An Eye-Opening Adventure in Socialized Medicine | NeuroTribes

I woke up in a rented room in London in the middle of the night, feeling like my eyes had been packed with hot sand and the lids were somehow glued together. When I pried them apart, the whites of my eyes were an angry crimson.

Maybe it was nothing. I'd been told that the pollen counts in the UK this summer are sky high. A raging heat wave in a city that doesn't really do air-conditioning (like my gloriously fogbound town of San Francisco) didn't seem to be helping. But when I squinted in the bathroom mirror, I saw a greenish-white discharge collecting around my tear ducts. This looked like more than a bad case of hay fever.

Then I remembered that one of the cognitive psychologists I'd come to London to interview mentioned that she'd recently had a bad eye infection. I Googled "conjunctivitis." It dawned on me that the bottle of water I drank in her office may have been a mixed blessing.

But what to do? I was far from home with lots of work to do and no idea how to see a doctor locally. Thankfully, I didn't have any appointments for a couple of days, and have health insurance from Kaiser-Permanente through my spouse's employer. But I knew that getting reimbursed for treatment by a doctor outside the Kaiser network can be complex; what about an out-of-country doctor?

When I dialed the 800 number on my Kaiser card to find out what to do, an automated voice from AT&T informed me that I would be billed at the standard international calling rate of $1 a minute. After navigating a maze of call-center prompts, I sat on hold for 15 minutes.

The first Kaiser rep who took my call fired off a barrage of questions. Was I experiencing "blind spots, double vision, floaters, hallucinations, or any other problems" with my vision? Yes — the goopy discharge from my tear ducts was making it hard to see, and I said so. But that turned out to be the wrong answer. The Kaiser rep simply repeated her question in a more brittle tone of voice and added, "Just answer yes or no."

Yes, I was having problem with my vision, but not "double vision, floaters, or hallucinations." Judging by the structure of the question, I suspected that it was designed to fish for a different sort of problem than the one I had, such as evidence of entopic phenomena that might indicate something awry inside the eyeball, or even in the brain. I didn't want to end up shunted onto the wrong track in the voicemail maze. "Floaters, hallucinations, and double-vision, no," I explained, "but problems with my vision yes, because the discharge from my tear ducts…"

"Sir," she cut me off sternly. "These are yes or no questions. Answer either yes or no or I will not be able to help you." I furiously tried to calculate which falsely binary oversimplifications were the right ones.

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http://blogs.plos.org/neurotribes/2011/07/12/an-eye-opening-adventure-in-socialized-medicine/