My Turn at Mayo Clinic
Dear Friends:
I’ve been reading Moby Dick since the start of the year. I took it off my shelf and said I’d try it, finally (I bought my copy in grad school), and I was allowed to put it down once it stopped being good.
It hasn’t stopped being good.
What seems to dismay people—that it’s more a compendium of 19thC whaling practices than a narrative about whalers chasing a metaphor—is the sort of thing I’m into, because what I like about nonfiction is watching the interplay between author and narrator. Ishmael, the name Melville’s asking us to call him as he persona-fies himself into what he thinks is a novel, is a rookie whaler who somehow has sudden strong opinions and know-how about whaling. His understanding of Queequeg is less strong, but I love their proto-homo love for each other.
Reading it, I’m reminded what my pal Amanda said she liked about Bravo’s Below Deck, another enduring maritime saga: it’s a reality show about labor. Our heroes are the people who work, and the people who yacht perpetually reveal themselves to be idiot shitheads.
What a surprise to find Ahab to be such a non-entity in the novel, at least within these first 400 pages.
Yours:
Dave
Endorsements
1. The Point’s survey on men
The Point calls itself ‘a magazine of philosophical essays on everyday life and culture,’ but that sounds more stuffy than the triannual journal actually is. Most of its issues are centered on a topic, and The Point asks what I find always to be an extremely useful question: What is [topic] for? Like in classes: What is nonfiction for, to you? I’ve asked students more than once, to get them thinking about this genre’s utility, and also what they value in it. ‘What are men for?’ The Point recently asked in a survey it emailed me, for an upcoming issue on men. I, as you may have heard, love men, I always have, and loving men has always been a shitshow, watching time and again these beautiful creatures destroy each other and continually let their rotten received values get things wrong wrong wrong. For example: dominance/‘alpha’ hierarchies arise only in captive wolves, which tells us so much about what’s wrong with men. Anyway, anyone can fill out the survey (sample Q’s: ‘What would you say is the biggest challenge or hurdle that men face today?’ and ‘What are men to blame for?’), and I look very much forward to The Point’s findings.
2. More Perfect Union Substack
Recently got turned onto this news Substack via Instagram. More Perfect Union, per its title, finds stories on labor issues and frames them in a way that views pro-labor policies as patriotic, or at least as humane and good. Their website I find alarmist and clickbait-y and terrible, but the newsletter is full of the kind of news I want but don’t find elsewhere: stories about improving labor conditions and politically engaging the working and middle classes. More Perfect Union informed me about the shitty work conditions at Alamo Drafthouse, laid out the strategies Democrats are taking to help workers in my home state of Va., and talked with 3 House Democrats about how they won their seats in what were thought of as solid-GOP districts. Reading the Substack, I’m left with the feeling that a lot of people in this country want the kinds of policy I want, and are taking steps to make it happen. It’s very much good news.
My Turn at Mayo Clinic
Last week, I was sitting in a passenger van in downtown Rochester on my way to the Minneapolis-St. Paul airport, trying not to burst into tears. Nine or ten people sat in the rows in front of me, behind me. I had just seen my seventh doctor in two days, a rheumatologist around my age who had a frank and oft-bewildered candor I both don’t see in doctors and very much respond to. Just thinking of him, and the overwhelming level of care he and his colleagues had given me: it was suddenly too much, and I had to get my hankie out, wipe at my eyes.
I went to Mayo after a year or two of contracting a number of things that very few people contract: none of them serious, but all of them peculiar. I’ve hoped (and Christmas-wished) there was an underlying issue that could fix them all. ‘When people get the kinds of things you’re reporting, doctors’ll go, “Huh, that’s weird,” the rheumatologist told me. ‘We also go, “Huh, that’s weird,” but we say, “Okay but let’s see what’s going on.”’ He asked me a zillion questions. He ordered multiple imaging procedures. Our conversation was 45 minutes long, cut short only because I’d been too optimistic in scheduling my shuttle. The rheumatologist kept repeating ‘I want to be mindful of your time’ as he explained clearly all the many things that might be going on inside my body. I don’t think a doctor has ever said that to me.
It wasn’t my first time in Rochester. In the summer of 2010, N & I were planning our move to Alabama, and he kept having some stomach pains that turned out to be intestinal bleeding. His doctor in Lincoln said it was a one-in-a-million thing. When it happened again weeks later, his doctor (still practicing btw!) said the same thing. N said, F that, and took himself to Mayo, where within an hour they’d diagnosed it as intestinal cancer.
Well, not quite. His doctor was pretty sure that was the case, but they needed test and image results to know for sure. N called me that afternoon with the news; I was in Alabama, unpacking boxes. ‘Right now they say it could be cancer or celiac disease,’ he told me, and I froze, terrified. Then, my partner—the best cook I’ve ever known and a lover of good food—said, ‘I hope to god it’s cancer.’
Weeks later, they went in there and took it out, but not before scheduling him a consultation with a geneticist, who looked at N’s genome and let him know what other forms of cancer he was predisposed to. So he’s been in the clear for over a decade, but it’s visits back to Mayo every other year or so for screenings.1
Usually we tack this on to a Fourth of July trip to Minnesota, and while N has his appointments I walk the halls. Mayo is a lot of buildings in Rochester, but the bulk of it is two massive wings: the 18-story Mayo Building and the 21-story Gonda Building. Someone plays a piano most days in the ground floor atrium between them. When I’m not repeating ‘gonda building gonda building gonda gonda gondabuilding’ to soothe myself, I look at the art. Mayo is loaded; they have lots of art. There’s a long-ass hall of signed Warhol prints, animals mostly (admittedly, the cheaper stuff). But I loved this set hanging in the waiting room outside the ultrasound clinic:
At any rate, this time, it was just me Mayoing alone. They did all the scheduling of who I was to see, and when, based on a questionnaire I’d emailed them back in December. Like I said: 7 appointments in 2 days. Every doctor I saw I saw for an hour. Thursday morning, my internist felt something under the skin of my neck when she had me swallow water. Five times I did it while she repositioned her fingers, then ordered an ultrasound; hours later it was scheduled for the following morning, thirty minutes after the procedure my test results were in, and ten minutes after that notification, as I was reading the results in the online portal, someone called to tell me I’d been scheduled to meet with an endocrinologist for an hour the next business day.
Mayo is fast. What they found in me was a nodule on my thyroid they didn’t love the size of. But the endocrinologist was sure it’s not causing any of the symptoms I went to Mayo to fix. And it’s likely not cancerous, but there’s a chance, so now I’ve got my own schedule of regular screenings.
Mayo is fast, and thorough, but I only had two days. I left with solid plans (for the first time) on how to tackle my allergy thing and my acid reflux, but I didn’t get a chance to see a vertigo specialist, and my rheumatologist wants an MRI and CT scans, which will take time for my home doctor to schedule.
Jury’s still out on how/whether my skin thing’s going away, or what my red ear thing is all about. I was afraid of spending all this time and money going to Mayo only to have them tell me nothing’s wrong with me. ‘But then you know,’ N said. ‘If Mayo says it, it’s true.’
I believe him, but I’m still waiting for a wizard to come and wand these things out of me.
I’m lucky in lots of ways, and one is that I have a primary care physician here in SF whom I love and trust and kind of idolize. He is terrific. Mayo practices what it calls consultative care: everyone there looks and tests and consults with each other about what’s going on with you, then they make a plan to take to your local doctor.
Mayo doctors see 5 or 6 patients a day. Most doctors in this country try to squeeze that many into an hour. I’m not a doctor, but I imagine I would be happy amid the crunch of appointments to take on the advice of colleagues who had the luxury of time.
I thought about luxuries a lot at Mayo. Health care is still, infuriatingly, a privilege in this country, not a right. Forever, when I heard of Mayo I thought only rich people went there. Rich people do go there,2 but the clinic is in-network for my employee insurance plan; going there cost me only time, airfare, and 2 nights of a hotel room.3
The thought I’m trying to get to I had when I went on sabbatical in 2019: Why can’t everyone have this? What would it cost this greedy country to give every full-time worker 6 months paid leave every 7 years? The time my sabbatical gave me back to explore who I was outside of my job helped me reset and be better at that job when I returned. I can only see the gains.
Mayo is like Disneyland for health care: some people decades ago imagineered a better way to treat patients, in all the meanings of that phrase, and at nearly every step in the Gonda building you see it at work. So: why can’t everyone have this?4
No time here to write a policy paper about how to make it happen in health care facilities nationwide, but if it’s weird I’ve made this whole Main Matter an ad for the Mayo Clinic, it’s only because I want everyone I know and care about to get there, sometime, if they need it.
Something strange going on in you your doctors can’t figure out? You can request an appointment with Mayo online.
Good luck, godspeed. I wish everyone better health in 2024.
This week’s thing I didn’t buy at the antique store are these pencil drawings of celebs who very well may have gone to Mayo.
End of the story: When N called his Lincoln doctor to tell them he’d been treated for cancer at Mayo and wanted to schedule an appointment to talk next steps, his doctor (again: still practicing!) sent him a registered letter in the mail the next day dropping N as a patient for not following his medical advice.
My first night in Rochester, the host where I had dinner told me I’d just missed a celebrity dining that night. I asked who, and he said it was Stevic Mackay from 12 Foot Ninja. This was 100% lost on me, so I asked who was the most recent celebrity before him. ‘Who’s the guy from 300?’ he said. ‘GERARD BUTLER?!’ I shouted, having long had A Thing for Gerard Butler. The host nodded, and ran his hand over his belly. ‘He was having longterm digestive stuff and I think he was here to get something removed,’ he said, informing me that the workers of Rochester are kind but not discreet.
Not trivial expenses, I understand. Maybe here’s a place to note that Mayo has clinics in Phoenix, Jacksonville, and London if any of those are easier/cheaper for you than Rochester, Minnesota.
I should point out that my fantasy of everyone getting access to Mayo is not solely the fault of our health care system. A friend of mine in a similar boat as I’ve been in, with a lot of strange things they needed diagnosed, applied to Mayo for consultative care just as I did, but was turned down for whatever reason, so apparently Mayo sometimes decides it’s not for everybody, despite how much I’m trying to wrap this Shenny up by suggesting otherwise.