Living in New Zealand? Priceless

We went up the stairs to the first floor and checked in with the receptionist at the hematology department. It was several minutes after 12pm. My hands were cold and sweaty. A man in his 70s came out of the doctor’s office. He was stooped and grey and coughing heavily as he wandered down the hall. The doctor invited me in to his office.

      “How are you?” he asked.

      Was he kidding? I hadn’t been sweating and pacing all morning to do his work for him.

      “You tell me.” I said defiantly.

      “I’ve just come off holiday. I haven’t checked through your results.” (Seriously? This wasn’t chicken pox, this was cancer.)

      He was good-looking, tanned and obviously still on a beach somewhere in the South Pacific sipping pina coladas. I tried not to exhale loudly as he clumsily and half-heartedly flipped through my chart. But when he finally realized he was in a small, sterile office and no longer in Fiji, the information came flooding out. All the excess plasma cells that had spilled from my bone marrow into my blood were gone. My kidney function had come back to normal (I didn’t know it could get better. Once there was “damage” I thought it was irreparable so this was very good news – I was thinking kidney transplant down the line). My hemoglobin was also back to normal. My MRI showed the bone marrow infiltration by plasma cells, but no problems in the bones themselves. That meant the cancer had not created tumors on my bones or on my organs. I was trying to rapidly process all this. I gave Alex’s hand a squeeze.

      The doctor refilled my prescriptions and did a physical exam. He felt around my neck and pushed on my stomach.  He asked me if I had any pain and I said at this moment, sitting here, I was in no pain. He checked my mouth (I assumed to see if I had any mouth sores, a possible side effect of the weekly chemo drug cyclophosphamide I had been taking since my diagnosis).

      My doctor delivered good news and bad in equal measures without a lot of emotion. While at first I found this way of delivery odd, I came to rely on his calm rationality. He was the only person in my life at this time that didn’t reduce me to a puddle of tears and I was grateful for that.  At this first important appointment he did not commit to anything more than saying that my body had responded well to the chemo. Since it had, and since I was a “special case” (at more risk of dying quickly) we should “press on” with the drugs. Normally myeloma patients would get a “rest week” after a four-week drug cycle. I would continue getting the velcade and chemo every week. I asked him what happened next. He said I would continue on with twelve weeks of medication followed by a stem cell transplant. At the word transplant I immediately pictured my open chest with a set of bloodied gloves cutting out major organs and replacing them with slippery pink donated items taken from a chilly bin. I didn’t ask him to explain. I wasn’t ready for the frightening details yet. I had twelve weeks to get through first.

      When I asked him if I should keep taking allopurinol pills although the chart given to me by the nurses said to stop taking them, he said:

      “I think I wanted you to keep taking them,” he looked at the chart. “I forgot to write it down”. 

From thinking he was the cleverest doctor in the world, my respect fell to the floor. I didn’t say anything but maybe I rolled my eyes, I’m not sure, because suddenly he got defensive.

      “You know you are getting really good care here, equal to anywhere in the world.”

      It took me by surprise. I wasn’t sure why he said it. I was incredibly grateful for the treatment and I didn’t mean to give the impression that I was not. I wondered if it was because I was American and he thought I might be comparing New Zealand healthcare with that in the USA. Let me just state here:

      I am really grateful for the care I have received in New Zealand.

      In America I would be living on the streets after paying for the velcade alone.  Having a life-threatening disease is bad enough, having to worry about how I would pay for having a life-threatening disease would have tipped the scales of my stress. Paying taxes to contribute to a national healthcare system is the best use of tax payer dollars I can think of. Not only did I not have to worry about paying $2000 a shot for the velcade, the prescriptions were also heavily subsidized: Dexamethasone 4mg tablets (steroid): total cost: $65.33-govt subsidy: $62.33=patient price: $3.00. Cyclophosphamide 50mg tablets (chemotherapy): total cost $30.70-govt subsidy: $27.70=patient price $3.00. Zopiclone 7.5mg tablets (sleeping pill): total cost: $6.96-govt subsidy: $3.96=patient price: $3.00. Total subscription cost for another four weeks’ treatment? $9.00. Living in New Zealand? Priceless.

      It was incredible. If a small country like New Zealand could do this, why couldn’t the USA with all the people and resources it had? People shouldn’t be stripped of their life savings because they get sick. I think New Zealand has the right attitude and I appreciated that I was benefiting from the government’s forward thinking.

      I nodded to show him that I knew I was getting good health care. I felt like a child in the principal’s office accepting that I had gone astray. I thanked the doctor profusely. I would have to watch myself in the future. It appeared I might have annoyed him and I did not want to annoy the man set with the task of saving my life.

      It had been a strange day. I was confused, tired and unsure of my future. But at least there was a plan. We went out to the car and found Alex’s wallet stuck in the groove where the hatchback roof fit into the boot.  I had to laugh. I could see I was going to have to be patient with my doctor, with my disease, with my family and with myself. I couldn’t always rush to look at the big picture. It was going to be the little successes that made all the difference.