The Value of A Medical Service - II

John was a pleasant man with late stage polycythemia rubra vera, a chronic disease in which the body makes excessive blood: too many platelets, red cells and white cells. Eventually, his bone marrow failed as it was replaced by fibrous tissue. Other organs made his blood cells.

I had followed John, a retired engineer, for years. In addition to the usual medical issues, we talked about his family, his church work, his computer programming and other activities. Gradually, John's blood counts worsened, he stopped eating normal meals because he filled-up too quickly, and his spleen sat in his abdomen like two professional-sized footballs, lying side to side. John needed to have that enormous spleen removed.

It took more than two weeks to find the right doctors: a general surgeon to perform the high-risk operation, a vascular surgeon who specialized in capturing lost blood so that it could be given back to the patient, and other members of the support team. Finally, John came to the brightly lit and crowded operating room where his surgery began. His huge spleen was glued to his left diaphragm (the muscle which moves air in and out of the lungs). Surgery was difficult and bloody. The team spent five hectic hours dissecting and removing the spleen, dealing with John's massive bleeding, capturing and recycling John's blood, transfusing John with blood components from the Red Cross, and dealing with John's unstable vital signs.

Finally, the surgery was over and John was in the recovery room. I left the operating room to tell John's family and friends how he had done, indicating that their prayers may have played a role in his positive results.

Two weeks later, John was in my office. His enormous abdominal mass was gone. He was eating again. His blood counts were dramatically improved. A month after his surgery John was feeling better than he had in months. That's when he told me that, because he found that he could buy health insurance for five dollars less per month, he was moving to a different plan and wouldn't be seeing me any more.