In my 19 years of clumsy escapades, I’ve never once broken a bone. I’ve never needed surgery, never required follow-up appointments and never spent more than a few hours in the hospital or the doctor’s office. So when the back of my right heel started bruising and swelling at the beginning of this year, I didn’t know exactly what to do. I stopped running, started icing and tried to wait it out. But the strange, dull throb of pain near my ankle kept creeping its way up my calf. Eventually, I capitulated and owned up to those elusive three little words: I need help.
The question emerged: where can I get it? My Google search for “physical therapy near me” located the Duke Urgent Care orthopedic center 10 minutes away from my home.
After filling out extensive paperwork and paying my $40 insurance copay, nurses sent me into a room and told to wait for the doctor. After a bit, the doctor entered and there wasn’t much discussion before she decided to put me in a boot. “It’s probably Achilles tendonitis,” she said, strapping my new plastic companion onto my right leg. “I don’t know for sure, but that makes sense—wear this for two weeks and you’ll be fine.” Begrudgingly, I accepted my diagnosis and commenced my fourteen-day stint of hobbling around campus.
After I finally removed my boot, my heel had only gotten worse. Pain spasmed up my calf in the middle of class, my toes seemed permanently numb and my ankle wouldn’t budge. I decided I needed another diagnosis.
Exactly three weeks ago, I found myself at a new urgent care center. Still run through Duke Medicine, this location was farther from campus. The waiting room was packed. As I waited, I watched the scene. A small child in a car seat screamed in the corner; her mother rocked her with one hand and covered her own mouth with the other as she coughed. Two older men, one with a cast reaching up to his thigh, chatted in Spanish. A slim woman tried to maneuver her wheelchair through the room, scattered with seating. 20 minutes passed, then 30, then 40.
After more than an hour, I finally heard my name. As the nurse took me through the back doors to be processed, she began asking me questions: “When did the pain start? How bad is it? Where does it hurt?” I answered her questions in detail and asked if she could refer me to an orthopedist who might have more insight into my esoteric problem. She looked at me and snickered. Before she responded, a woman passed by the door and my nurse waved at her, chuckling. “I’ve got a good one for you,” she said.
I had a strange suspicion she was talking about me, but I brushed it off. Soon, my nurse finished her tests and brought me into an examination room. “The doctor will be with you shortly,” she said.
I reached for my backpack when I heard her voice again, this time on the other side of my door. “Can you believe that? Says she doesn’t think she has Achilles tendonitis, wants a referral to the surgeon,” she said, laughing. “In urgent care! Good luck with that. She’ll get some Ibuprofen and an ice pack.”
My nurse was right—after spending four hours in urgent care, those two things were exactly what I got. Once Advil and ice had failed me, I made two additional tries at two separate urgent care sites. Still, I left with no referral, no diagnosis and 160 dollars’ worth of copays.
Throughout my childhood, I’d never felt truly out of place in the medical system. Although I’ve been fortunate enough to avoid hospitals for most of my life, my dad is a doctor. When I need medical help, I know I always have an avenue to it. And in a new environment, hundreds of miles away from the medical connections I’ve always had, I realized that to be taken seriously in the medical system you must have leverage. This is by no means a Duke-centric problem; this is a problem across the country. I’ve been lucky enough to always feel listened to in medical situations, because my leverage is my dad.
Away from him, I became another misguided, naïve patient in urgent care.
For weeks, I was shrugged off everywhere I visited. I tallied the five different diagnoses I’d received, none of which fully explained my symptoms. After finally hobbling to Harris Teeter to pick up a “stronger Advil” one doctor prescribed to me—only to realize he hadn’t actually called in the prescription—I gave up. I felt completely alone with nowhere to turn. I had run into wall after wall; no one had taken me seriously. I didn’t know where I could find the leverage I needed to get the help I wanted.
But this is not a story of a single problem. If I feel this alienated by the medical system, who else feels that way? What if I spoke limited English and was trying to get help? What if I had no entrance the system other than urgent care? What if I didn’t have a car to get to the doctor’s office, and what if I couldn’t pay my copays? What if I didn’t have insurance? I realized that my panicked feeling of helplessness when I had finally exhausted my options might not be a transient feeling for others. If I—a fortunate, white female—feel this deep frustration at my lack of ability to get the help I needed, how does this system work for systemically marginalized populations? I suspect not very well.
This is a significant problem, particularly in Durham. As of 2013, over 20% of adults in Durham were uninsured, a rate much higher than that of North Carolina at large. A disproportionate proportion of uninsured adults are Hispanic Durham residents. The Community Health Assessment, run by the Durham Department of Public Health, ran an opinion survey within the Durham Hispanic community in 2014. It revealed that two of the three most widely repeated struggles were lack of health insurance and discrimination within the health care system. In 2012, almost a quarter of Durham residents said they wouldn’t see a doctor due to how expensive it is. That’s over 60,000 people.
Eventually, I saw the orthopedic surgeon I had sought for weeks. This wasn’t the product of a referral, a phone call or an office visit. My friend knew the doctor. She put me in contact and I made an appointment. Simple. After weeks of slogging through the medical system, all I needed was a single connection. All I needed was a little leverage.
But health care shouldn’t be about who you know. I was lucky to find my leverage, but that doesn’t make this system fair. Every person should be taken seriously about something as important as health. Every person should be able to access the care they need.
And every person should feel listened to, cared for and respected—that’s what health care is about.
Cameron Beach is a Trinity sophomore. Her column typically runs on alternate Mondays.
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Cameron Beach is a Trinity sophomore. Her column runs on alternate Mondays.