Doctor Visit

Years of way too much stress have taken their toll on my health.  Still, I have no regrets.  I’ve been fortunate enough to have made a positive and, I hope, lasting impression on many people’s lives.  For a long time I treated my calling as a public defender as one worth dying for, just as we send soldiers into war who get maimed and die for our rights and our way of life.  My job as a Public Defender lies at the nexus of where those rights and the individual come together, which can and is often a turbulent spot in our culture.  Mine and that of other people who’ve dedicated their lives to indigent defense, is a special calling, and one of great stress.  The stress caught up with me, with ballooning weight, high blood pressure and diabetes.  I came to American Samoa to slow down, and, my life here has become something of a monastic one.  It’s just what I needed, and I am happy to report that, in the first two weeks I was down 13 pounds, my latest blood pressure was perfect at 119/59 and my blood sugar was perfect at 108.  As I’ve said to many people, I intend to return from this adventure a skinny man, and it looks like I’m off to a strong start.

I had originally been scheduled to leave Royston for here June 24, so, I went to my drug store there and had all my prescriptions refilled to give me a month to get settled in, find a doctor and make connections.  But, because I didn’t leave until almost a month later I ran out of a couple of meds soon after my arrival, and, since it would be another week or two before I could see my new doctor here, I had to make a visit to the emergency room.  There was no emergency other than just needing refills on a couple of meds.

All of the medical business for the island takes place at the Lyndon Baines Johnson Tropical Medical Center.   They are able to adequately provide most routine health care.  However, more advanced or complicated treatment must be had off-island.  That typically involves a plane ride to Hawaii, or, maybe Australia or New Zealand. 

I went to a party the other night and met a young palagi couple (palagi is the word for white folks, typically American) who had only recently arrived from the states for the husband’s 2 year gig as a prosecutor for the Attorney General’s office.  Here, there is no District Attorney’s office.  Instead all the criminal prosecutions are handled in the criminal division of the AG’s office.  The wife of the young couple is pregnant, and looks to be maybe a little further than half-way along.  She intends have her baby, their first, at LBJ on the island.  How exciting!  Dual citizenship and all that!  “Where were you born?”  “American Samoa.” “Where the hell is that?”  Folks have been having babies on this island for a long, long time.

The prerequisite for all medical treatment, doctor visits, optometrist visits, prescription drugs, etc., for us contract government employees is to obtain a medical card.  I had done this the day before and doing it had been something of a minor adventure.  First, I had to show a copy of my contract to receive a card.  Then I had to find the office which issues the card.  Not having any idea about how to go about doing that, I went to the administrative office.   Just as a security guard had provided invaluable assistance in Honolulu, a security guard for the hospital helped direct me.  The administrative office then sent me through the maze that is typical of a hospital until I found the records window.  I was also there to pick up a psychological evaluation for one of our clients, which was also handled at the records window.  Two birds conveniently with one stone at the same window.

The emergency room is where many people on the island go for their primary medical care.  Most only go when they have an immediate need to see a doctor.  Thus, it tends to be full all the time, and there’s typically a longish wait.   All the seats in the waiting area were taken and I had to stand during my wait.  But they worked me in pretty quickly.  There was a $30 fee for the ER. They didn’t have one of my meds, but they were able to reproduce it with a combination of two others, so, other than involving a couple of trips between the pharmacy, which is located inside the hospital, and the ER doctor, I got my refills.  Refills were $20 each, so that set me back another $80. 

There are “drug” stores around the island but, they do not dispense prescription meds.  Rather, they’re the source for over-the-counter remedies.  The prescription meds are dispensed through the hospital pharmacy.  And, the way that works is this.  Upon arriving at the pharmacy, prescription in hand, walk up and take a number ticket from the little dispenser, just like getting gift wrapping at Macy’s.  After a looonnnggg wait, when your number flashes on the LED screen, walk up, hand the clerk your ticket and prescription, and they fill it while you stand there.  Pay them and you are on your way.

About a week later I was able to see my doctor, Dr. Sean.  He’s a really cool guy.  He’s been on the island for 6 years.  He got his medical training while he was in the army.  Once he finished medical school, he served out the remainder of his tour of duty to fulfill his obligation for the expense of medical school.  When he mustered out, he was debt free.  Not having a $200,000+ debt from medical school allowed him to come to American Samoa and help the poor people here for substantially less pay than he would make in the states.  So, that’s pretty cool in my book.  There was no charge to see the doctor, as it’s covered under my contract, which was a nice touch.

Next:  My Frame of Mind