. That was over. But. I still had to walk past her when (if?) whomever was in my changing room finally came out.

And you thought that was the sitcom plot device of irony moment, didn't you?

Yeah, well, you're right, that's a good one. But. Heh heh, this is me. This is Trillian. There are reasons why you read this blog.

And I suspect this is one of them.

So, the would-be manager who rejected me last week was engaging herself in her Blackberry and I was waiting for my changing room. The antechamber was chock full of women. (And let me take this moment to say how proud I am of those women and how pleased I am that so many of them were there to have what is hopefully just an annual routine exam. And also to remind the ladies in the audience that it's October and it's breast cancer awareness month so be aware of your boobs and take care of them. If you're in Chicago or Dallas Leslie's List has pricing and sources for mammograms.) Right, so the room is full, nowhere to sit, woman who interviewed me five times and then rejected me last week sitting there awkwardly trying to avoid me and occupy herself with her Blackberry, me standing there naked except for socks and an exam gown waiting to get into the changing room where my clothes and purse are locked up. I kinda had to stand next to the swinging entry door because there was nowhere else to stand except for the middle of the room. Which, I suppose, if I wanted to just go for broke ridiculous, I could have stood in the middle of the room waiting for "my" changing room. But I didn't. I opted to try to be as inconspicuous as possible for a 5'11" naked woman wearing nothing but socks and an exam gown to be and just cower against the only spot of bare wall which happened to be by the swinging entry door.

This was an "Are there God, it's me Trillian" moment. Sometimes I try really hard to give God a chance. "Okay God, I really do want to believe in you and I'm more than willing to Believe, but if you're there you know me, you know my issues. And you also know I'm a decent person, I follow your rules and respect you and those who Believe in you, I mean Thou, and maybe if you, I mean Thou just helped me out once in a while I'd be more receptive and so please, for the love of God, I mean you, I mean Thou, please get that woman out of my changing room so that at the very least I can put on some clothes and regain a shred of dignity in front of the woman who just crushed my hopes and dreams of finally landing a job. Please? God? Please? Just this once, please?"

If there's a God, and if He heard my prayer, he's a mean, sick, twisted, spiteful, vengeful deity because what happened next defies everything we've ever been taught about God.

Instead of mercifully freeing up my changing room, He presented me with the one thing that could make this situation worse.

The door came swinging open, almost hitting me, so I had to step out and away from the door and into the aforementioned center of the chock-full waiting room. And who do you think came strutting into the waiting room, fully clothed?

Yep, my former nincompoop boss.





To recap, we have:
Me, naked except for socks and an exam gown, 5'11" worth of sickly pale legs and arms sticking out of said exam gown the only one standing in the middle of:
A room full of seated women who are half naked, wearing exam gowns, including:
A half naked woman who interviewed me five times and rejected me for a job last week.

And my former boss, fully clothed, who laid me off two years ago.

Oh, life is sweet, isn't it?

My former boss, never, ever keeps her mouth shut. She's a nervous talker. When she's nervous she talks. A lot, about anything and everything. She's loud, obnoxious and usually the only one talking, saying nothing, really, but blathering on and on and on and on. (I know, kinda like this blog post, but at least I'm aware, and there is some shred of intent, whereas my former boss is the most self-unaware, aimless person I've ever known.)

So of course she said something. Something really loud and rambling and in no way covering the awkwardness she was feeling about running into someone whose life she ruined by laying her off. 

"Trillian, my GAWD, how are you? What a coincidence to run into you here! Wow, they're really busy today! Are you here for a mammogram? October is breast cancer awareness month! What are you doing these days? I heard you moved. Did you move? Did you sell your condo? The market's horrible did you take a big loss? Someone said you're working at (competitor company). Are you working there? I heard they lost (XYZ account). Wow your hair is really long!" She made a move toward me. Oh crap. She was coming in for a hug. No, no, no, please, no. Not here, not now, not ever. No. Every half naked be-gowned woman in that room was staring at us, including the woman who interviewed/rejected me for a really good job that I really wanted.

And still, still, "my" changing room was occupied. What the bloody swutting Belgium was going on in there?

All I could think of, the only words I could consciously form in my head were, "Nowhere to run, nowhere to hide, got nowhere to run, nowhere to hide..." Yes. The Martha and the Vendellas song. For a split millisecond I contemplated breaking into song because the whole situation couldn't possibly get any weirder anyway, so why not just break into song? Well, because, wasn't a dream sequence in a sitcom.

My former boss did, indeed give me a sort of half-assed air hug. I didn't reciprocate. For many reasons, but top on the list is that I wasn't sure how securely I'd tied the gown and I was afraid of what might happen if I moved too much or lifted my arms too high. I know a full frontal nudity hug in a women's changing room full of half naked women, including a former boss and would-be boss sounds like a titillating scene in a porn movie, but it's not.

I just stood there, enduring. I noticed the woman who interviewed/rejected me last week was doing that thing where you try not to notice what's playing out in front of you but it's too awkward and too public to not notice and everyone involved knows this so you just try to seem apologetic and sympathetic.

Then a nurse poked her head in the door and called out the name of the woman who interviewed/rejected me last week. Up she stood to move toward her summoning nurse, and, I and my former boss, who was obviously (and just this one time we can't blame her) clueless about my "relationship" with this woman, broke our "embrace" in the middle of the room to let her pass. As she passed me she bowed her head and mumbled an "excuse me" and gave me a slight apologetic grimace. I'm not sure if the apologizing grimace was for not offering me the job after all she put me through during the interview process, or for breaking up the reunion between me and my former boss.

I had another fleeting thought. "Wouldn't it be funny to introduce these two women? After all, they have a lot in common, they both held my future in their hands, and they both rejected me for employment, they both broke my dreams...so, yeah, really, they should get along really well. And it would add the icing on this many-layered cake of weirdness."

Instead the woman who interviewed/rejected me left for her exam and my former boss, our "moment" interrupted and over, went into a changing room and I took the vacated chair left by the woman who interviewed/rejected me.

Then, finally, finally, I found out why "my" changing room was occupied for so long. And of course the reason made me feel like a total callous bitch. A fully clothed middle-aged woman emerged with a be-gowned elderly woman walking with two canes. Crap. I'm an intolerant, impatient, horrible shrew of a human being and I'm going to rot in Hell.

Or, more likely, I'm already in Hell.

*Sorry God*

I sprinted into that changing room so fast I'm sure I left a contrail. I jumped into my clothes and hoped to be out of there before my boss, who was always kind of a slow-paced lumbering lunk, emerged from her changing room.

It was then, and only then, I remembered what I wore to this exam. It was an early morning appointment so I'd just thrown on the t-shirt on top of the pile and a pair of something that could pass for pants but as close to sweats as possible, and the comfiest sneakers I own. Which amounted to: A four-year-old pair of trainers with a lot of miles on them, loose fitting baggy crotched yoga pants, and a Spinal Tap t-shirt that's at least 15 years old and looks every day of that age. Oh. And a jean jacket that doesn't quite fit right anymore. Okay, normally this wouldn't be a big deal, right? Home, bus, exam place, bus, home.

Had I known I was going to run into the woman who recently interviewed/rejected me and/or my former boss I would have worn something more, oh, I don't know, professional? Or, well, something, anything, that doesn't make me look like I've been unemployed for two years. I mean, at least I bothered to take a shower and wear some makeup. Because, you know, I didn't want to scare the other passengers on the bus. (You know you've made perhaps at least a couple bad life choices when you reach the point that the only reason you take a shower and wear makeup is because you don't want to scare bus riders.) But hey, at least it was just my former boss who saw me in my schlumpy clothes, not my would-be boss who interviewed/rejected me, right? That's all that really matters, right? Who cares what my former boss thinks, right? Right.

I wasn't quite swift enough to beat my former boss out of the changing rooms, and so, there I was, in a pair of schlumpy baggy crotched old yoga pants, ratty worn out sneakers and a Spinal Tap shirt, running smack into my former boss who was now half naked and wearing an exam gown, standing up because the elderly handicapped woman took the only vacant chair. I was way too close in proximity to my former boss. Overlapping personal space close. Crap. Can I just get out of this inner circle of Hell? Please, can I just get out of this place? I pulled away from my former boss, smiled, again, and said, "Good to see you" and left.

As I left the antechamber and headed out to the hall to the exit, I nearly ran smack into the woman who interviewed/rejected me. She was standing in front of an exam room, apparently waiting for her exam.

Of course.

So much for avoiding her seeing me in my craptastic baggy crotched yoga pants, ratty sneakers and ages-old Spinal Tap t-shirt. And ill-fitting jean jacket. And so much for any chance of her calling me for any other job opening she might have in the future.

Closure. At least I have closure. 

And that, my friends, is the sitcom plot device of ironic madcap hilarity.




*And spare me the hopeful pabulum about Obamacare. From what I understand based on a few conversations with my doctor and my mother's doctor, the Healthcare Reform Act doesn't reform this aspect of healthcare. The same "if you have to ask, you can't afford it" attitude will continue because the reform does not include reforming patients' rights to know their cost, with or without insurance, prior to making the appointment or even prior to receiving treatment.