Wednesday, March 3, 2010


Cleveland Clinic
9500 Euclid Ave.
Cleveland, OH 44106

by Beau Cadiyo

I’d purchased a second-hand bicycle whilst at university in Cardiff, and was cycling to rowing circuits one wet afternoon in early April. I stopped at a light at Park Place next to a thirtysomething woman in a small two-door car. I looked over, she looked back and it was established to my satisfaction that we were racing.

When the amber light signaled the turn to green, we were off. I held an early advantage, seeing as she had to shift into gear, and as my legs pounded, the sun reflected off the wet pavement. Too late I realized I was almost on top of a pothole, which had filled with rain and disappeared into the rest of the pavement. I pulled up the front tire, but my wheel was not properly connected to the fork – the wheel continued forward, dropping into the puddle and then veering off to the side, as my bicycle reared up, then crashed down. I was able to say “oh shit” as the pavement rushed toward my face, before my body rolled over the bars spectacularly and my field of vision spun from the black of the ground to the blue-grey of the sky.

Luckily, my competitor was a nurse; she stopped immediately and called an ambulance. My mother had given me my helmet, of which we found only 13 pieces. Most of the skin on my lower face had come off, my upper lip was pierced and my bottom front teeth had been ground down somehow. Twenty minutes later I walked into the first emergency room I’d ever visited.

They saw me immediately, which I felt was simply basic courtesy. The nurse who examined me said that my helmet had saved my life; she didn’t have to mention that it hadn’t saved my face. The nurse who stitched up my lip asked if I would grow a moustache to conceal the scar. Then a young, slender dental student with bright blue eyes came to put cement on my teeth; a short while later, I was shagging her in my friend Frank’s bed.

When I was deemed as fixed-up as I could be, they gave me some painkillers and antibiotics and suggested that I put Vaseline on the scars to help them heal. At the front desk, I pulled out my wallet.

The nurse looked confused, as if she wasn’t sure I was in my right mind after my ordeal. “You don’t have to pay for medical care here. It’s paid for by taxes,” she explained, as if to a child. What if I was American and wasn’t paying taxes? She turned to look at the nurse next to her, who shrugged. “Just consider it a gift, from our country to yours,” she said, and smiled hesitantly.

My next trip to the emergency room came nine years later. I’d developed a hard pain in my forehead, which was joined by a rash and then elephantine swelling around my face. I went to my insurance company’s website to find a local doctor. Of the top 15 listings, only three numbers actually went through to doctor’s offices, and two of those were duplicates. Of the two, only one could see me within a week. They said that rather than waiting for an appointment, I should go to the hospital, which I did, after talking to a doctor at the Cleveland Clinic who gave me some names to drop. Most doctors left at 4:30 or 5 p.m., he said, and if I was to have any hope of seeing the good ones, I’d need to persuade them to see me quickly.

I entered the waiting room behind a slender young woman who was screaming and holding her stomach. After I’d checked in at the processing desk I went to the waiting room; there were perhaps 100 people packed into it, most sitting down, a few children running between legs. The woman’s screams pierced the air – “God, I’ll stop doing it, make the pain stop and I’ll stop doing it.” Everyone tried to ignore her.

I was called back to the check-in desk for a more detailed interview and was quick to drop the names of the doctors. The nurse shrugged, making it clear he was unimpressed, and sent me back to the waiting room. Another nurse came out to give the screaming woman some painkillers. I suddenly realized that 90% of the people in the waiting room were black.

I was called soon after, leapfrogging almost everyone else in the room. I was shown to a private room – well, a curtain around a bed – and I waited.

And waited. After about 30 minutes, I saw a doctor, who fired a few quick questions at me and spat out a diagnosis: I had shingles. He looked in my ears and nose, and after checking that I had insurance, he suggested I get a chest x-ray just to be safe. Two and a half hours later, I was escorted to the x-ray room by two young, non-communicative nurses; another hour and a half was spent waiting for the results.

A nurse appeared at last to tell me that everything was fine, to give me my prescriptions and to validate my parking ticket (otherwise, parking was $20). In the payment room I presented my insurance card and paid the $100 co-pay. The exit took me back through the first waiting room. It was still full. As I walked through, I could tell the patients thought I was a doctor, and resented my leaving early while they suffered.

I returned a short while later with Frank Hoxha to eat in their food court, which is part-cafeteria but with a McDonald’s and a Starbucks attached. Before I went, I Googled “Healthiest sandwich at McDonalds.” The first site that popped up listed the Grilled Chicken Sandwich as the healthier choice of sandwiches, so I resolved to get that. After all, if a McDonald’s was allowed to open inside one of the top hospitals in the world, surely it would be required to serve only the “healthiest” options from its famously unhealthy menu.

In the end, it was indistinguishable from any other McD’s that you might see anywhere else in America, except that the majority of the people waiting for food (six of nine of us) were in hospital uniforms. All of the hospital workers were overweight, and three of them ordered Filet O'Fish sandwiches (380 calories, 18g of fat, 40 mg of cholesterol, 640 mg of sodium) with large fries (500 calories, 25g of fat, 0 mg of cholesterol, 350 mg of sodium). I got the Grilled Chicken Sandwich (420 calories, 10g of fat, 70mg of cholesterol, 1190mg of sodium) as a meal (i.e., with fries and a drink). The total should have come to $5.80. However, I asked for orange juice (180 calories, no fat or cholesterol, 5mg of sodium) instead of soda (health content variable). One might think that ordering juice, which should be the healthier option, particularly inside the walls of a world-famous hospital, would be rewarded, but instead it was punished: my total was bumped up to $6.90. I paid 19% more to eat “better.” It was, of course, not really “better” in any quantifiable sense. I was not given orange “juice” – it was sugar, water and orange coloring, without even a semblance of pulp added for authenticity. It tasted like flat orange soda.

My sandwich was similarly disappointing; the chicken was, at least, chicken, but it was old and slippery. The bun was slimy; the tomato slipped out, and when I took a bite of it separately, it was entirely devoid of taste. The mayonnaise was the most flavorful thing in the sandwich. The fries were, of course, McDonald’s French fries; they were an incredible vehicle for the ketchup.

I spent a fair amount of time trying to figure out why McDonald’s might be allowed to peddle their wares in a temple of health like the Cleveland Clinic. I suspect the reason is that the Clinic – which might be expected to show people how to get and stay healthy – is just another business looking to maximize profit. While the CEO of the Clinic made some waves a few years ago, the fact that the people paying for McDonald’s on the ground floor today might be the same people paying for bariatric surgery on the fifth floor in ten years is apparently not cause for much more hand-wringing in the Clinic’s boardroom.

It looks like the owner of the McDonald’s franchise has about four years left on their lease with the Clinic. I’m not sure how much time is left, but I hope the Clinic declines to renew it. America’s health-care system is already a travesty without an internationally respected hospital tacitly endorsing McDonald’s. This is especially true now, with the Republicans blocking any improvements to America’s health care system, even as heart disease blocks the arteries of their leaders. The Clinic doesn’t need to be sending the message to vulnerable patients that McDonald’s is good enough for the Clinic, so it’s good enough for them.

McDonalds on Urbanspoon

No comments: