The joys of NHS

In theory, universal health coverage is a great idea. In pratice, it's actually not bad -- but there are some perks to HMOs (I know, an oxymoron) that I find myself missing.

Last week, my back decided it had tolerated enough bad beds, sorry excuses for desk chairs, constant walking, chronic stress and assorted preexisting structural problems. The result? I've discovered the joys of lower back spasms. Of all the issues I've had lately, this may be the one that has me the most upset (and, consequently, leads to *more* back spasms). I'm a voraciously active person. If I'm not biking, I'm walking. If I'm not walking, I'm jogging. Favorite things to do? Hike. Bike everywhere. Kayak ineptly. Horseback ride. Walk the length and breadth of a city to get the feel. Things I'm suddenly afraid will be curtailed? All of the above. What that would mean for my life? Really, truly, can't think about it yet. But stuff hurts A LOT that never used to hurt. I'm desperately hoping that it will improve after school ends and that somehow I'll figure out whether this is all related to a short leg, a screwed-up sacrum or a torqued pelvis and get it sorted for good...the alternative is too depressing.

So, I managed to see my GP today (general practitioner), per the suggestion of the college nurse. I brought a hefty load of reading material to the appointment; it is an established fact that surgery appointments here (not "knock you out" surgery) are always behind schedule. Today, for example, I had enough time to plow through an incredibly dry article on issue linkage and water resources management, even though I arrived about five minutes before my appointment. During the 20 minute delay, a host of patients filed in and out, spending about three quarters of their time in the waiting room and no more than a quarter in an actual doctor's office. I felt particularly bad for the middle-aged man to my right, who'd been sitting grumpily in a chair when I entered, who became even more disgruntled when I was called before him, and who was downright surly when I left the building.

I'm fortunate to have an incredibly nice GP, but doctor's appointments here are different than the ones back home. You don't really get to chat, or even to bring up questions about other health issues that suddenly occur to you. They are efficient to the point of making you feel sort of like you're on a medical assembly line: introduce, diagnose, prescribe. Next! If you're lucky, you'll get ten minutes with the doctor -- I seem to average somewhere in the neighborhood of five. This causes you to become incredibly skilled at spitting out your medical history and current problem in 30 seconds or less. For example, today's conversation went something like this:

"Well, how do I sum this up quickly? Um, the thing is..." Oh crap, she's already giving me that impatient, "get to the point" look. "Lower back pain. Knife-edge spasms. Two weeks. Couple months stiffness prior. Could be short leg. Might be ilio-sacral. Don't know. Acupuncture. Chiropractic. Massage. Ideas?"

Before I knew it, I was plopped onto the examining table for a 12-second exam that consisted of bending my legs in various positions, noting that my glut was tight (no, really??), and referring me to a physical therapist for "evaluation, advice and exercises."

Great. Sounded good. The problem? Oh, I have to wait for six months or more to see this therapist. At which point I will no longer reside in Cambridge and will have the delightful choice of either a) taking a frigging three and a half-hour bus ride to see some guy about back pain, which will have increased considerably after the roadtrip; or b) trying to transfer my place on the waitlist to the therapist in Oxford, with no guarantee that it will actually happen. I tried repeating the NHS mantra, "It's free, it's free, it's free," but my back knew better and tightened up another notch.

So, I asked, feeling a bit deflated, what should I do in the meantime? The answer? Keep moving.

I reiterated the whole problem with the knife-edge pain and the discomfort moving. "Yep," she said brightly, "Motion is very important."

Maybe if I go bang my head against the wall hard enough for the next six months, the pain in my skull will distract me from my aching back.