Thursday, September 10, 2009

Shuffling to Mecca

Doctors in beleaguered inner city hospitals refer to the Mayo Clinic and its ilk - not that it has many ilks - as "Mecca." It is where the privileged go, praying to survive what would surely kill them in lesser facilities. I went there this week.

I'm not dying, any more than all of us are dying, and I suffer from nothing that qualifies as more than a minor medical inconvenience, but I shared the Mayo Clinic with enough people in crisis that I felt some disquiet at consuming Meccan resources for piddling concerns like elevated blood pressure and the occasional fibrillating atrium. But it's my heart and I try to do what it tells me. My heart took a lesson or two before I left.

The Mayo Clinic in Jacksonville is a luxurious, sprawling park of a medical compound, with monumental landscaping and aggressively competent buildings and amenities. It has its own Marriott, for instance, and a good one, if you like that sort of thing. My consultations - I went for one and got three - took place in the Davis Building, which stands apart from the hospital and the research buildings and probably a lot of other features you don't see unless you are in a lot more trouble than I was. I started with Dr. Geoffrey Gates, an endocrinologist. His job was to decide whether one or more of my overambitious adrenalin glands are boosting my blood pressure and what to do about it. Describing Gates describes the Mayo Clinic.

Dr. Gates is the quintessential Mecca specialist - Mayo Clinic Med School, Harvard Fellow, good teeth. He made sure I knew all that in the most unassuming fashion: "Sometimes all we know, whether at Harvard or Rochester or anywhere else, is that adrenalin glands usually have lots of lumps by the time you get to our age." That last was a nice touch - Gates is probably 52; I'm 61. Oh, and "Rochester" is the code word I heard all week for the Mayo Mother Ship in Minnesota. Where I grew up, "Rochester" was Jack Benny's sidekick.

Despite Gates's endearing bedside manner - oops, just a figure of speech; I was never in a bed - he is so supremely confident that he is willing to share his uncertainty, and he does so in a way that imports that if he doesn't know the answer, then no one does. Every last denizen of the Mayo campus radiates that same quiet confidence and abiding competence, avoiding even the appearance of arrogance while in fact engaging in an arrogance that seems perfectly justified. I barely noticed how vaguely dissatisfying it is to come away from the Mayo Clinic with no answers, despite a promise that some testing in November will get us closer to one.

I squirted a lot of blood into tubes, let a machine monitor my O2 intake, sat with two more Dr. Gateses, and left convinced that I was the most important patient any of them had ever seen. I was wrong, of course. Waiting his turn in the lobby as I was leaving was a young man with one leg and the type of hairlessness that bellows "cancer." It's humbling to have your convictions erased so promptly after they are formed.

No doubt some of the other waiting room supplicants were, like me, there to resolve some puzzling medical inconsistency. But too many of them left divots in my emotional landscape beyond mere sympathy for victims of health catastrophes. I was struck by a couple in their 40's wearing Harley-Davidson colors, she a big-boned gal with an H-D swagger, he wheelchair-bound and weighing perhaps 100 pounds. I saw a younger couple walking so slowly, one matching the other's careful pace. So intimate was the couple's shared pain that I could not tell which was the patient and which the caring partner.

We stayed one night at the on-campus Marriott, claiming the special "Mayo rate" - $159. The hotel restaurant was located in the main lobby for the convenience of guests who needed wheelchair access or personal assistance with eating or with sometimes-bulky oxygen equipment. Families chatted cheerfully - after all, this is Mecca - and the atmosphere was curiously upbeat. I could not match the mood in the room, and we dined elsewhere, feeling somehow cowardly.

Not all the Mayo patients I saw were the children of privilege, although there were two Bentleys in line for valet parking when I dropped off my 12-year-old Acura. But there were no evident children of poverty, although it's damned hard to guess the financial wherewithal of anyone wearing his jammies in the daytime. Patients and family of color were exceedingly few. Privileged or not, I came away with a fresh appreciation for my relatively superlative state of health and a sense of having been at last to Mecca.


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