Will It Go Round In Circles?

This day was good.  And I am exhausted, but need to write this down against forgetting. 

I'm negative. Covid-19 negative.

I am sleeping downstairs for the time being using a chair, an ottoman and a table as a bed.  That is a story for another day, but just know I am.  

I got up late this morning--well after 7--and after the perfunctory coffee, and some raisin toast, went upstairs and sat on the side of Jenny's bed and woke her up.  For reasons I can't

A spinning gyre.

explain, it made her day.  She was so pleased I had done this, she told me how lovely it was that I had done that.  My first thought was, I bet she wishes el pinché could do it instead. My second thought was, accept that she is happy and move on with the day, expecting a more pleasant few moments with her than last night's debacle.

Jenny left around 9 to pick up meds and do whatever else was on her list, which was not short.  I don't know how she manages to function, when she has such little energy, but ours is not to reason why.  .  .

I worked all morning, drafting, listening to a lawyer to whom I had to explain just cause and due process, and drafting, and just waiting for my doctor's appt.

I saw a doctor at Kaiser today. Okay, so not a doctor, because you almost never see a doctor.  I got, instead, a PA fresh out of school, I would hazard to guess.  I am a walking time bomb people.  Before I met with him, the Medical Asst took my blood pressure.  It was precisely terrible. It didn't get any better when the P.A. came.  

I told him both knees were bothering me.  He focused on the newly injured knee exclusively.  He asked me what happened, how did I injure it.  I wrote a narrative, per Kaiser's request this morning, shit, I should have just sent him a link to my journal, although he wouldn't have bothered to read that either.  

When he was done examining my knee, he said, based on his tests, his surmise would be some soft tissue injury, but not ligament damage.  He recommended a wait-and-see approach. If my knee isn't better in 3 weeks, he told me to come back and we could then do an MRI.  

I took a deep breath, but apparently it wasn't deep enough, because I let him have it.  A lot.  I explained that I am hobbled now, that I was at Urgent Care three weeks ago, and they told me to come back to see my primary doctor so an MRI could be ordered if I hadn't gotten better in a week.  I asked him to help me understand why I  should wait. I explained they did this to me twice now at Kaiser, x-rayed what they knew was soft-tissue damage, got me a referral for an MRI for my shoulder injury and more recently recommended getting an MRI ordered from my primary physician for my knee, as noted above.  Note, that scan for my shoulder was cancelled by my primary without consulting me. As was the cardiac stress test, the PT test, the MRI for my arteries in my neck--shit I'm fucked.  I listed all of these things.  I took a breath and let him talk, only after asking him to explain his logic.

He said there are finite dollars at work, that MRI's are only ordered when necessary and that people wait a long time, so they don't want to order them when not necessary.  I didn't lose my shit, but I wanted to.  He just had done an exam and determined I had an injury, which I have had after hitting my knee on a rock TWICE, for three weeks. Moreover, the urgent care folks directed me to come back and seek an MRI if my injury wasn't better.  I said all of this to him, my speech quickening I am sure, my voice full of anger and exasperaton.  I noted that while it is true there are finite dollars at work, Kaiser has a duty to provide care, and that I wouldn't be denying anyone the ability to get an MRI sooner. No matter what, it takes forever to get an MRI, unless you are seen through urgent care and they make the determination it has to happen stat, which I am guessing is not very often any more.  I pointed out that if my knee gets better while I am waiting for an MRI, I would cancel my appt, and anyone waiting could move up. It happens all the time, to be sure. So both arguments fall flat.  

He tried to parry, arguing and explaining standard of care to me and how they are determined and what he bases his recommendations upon.  But that wasn't what he said initially, and because I have been reading the standard of care documents for PDAC for the last year, I know that there are documents which make recommendations--and I have not been privy to what the standard of care document is for this injury, but I do know I am hobbled, if you saw me walk I am obviously seriously injured, and that I was told that in order to determine what is wrong with me if I haven't healed in a week, I need an MRI. I explained my concern that this injury could get worse if it needs treatment and I don't get it. I then said, as an attorney who worked in healthcare for many years, I am baffled by Kaiser's reticence to provide the MRI.  I then said, moreover, my wife is dying of pancreatic cancer, and I care for her, I cannot afford to be hobbled.

He agreed to order the MRI, with the proviso that it might be rejected.  This is a new thing, and may explain why all the referrals on my chart got axed.  There is a committee that is reviewing these referrals and then removing them.  However, I was explicitly informed when I asked about this, in writing, why the referrals were in "pending review" status and now missing, that my primary care physician had taken that action.

I got the PA to reinstate the stress test, a fat lot of good it will do me with these knees, but I will try.  I got him to prescribe new blood pressure medication, which is a good thing.  I explained to him that my beef is with Kaiser, not with him as a professional, although how anyone could operate in a system that seems designed to withhold care I do not understand. So, for today, a happy ending.

When Jenny was caught cheating on me last year with Eric el pinché, who she professes to love even today, she said it was my fault for never responding to her long texts she would send when we were fighting, that she had nowhere else to turn. So, she opted to have the affair, apparently.

Today, in therapy, I showed how completely false that narrative is, and it made me feel better, almost happy in an otherwise grey field (btw, if you haven't heard from me in a while its because I am ridiculously busy, not depressed) of blah.  

I raised the issue of the fight we had last night in a colloquy with the therapist. I told her how I walked away from Jenny when she was angry with me and going on and on,  and went upstairs to the office and watched television. It's more like a den than an office, but whatever.  Jenny interjected that this was the problem, that we never resolve things because I leave when we are fighting (never mind that last night, as she does in many of our arguments described herein, she leaves the house in a huff). I failed, and I do mean failed to make that point, I simply forgot.  The therapist said that my leaving is a defense mechanism and sounds like something that has existed for a long time. I pointed out that the pattern we are discussing, Jenny ranting at me, me leaving, her sending endless texts (she used to call over and again before text messaging was available) has been going on for 30 years. 30 fucking years we have engaged in this dysfunctional fighting. The therapist told Jenny that I leave because I am overwhelmed by her--which is accurate. I lose the ability to think, and neither of us is particularly rational during these interactions, and I tend to go into full hostile witness mode with her if I stay.  

Jenny was butt-hurt that I suggested she order from UberEats last night because she didn't want to eat leftovers in the fridge and I was tired after a long day, and I was offended that she suggested I drive to my appointment, given she drives everywhere else and if she doesn't, I am driving her to every single doctor's appointment she asks me to do.  Neither of us addressed this in therapy, but I knew that a fight was brewing and was coming down the road like a truck on a 28 hour run to deliver beer to Atlanta, an hour behind schedule.  I told the therapist this.  

Jenny tried to relitigate last night.  The therapist wanted to focus on the pattern.  I was just sitting there feeling vindicated.  Vindicated. The therapist helped me understand that the lie that my failure to respond to Jenny's texts was not the driving force behind the affair. I knew it in my heart that this dysfunctional pattern was owned by us both, but somewhere had, even though I know better, a sympathetic ear to the claim that I failed to try hard enough when I didn't listen to her ultimatums. Albeit, the ultimatum was not I will fuck someone else for three years, travel with them using our money, go to hotels 2x a month for this third-rate romance (again, using our money exclusively), and generally shit on our marriage. Still, listening to the discussion about this pattern of unresolved conflict being, well, a pattern of dysfunction shared by both of us, does put the lie to the claim that but for my failure to respond to emails, she wouldn't have fallen in love with someone else.  BTW, she has been to school so much in the last two weeks, one would think she was back at work full-time.  Because I'm not stupid, and because I am learning to let go in individual therapy, I am not going to make an issue of it.  It isn't that she thinks I am stupid or a nebbish, although both are likely, she truly feels justified in this love affair, and believes I should stand aside so she can be happy. I just wish she would go into remission so I could move out and move on with my life. 

Finally, in a story destined to break my heart, every single day Jenny has told me for the last 10 days or so, that she is going to beat this disease, that she is going to survive it. Period.  I am all for positive thinking, but I don't believe it, and wonder whether saying this over and again to me and the kids is somehow not good for the kids or her.