‘It is as painful perhaps to be awakened from a vision as to be born,” James Joyce wrote famously in his masterpiece “Ulysses.” I recently had such an experience when my office manager—who protects me from the daily insurance grind of referrals and approvals and pre-certifications and blood drawing—was out sick. Thus the veil was lifted from my eyes, and I awoke to the harsh realities of our medical future.
One patient was severely depressed and needed medication and a referral to a psychiatrist. Another was having trouble breathing from asthma that requires inhalers. A third had a faded rash on her arm that she was ready to call a spider bite until she showed me a two-day-old iPhone photo. It was the angry red rash of Lyme disease. Each problem had an effective treatment but each visit took over half an hour to carefully complete.