Health care in America: even my doctor lines up for the community multiphasic blood screening, rather than going to the regular lab.
It costs thirty-two dollars for the usual screen, plus ten dollars for thyroid, or PSA or B-12. The blood-drawing used to be held at the local rec park building. Now it’s at the county emergency services building, outside of town on a brand-new winding country road. They could just as well hold it at the public library, or firehouse, or agricultural center—any large room usable for voting, or the traveling reptile show, could be set up for phlebotomy.
I’ve had my blood drawn in a lab attached to a medical suite, or in a hospital, or at an off-site location attractive for proximity or shorter waiting times. Those labs all resembled each other in their hospital décor, their magazine-enhanced waiting areas and nurse-like receptionists, their blood-drawing chairs set next to tables crowded with tubes. Fainters could opt for a bed or gurney with a pull-around curtain. I used to be a fainter, but then I ran out of time for the process of losing and regaining consciousness. So I started chatting up the phlebotomists while staring fixedly at an opposite wall, and remained upright.
Last time I had my blood drawn at the hospital lab, routine stuff ordered by my internist, the bill came to two hundred dollars, even with my semi-expensive employee-subsidized health insurance. My doctor waxed sympathetic, but, hey, he got his own testing done in the community multiphasic screen. My doctor lined up at the rec park? I imagined his friendly bespectacled face and white coat as he stood patiently in line by the playground.
So I signed up for the same, fasted ten hours, and drove five miles to park, at 7:15 a.m., in a large crowded lot with everybody else. There was a line out the door. A greeter checked my name off a list in the lobby, and gave me the lowdown. She pointed to a room beyond the lobby. “They’ll give you your tubes in there,” she said, “and there’s food for after.” Give me my tubes? Not to sound squeamish, but I’ve never handled my own test tubes. I proceeded to a table lined with women in t-shirts and cardigans presiding over a cashbox, to pay forty-two dollars. They might have been working the school bake sale, a recent occupation of mine. I recognized their upturned smiling faces, their pleasure at exact change. They directed me to tables scattered with pens to fill out a form. At this point I could have been registering my kid for youth soccer, which occurs in an elementary school cafeteria, and which would, apparently, be a fine place for the town’s populace to sit down and get stuck with needles.
Form completed, I headed for the inner chamber, and another table of smiling women. A registrar studied my form, grabbed two plastic test tubes with rubber caps, and carefully wrote my name and identifying numbers on the label of each one. Then she handed me my tubes and directed me to stand in line. Four long tables were being used for the testing, with metal chairs pulled up by the ends. Boxes of medical supplies filled all of the table space. The lab techs, all female and dressed in patterned scrubs, looked harried, rushing from here to there, brushing strands of hair back toward ponytails. Who signed up for this shift, I wondered, administering community blood tests from 6:30 until 8:30 a.m. without pause. These must be the newest or worst phlebotomists. A tall, unsmiling woman snapped off her blue gloves. I hope I don’t get her. She raised a hand to indicate she was free, and turned away. Of course, I get her.
“Is there an arm you’d prefer?” she asked nicely. She had me sit in the appropriate chair and admired my visible veins. She had weird hair, a cap of blond wavy stuff rimmed at the forehead with flat cinnamon bangs, but now she looked me in the eye and smiled. “I bet you’re ready for coffee, huh,” she said. We chatted. She had this chatting thing down. Within a minute she knew that I was a college professor/writer with kids, and I knew that she was “an orange on the color wheel.” Orange signified a creative type, according to her boss, the woman who supervised this bloodletting factory and who also happened to teach a class about the color wheel. “How do you know which color you are?” I asked.
“You take the class,” she said. “There are four colors, orange, gold, blue, and green. If you know your color, then you can figure out how to get along with other colors. You must get some odd students, right?”
“So you would learn how to interact with them. Like for me, I learned about golds, who are really moral. I’m in a gray area with that, but if I know they’re golds and I’m orange, I can get along fine.”
Mulling the concept of there being only four colors on the wheel, I felt relieved to hear about the gray areas.
“Nonfiction, there’s nothing better than that,” she remarked. “My mom gave me this Good Housekeeping contest to do, 2500 words or less but it had to be fiction, and I was like, what? I don’t want to make it fiction, I want to write about real life! You know?”
“Yeah. My husband writes fiction.”
“Is it based on real life?”
I nodded. We both shrugged. “I know,” I said. “I’d rather put my name on it and call it nonfiction.” This comment represented a gross simplification, but I was following the phlebotomist’s lead in the creative art of chatting. Who knew we would be discussing writing? I thought of this woman’s mother handing her the contest clipping, encouraging her daughter’s talents. She was a creative type, an orange on the color wheel, sugar dreams arrayed before her like a gummi-candy buffet.
“I had this great English professor, she let us go all out, do whatever we wanted, you know, where other teachers would always be telling you, you have to say it this way or whatever.” She sighed. “I chose between writing, phlebotomy, and the whole medicine thing.” I would have asked why—the obvious answer being financial—but our time was up. My phlebotomist had drawn my blood, skillfully, performing an intimate transaction. And she had also looked me in the eye, and seen me, and engaged in a real conversation. I don’t know many people who can perform the metaphysical part of her task, especially in less than five minutes.
I had much to ponder. I passed up the free blood pressure test and the foil-topped cups of orange juice and the cellophane-wrapped muffins. Call me a snob, but I had brought a Kashi brand granola bar. Was it to distinguish myself from the mobs who would grab at the crackling wrappers of low-quality free food? Or was it to preserve some simple control over my choices while shuffling along with the masses? The community blood-screening show would pack itself up and head over the green hills to another county, vampiric peddlers.
I signed up to access my lab work on an e-portal, and drove the five miles home. Right in town, in the hospital, stood a well-equipped, permanent room especially designed for drawing blood. It was called a lab. But no one could afford to use it.
Kathryn Rhett is the author of Near Breathing, a memoir, and she teaches creative writing at Gettysburg College, in the low-residency MFA program at Queens University of Charlotte, and at the Iowa Summer Writing Festival. Her work is forthcoming in Harvard Review, and she keeps a blog at kathrynrhett.wordpress.com.
Q: Can you tell us about the motivation behind this piece?
A: First, it seemed an indicator of dire straits in health care that I had to have blood drawn in a cafeteria. Second, while I went in there with a snide attitude, I left feeling humbled by the kindness of my phlebotomist. Third, I was tired of writing long serious essays and wanted to write a brief impression.
Q: What’s the best writing advice you’ve ever been given? Did you follow it? Why, or why not?
A: Keep going. David St. John told me that. His method was attentive encouragement, and his belief was that the only way to get better was to keep writing. The only way to get to the good stuff was to write toward it, failing along the way.
Q: Please share with our readers a little about your own writing process.
A: I read all the time and write down quotes I like in a notebook, so that if I’m not writing at least I’m thinking. Sometimes I write longhand in a notebook and sometimes at the computer—whichever way helps me get the words out more easily. Being a working parent, I’ll write anywhere, anytime, in my head, talking to myself, on an index card—whatever’s available when a thought happens.
Q: How do you organize your home library? Tall to small? Alphabetically? Or, have you converted totally to e-reader?
A: Alphabetically by genre, poetry at home and nonfiction at the office. The fiction is all mixed up because my husband prefers chaos, and that’s his genre. Books I’m currently reading are in stacks on night table, kitchen window sill, and next to the couch.