Twice a week, a cripplevan picked me up at the warehouse and lugged my ass to the rehab hospital. The charge nurse had reserved a ride for me every Tuesday and Thursday afternoon; for the most part, a different driver arrived each time. I looked forward not only to amassing long-term skills but also to the break in my daily routine. At the warehouse I dealt with a mostly disingenuous dirt-stupid staff. I’d be a lying cuss if I claimed that I didn’t welcome interaction with friendly and quick-witted young women.

Arrangements for me to return to the warehouse after my therapy sessions weren’t nearly as dependable. I soon discovered that I had to phone the cripplevan company midway through every session to remind them of my reserved ride; I routinely had to spend about two hours waiting for my ride in the downstairs lobby, where damaged gangstuhs hit on the receptionist corralled by a station centered in the lobby.

The paratransit dispatcher often assigned my return trip to the same driver for weeks on end. Most cripplevan drivers are dump trucks of failure who delude themselves that they’re “medical professionals” whose time is at a premium. They—or more likely the dispatcher—harbored no regard for a cripplevan’s “cargo” and thought nothing of consolidating trips: There might be two or three people in the van when it arrived at the rehab hospital; the driver might make a couple more stops to collect passengers after picking me up, before heading north. The paratransit company rarely provided a vehicle large enough to accommodate the number of passengers. Sometimes an unbelievable reek hung in the air, proof that some caregivers were more concerned that their charges participate in scheduled singalongs and Bingo games than use soap. The warehouse was located on the far north side of the city, so mine was usually the last stop.

I worked with a skilled and genuinely amicable therapist. Her sometimes vaguely patronizing assistant also knew her onions. When only a few weeks remained in the program, my therapist arranged for some high-ranking rehabilitation doctor to evaluate me.

On the appointed day, she led me from the spacious rehab room to a stereotypical examination room. After a few minutes, a horse-toothed woman in her mid-thirties breezed in followed by several schlubs wearing lab coats. She offered plastic cheerfulness along with her hand, smiled and introduced herself as Dr. Gytt. The guys behind her remained silent; Dr. Gytt didn’t acknowledge their presence.

Dr. Gytt grilled me (e.g. “What do you hope to accomplish?”) while the members of her entourage listened intently and took notes. Then she regarded my therapist and asked about my progress. I felt like a grade-schooler eavesdropping on a parent-teacher conference.

After listening to my therapist, Dr. Gytt turned back to me: “Well, I think you’re just spinning your wheels in the nursing home.”

I agreed. I explained that accessibility and finances were issues, so I had no choice but remain tangled in the red tape of a clueless system stuck in the dark ages. I pointed out that people you’d expect to know better allow themselves to become sputtering emotional retards or grinning automatons when confronted by a person using a wheelchair.

I don’t think she listened. She smiled and continued: “I can understand that you’re scared. You should probably get into a group home so they can cook your meals, do your laundry, make sure you take your meds…”

I informed Dr. Gytt that I hadn’t taken meds in years, and that I’d displayed my ability to do laundry years ago in occupational therapy and, jumpin’ Jesus Christ Almighty hadn’t she ever heard of a microwave?

Dr. Gytt started as soon as I stopped: ”…And you can socialize with people your own age…”

I mentioned that I wanted people to leave me alone already.

“…And have people around who’ll handle your money for you.”

At the time, I successfully managed a checking account and a savings account. Given that I’d helmed varies guises of the former for fifteen years and the latter for twenty-nine years, maintaining those accounts had become effortless.

Dr. Gytt’s enthusiastic delivery of the final selling point convinced me that her head was entrenched in her ass. I unceremoniously wheeled out of the room and toward the lobby without listening to any more of her spew. A member of her entourage meekly held the door for me.

The rehab hospital’s self-congratulatory website claims their physicians help patients achieve the highest level of independence possible.

At any given time, two or three wit-challenged high school girls worked weekdays part-time in the basement laundry room. This schedule allowed them to attend weekend classes at LaBabette’s Academy of Beauty and dream of the butt implants they’d get when their careers as beauticians took off. Repeatedly my clothes came back from the laundry splotched with large bleach stains or permeated by the pungent reek of decay and old people piss. But I should point out: Mr. Gold treated them like retarded children, an extraordinarily foul aroma fomented in the plastic laundry barrels delivered by CNA’s, they slaved in a cramped and sweltering space. Those conditions wouldn’t have motivated me to do a bang-up job either.

After I’d lived in the warehouse a few years and normal awareness had long since returned to me, I heard semi-nightly commotions in the hallway; I eventually learned fires had been flaring-up in the laundry room. The fires sometimes proved dangerous enough that employees working the graveyard shift phoned the fire department. They must have also summoned Mr. Gold to the warehouse on those occasions. I’d grown accustomed to his treehouse-commander-cum-eunuch voice blaring over the PA during the wee hours, paging “Dr. Red” and then a few minutes later announcing “All clear.” I’m guessing he used the euphemistic name to avoid upsetting the residents. It worked. Most residents shunned common sense like it was soap.

A guy in his early twenties named Drew frequently served as first-floor night charge nurse. He unwittingly set himself apart from most nurses at the warehouse by cordially conversing with residents as equals, demonstrating an above-average understanding of his job, and displaying a quiet dedication to nursing as opposed to authoritarian ass-kissing.

One week, five early mornings in a row at roughly 3:00 am, I heard static-drenched radio transmissions and bellowing male voices coming from the hallway; laundry room fires had become a regular event. Drew happened to be serving as first-floor charge nurse the fifth night. Since the night staff had involved the fire department, it would be impossible for the administration to camouflage fire code infractions and the use of sub-par equipment. They needed a scapegoat and elected Drew. According to the administration’s official explanation, Drew set the fires himself so he would appear a hero for phoning the fire department. A fancy-sounding pathology—John Wayne Syndrome—lent weight to the allegations.

The administration effectively destroyed Drew’s nursing career. He’d likely be able to get a job in another nursing home—those places will hire anybody—but the administration’s fictitious account made it very unlikely that a hospital or privately practicing doctor would even consider employing Drew, much less discover his desirable professional qualities.

There were subsequently no more fires in the laundry room. I’m sure the administration’s newfound concern with fire safety stemmed from their determination to avoid fines and lawsuits.

The coworker asked, “Has he had any experience as a therapist?”

The supervisor frowned: “Well, Mr. Gold never said.” Quickly her smile returned: “But he’s an army man!”

One morning I rolled into the therapy room and found the new guy sitting at one of six desks organized in the alcove. I slogged through my morning exercise ritual, anticipating my post-workout cigarette. (In retrospect, I realize the profound stupidity of smoking after exercising; my shitful luck had magnified a deep-rooted smoker’s rationalizaion.) When I finished working out, I wheeled to the ashtray positioned on a bookshelf next to the new guy’s desk.

He forced symmetry on a sloppy pile of papers by tapping a long edge on the blotter. Then he stood and walked the short distance to the supervisor’s desk, gently placed the tidy stack in front of her.

At more than six feet tall, his frame appeared gangly. On closer inspection I noticed reasonably developed muscles. But what really struck me was the tiny melon atop his man-child’s body: Like the head of a toy plastic army man grafted onto the body of a Barbie doll. And some bad-apple prankster had swiped his chin when he wasn’t looking.

He returned to his desk and sat down; I continued smoking. I took the notion to introduce myself. I figured, we’d be working together and I hoped to demonstrate mental competence by initiating civil contact. After I finished my cigarette, I wheeled up to his desk, smiled, gave my name while I offered my hand. His face contorted into a grimace of unbridled disgust as his stare swept from my empty hand up to my eyes. Then he looked down and continued with his paperwork. I waited a few seconds and asked if he didn’t also have a name. He looked up and arrogantly emphasized, “Mr. (whatever-the-fuck-his-last-name-is).” I urinate in fear when I remember how much he intimidated me.

The next morning, I heard him politely introduce himself as “Simmy” to Thelma, an older woman who trudged to the basement for therapy each morning around the same time I wheeled down. Thelma used a cane, but otherwise appeared normal and healthy. Purposefully within earshot of other therapy patients, he always referred to her as his “star pupil” though her performance was average. One morning the supervisor took him aside and they conversed in hushed tones. He abruptly stopped with the “star pupil” routine, but continued showering a parody of respect upon conventional warehouse residents while treating wheelchair users like shit.

One of his colleagues was a soft-spoken gentleman who innocently displayed effeminate mannerisms. One morning while strolling at my side as I practiced using a walker, Simmy blurted, “I think [he’s] ‘sweet.’ Know what I mean?” He held up his hand, limp at the wrist, and extended his pinky. (The colleague wasn’t on duty that morning.) Then he brayed of the time while in the army, he’d “single-handedly” orchestrated the transfer of an allegedly gay soldier out of his barracks. Apparently he’d complained to his commanding officer that sharing the barracks with a gay man was “unacceptable.” The C.O. had reminded Simmy that the barracks housed numerous soldiers, and he could easily avoid anybody whose personal lifestyle got his panties in a bunch. Simmy crowed, “So then I told him I would sue if I caught anything by using the same shower as that faggot. Besides, the army’s for men.” The story clearly tickled him; he guffawed way too long. He marveled at his “unique” character and predicted that I’d always remember him.

To be fair, Simmy possessed a single positive trait: While the clueless warehouse staff treated me like porcelain in order to dodge lawsuits, he recommended I use my walker each morning when coming to therapy and suggested I cover twice the distance practicing with the device during sessions.

A week later as I smoked, I vaguely realized that the supervisor and I were the only people in the therapy room. Out of the blue she admitted, “Paco, I’m disgusted.”

I responded that I was disgusted too, and asked why she felt that way.

She explained that she’d been excited at the prospect of a much-needed addition to the therapy staff, but Simmy was proving himself a major disappointment. Many of the usually gutless patients had complained of his brash manner, and he regularly mocked her Mediterranean accent. I observed that from my perspective, he acted like an ass-cadet brandishing a gold-plated chip on his shoulder. She smiled and shrugged her shoulders. I might be wrong, but her gestures seemed to echo my sentiment; maybe she regarded out-and-out verbal agreement an affront to professional decorum. Then she confirmed her talent for sharpening clichés by stating, “The bigger they are, the harder they fall!” She pleasantly grinned, but her voice dripped venom.

The warehouse often found itself understaffed. Therapists would sometimes be absent for days from their primary jobs, substituting for CNA’s¹ who’d called in “sick” or just hadn’t bothered to show up.² One afternoon the administration assigned Simmy to CNA duty on my floor. A superior of his must have lectured him on appropriate warehouse behavior. Contrary to the impression he tried to create, he betrayed himself as an ass-kisser who embraced criticism spewed by authority figures; he smiled, spoke to me in a nauseatingly polite tone, even shook my hand. I could see right through his act.

When Simmy had worked at the warehouse slightly more than a month, I heard him engaging in a muffled, very solemn conversation with a colleague (not the effeminate guy):

After some unintelligible mumbling the colleague asked, “Why?”

Simmy answered, “For personal reasons.”

The colleague wondered: “Have you told anyone here yet?”

Simmy replied, “No. I’m going to make my final decision Sunday night.”

“Well, you should go to P.T.A. [Physical Therapy Assistant] School. You’d probably get good marks.”

Two weeks later—well after the deadline he’d imposed on himself—Simmy quit. The therapy department supervisor revealed that Simmy’d told her he felt the warehouse “was holding him back.”

¹ CNA duties always took precedence over a therapist’s principal tasks. This made sense when you considered the administration routinely “promoted” untrained and amazingly stupid CNA’s, giving them jobs as therapists. Nobody seemed to notice.

² This is what happens when convalescent facilities hold prospective employees to phenomenally low standards.

As soon I returned to my apartment, I wheeled over to my computer and searched the directory of the major hospital hosting the Special Needs Dentistry program. I found a contact’s name and mailing address, and copied it into my address book. I’ve discovered that letters of complaint submitted via snail mail generally command more attention than emails.

I kicked off the letter by emphasizing that that I’m 100% mentally competent. Then I mentioned the rudeness and incompetence of the receptionists; the undependability and caveman decisions of the entire medical staff and especially of the revolving-door novices with whom I came in direct contact.

I questioned a system that assumes anybody who uses a wheelchair and talks kind of funny is necessarily mentally disabled. And I asked if the administrators of the Special Needs Dentistry program consider mentally disabled people seventh class citizens, only worthy of serving as guinea pigs at the convenience of bungling rookies and their lickspittles. I concluded by suggesting that only cowards and bullies manipulate those organically weaker than themselves. That evening I mailed the letter.

Three days later, a woman representing Special Needs Dentistry phoned me while I listened to a pre-geriatric Stooges CD. She cheerfully observed: “That music sounds familiar. Who is it?”

Without skipping a beat I answered²: “Fritzy and the Dickweeds.”

She made a transparent attempt to ingratiate herself with me: “Oh yeah, Franny and the Dickweeds. They’re one of my favorites.” I immediately knew that I was dealing with a mealy-mouthed PR shyster.

The PR shyster clearly based her spiel on a script. She apologized for the public aid stooge’s “oversight” and predictably stressed that his folly wasn’t the Special Needs Dentistry program’s fault. She went on to brag that the program provides a vital service to the community by serving those “less fortunate.” After declaring, “We’re willing to work with you,” she paused as if expecting thanks for a tremendous favor. Rather than acknowledge the mistake and send me to an appropriate dentist, she suggested that “we” forge ahead and “get your work done.” Then the PR shyster divulged that she’d made an appointment for me to visit Special Needs Dentistry a little less than two weeks from then; she assured me that I wouldn’t experience any problems.

An intern different than the naïve woman saw me. To my surprise, she worked with an assistant. While I settled into the examination chair, a male MD barged into the room—at least I assumed he was an MD; he wore scrubs, whereas the interns settled for street clothes shrouded by a lab coat. The intern and her assistant instantly switched into subservience mode. He ignored me, made eye contact with them and asked if everything was okay.

After he popped out of the room, the intern regarded me. She spewed the same crap about yanking the cavity-damaged tooth before proceeding with the bridgework, but this time she added a twist: She must surgically remove it. According to her, my X-rays exposed abnormally long roots anchoring that particular tooth. The fact that some unseen ‘them’ had unceremoniously lost my first set of X-rays didn’t bolster my faith in her diagnosis. She made a point of reminding me that public aid doesn’t cover anesthesia. Before concluding a typically abbreviated visit, she advised me that she’d devote my next appointment to a proper cleaning. I’d already decided that I wouldn’t return and didn’t bother mentioning that another intern already cleaned my teeth.

Before I rolled out of the examination room I slid my sunglasses into place. The assistant asked: “Are you a player?”

I turned to her: “No. It’s sunny outside.”

She cracked a dramatic smile and nodded her head: “I’ll just bet you a player! You look like a player in those cool shades! I better watch myself ‘cause you a player! Watch out ladies, he a player!”

Eventually I visited a private dentist (i.e. not sanctioned by public aid) who examined my teeth and immediately began the bridgework. I charged the whole shebang on a credit card designed to facilitate payment of medical fees on easy terms.

¹ By the way, I completely understand the concepts of triage and appropriate money management. I also realize that my procedure, though potentially warding off serious infection, was cosmetic. I’m not some pampered Little Lord Fauntleroy with an attitude of entitlement. But given the manner in which every branch of the medical establishment treated me, I’d be remiss to shirk conclusions because they’re unpopular and/or hard to swallow.

² As I’ve written: Many people accuse me of having a chip on my shoulder. The fact is, while occasionally strangers harbor genuinely good intentions, wheelchair users can almost always spot a condescending asshole—I get lots of practice—though the condescension may not be apparent to others. It’s like a seasoned auto mechanic who can diagnose an engine by merely listening to it, while the vehicle’s owner remains oblivious.

I wheeled the few feet into the waiting room and parked in front of a stationary chair. Though there were no other patients, the TV positioned on a wall mount blared. Less than a minute later the receptionist scurried in and stopped in front of me.

Clearly bewildered, she surveyed the room before directly addressing me: “Are we sure we came alone?”

Exasperated, I curtly responded by asking, “Do you see anybody else here?”

She again glanced around the room: “Well no, but somebody usually brings people like you.”

I couldn’t help but raise my voice: “What the fuck do you mean, ‘people like me’?”

She wagged her extended index finger while scolding me: “Don’t talk to me that way!” (I find lackeys that speak down to me and then demand respect amusing, though nonetheless pathetic and irritating.)

I figured I’d rode out enough self-important prattling and spat: “You can kiss my ass!”

After a brief stunned silence in which she hovered on the verge of tears, she threatened me: “Well! If you’re going to talk to me like that, I’ll make sure you can’t ever see your dentist again!”

“Bullshit,” I countered. “By the way, who’d you have to boink to get this job?”

She stormed out of the waiting room. Immediately after she’d gone, a boy and his parents walked into the office and sat down.

Many people accuse me of having a chip on my shoulder. The fact is, while occasionally strangers harbor genuinely good intentions, wheelchair users can almost always spot a condescending asshole—I get lots of practice—though the condescension may not be apparent to others. It’s like a seasoned auto mechanic who can diagnose an engine by merely listening to it, while the owner of the vehicle remains oblivious.

“She was just doing her job” is not an acceptable explanation for the receptionist’s behavior. There’s a difference between a reason and an excuse: A reason is the unavoidable circumstance externally imposed by cause and affect; an excuse is just a self-serving rationalization. When people whine that they were “just doing [their] job,” they’re shirking personal responsibility by offering a cowardly excuse.

To be fair, the receptionists at Special Needs Dentistry routinely deal with mentally disabled patients and likely operate on autopilot. But if a person possesses a reasonable amount of intelligence and considers my blanket demeanor, they quickly realize that I’m in control of my mental facilities. And anyway, the public aid stooge shouldn’t have sent me there in the first place.

About two minutes later, the receptionist whizzed past me on her way to the front door. She made an obvious effort to avoid acknowledging my presence.

Then, roughly five minutes after that, the naïve intern appeared and asked me to follow her down the hall. She stopped in front of her examination room, seemed embarrassed and stared at the carpet as she began:

“I didn’t want to say anything in front of anybody.” She raised her head. “But you really upset my receptionist, to say the least. I won’t see you until you’ve calmed down. Go make an appointment with the other receptionist.” I didn’t say anything, turned and wheeled past the reception window, through the waiting room and out the door.

I parked on the sidewalk outside of the building and used my cell phone to order a cab. While I waited, I vowed to write a letter to whomever bore responsibility for Special Needs Dentistry.

Three months later on my second visit to Special Needs Dentistry, a new budding tooth mechanic awaited me: a young woman who, like the aspiring DDS I’d previously seen, spoke with an eastern European accent and demonstrated a impersonal attitude. I twice asked about my former intern’s whereabouts before she looked up from my paperwork and absently replied, “Oh, she’s finished here.” Next I asked about my X-rays; she claimed “they” hadn’t developed them yet. Then she advised me that she must clean my teeth before committing to a course of treatment. The almost-a-DDS proceeded to shove pencil-like instruments into my gaping mouth that basically traumatized my teeth until they were clean. After she finished, she explained that the unseen “they” will probably have processed the X-rays by my next visit. The soonest the receptionist could fit me in turned out to be three months from then.

I kept the appointment and arrived to discover I’d been assigned to yet another student masquerading as a dentist. Perfect English flowed from her mouth and she exuded an unmistakable naïveté. I didn’t bother asking about the absent wanna-be dentist. She admitted that for whatever reason my X-rays hadn’t come out, so she’d have to take them again. She crammed a bite block containing film into my mouth, aimed the wall-mounted X-ray machine and clicked. After every click, she’d replace the exposed bite block with a fresh one, again aim and click. While trying to cope with the unwieldy X-ray machine she mumbled to herself: she hoped the unseen “they” would handle my X-rays properly this time. After finishing, she politely excused herself, claimed she’d see me next time and, before I could say anything, whizzed out the door.

I showed up four months later and as promised the naïve woman saw me. She’d spoken to public aid; they’d informed her that they would only cover half of a 6-unit bridge i.e. 3 units: my left front tooth unit, the damaged unit to its left, and the unit next to it. She casually mentioned that either side of the bridge might crumble during any given step in the replacement process, in which case the lackeys at public aid would forget I exist. Referring to the developed X-rays, she broke the news that I harbored a cavity like she was telling me a favorite uncle had died. Then she started to lecture about proper oral hygiene. I interrupted, reminded her that while I’d been in the coma and several weeks thereafter, the doctors and nurses had concentrated on issues more important than brushing and flossing. She reluctantly conceded that it was probably this period that spawned the cavities; she appeared slightly disappointed that she couldn’t recite her doubtless well-memorized advice concerning dental care.

But she pounced on the next opportunity to read from a mental script. She announced that she must yank the offending tooth from my mouth* before installing the sawed-off bridge. She also reminded me that public aid didn’t cover oral anesthesia for extractions. (This wouldn’t have loomed as a great concern had a single competent dentist been treating me.) I promised that I’d tend to the cavity later, and emphasized that I wanted her to deal with the bridge immediately. My resolve flustered her. Her face reddened and her breathing became labored; she argued: “But that’s how the book says to do it! Besides, I don’t want you to have any trouble down the road with that tooth.”

I almost commented that she had a bright future as a sycophant, but I thought better of it—my prediction may have encouraged her to continue talking. I guess she considered a few minutes of relaying her prognosis a complete visit; she again claimed she’d see me next time and whizzed out the door.

By my next appointment twelve weeks later, I’d managed to skip the warehouse and move into my own apartment. I checked in with the receptionist, a young woman different than the movie-magazine toady. She asked if anyone had brought me. I glanced behind myself—of course there wasn’t anybody there—turned back and politely answered, “No. I came by myself.” Then she cooed that the dentist would see me shortly, I should take a seat in the waiting room. She pointed to the chairs in full view a few feet away.

I’d just spent literally years enduring dumbed-down baby talk spewed at me by clueless emotional retards; at that time I was discovering that mostly clueless emotional retards populated the outside. I had given Special Needs Dentistry a more than fair chance, and the people involved had proven themselves chronic fuck-ups. Something had to give.

* As I mentioned, the wanton bungling of medical personnel subjected me to public aid dental care policies that made about as much sense as tits on a boxcar. In the state where I lived, public aid would shell out for the extraction of a rotten tooth, but not for the less expensive preventive filling

The cripplevan driver found the “Special Needs Dentistry” facility across the street from a major hospital. As I entered the small one-story building, I naively assumed that “Special Needs” referred to my gimpiness. A glance around the waiting room proved me wrong.

I noticed a boy of about ten who drooled on his bib and wore a bike helmet, sitting next to a haggard-looking woman—presumably his mother. A teenaged girl uncontrollably blinked and craned her neck while she squirmed on the chair next to an older woman. The woman tried to sound firm but gentle: “Now see here, we sit up straight and act like a big girl or we don’t get our special treat.”

My heart can’t pass as a prune, but I immediately knew I didn’t belong there. I almost turned to leave when I considered my dentist’s forecast of possible infection, the pain and inconvenience accompanying such infection, and the astounding stupidity and sluggishness of the public aid drones on whom I now depended. Those thoughts convinced me to wheel toward the weensy reception desk.

After several polite attempts, I managed to intercept the attention of the young receptionist hypnotized by a gossip-mongering movie magazine. She looked up, scowled and sighed. I advised her of my business and she mutely thrust a new patient form attached to a clipboard at me. She again scowled and sighed when I mentioned that my hands don’t cooperate with my brain and my penmanship is sub-lousy; she’d have to ask the questions listed on the form and write the answers for me.

My new dentist—actually an intern—spoke with an eastern European accent and conducted herself in a clinical manner.* She grilled me about my oral hygiene regimen and demanded that I articulate my reason for visiting her; she allowed that she’d read my chart, but stressed that “the patient should know why they’re here.” She deadpanned each step in the standard method of repairing my tooth while shoving X-ray plates that seemed made of shirt cardboard into my mouth. She noted: “Before we go any further, we must take pictures.” The X-ray machine resembled a white Stride Rite box with a black toilet paper tube jutting from it, attached to swing arm apparatus mounted on the wall. She aimed the tube at strategic areas outside my mouth and clicked.

She explained: At my next appointment—three months from then—she planned to clean my teeth and map a definite course of treatment. Eventually she’d cast a mold of my teeth; she assured me the process wouldn’t take long. I asked when she would cast the mold and she replied, “The appointment following the cleaning.” Then I made the mistake of wondering aloud if it wouldn’t be more efficient if she performed the casting immediately after the cleaning. After a few seconds of silence during which she glowered at me, she indignantly spat, “No. We do things a certain way for a reason.” She didn’t elaborate.

I would’ve ordinarily thought fuck this fully and skipped subsequent visits. But by then I’d resigned myself to wading through a cesspool of irrationality prior to receiving medical care. During the next several years I would discover that I’d grossly underestimated the depth of the cesspool.

* A person’s ethnic background doesn’t necessarily determine their level of competence in any given profession; dentist appointments aren’t social calls. But doctors or medical students from other countries, practicing or studying in the United States, are much less likely than American doctors to veil their perception of sick or injured people as expendable learning tools. Many American doctors regard their patients as cash cow textbooks, but camouflage their motives with clumsy displays of their “compassionate” bedside manner. Simple-minded people buy this self-serving crap.

A cripplevan lugged me downtown, to the nondescript government building where I‘d scheduled my meeting with a public aid stooge. I checked in with one of several receptionists; she immediately led me down a long hall past file cabinets, copy machines, and plastic plants, to the public aid stooge’s office.

The humble nook reeked of subservience. He sat behind a commonplace desk, ignored me and sighed as he asked the receptionist: “What’s his name and what’s he want?” She answered while placing a manila file in front of him. She scurried out of the room; he brusquely flipped through the file. He finally regarded me and simpered: ”So, Mr. [Paco], we think that public aid should pay for our dentist, hmm? Well, we’d like to, but public aid doesn’t…” He over-enunciated a dumbed-down explanation of the policies for funding dental procedures. I politely allowed him to finish his obviously scripted presentation.

Then I responded by assuring him that I understood the policies. I related my dentist’s concern about infection, and pointed out that it would be financially “prudent” for public aid to cover the tab and be done with it, rather than leave themselves subject to long-term nickel-and-diming. He continued to simper while his eyes bulged: “Wow! Where’d you learn a big word like ‘prudent’?” I remarked that I’d graduated from high school, and asked if he’d done the same. I also wondered aloud: “Since when do two syllables make a big word?”

But he ignored me and dialed his phone as I spoke. He advised: “I have to call my boss and see what he says. I’ll put it on speakerphone so you can hear.” When his boss picked up, the stooge began: “I have Mr. [Paco] with me, and…” He explained the situation and my grounds for appeal; made eye contact with me, smiled and winked as he repeated the word “prudent.” His boss recognized my logic and okayed the expenditure.

The stooge insisted on “helping” me maneuver my wheelchair out of his office and up the hall. Despite my repeated objections, he grabbed the handles on the back of my wheelchair and started to push. Asshole.

The day of the appointment with my new dentist arrived. I rolled out of the cripple-van and toward a building. The plaque next to the doorway announced “Special Needs Dentistry.”

The wanton bungling of medical personnel subjected me to public aid dental care policies that made about as much sense as tits on a boxcar. In the state where I lived, public aid would shell out for the extraction of a rotten tooth, but not for the less expensive preventive filling. They didn’t cover painkillers, even those administered during critical oral surgery. If you hosted an unexpected infection, you were shit out of luck until they approved an antibiotic, a process that usually took weeks. And they wouldn’t approve cosmetic procedures—like repairing my chipped crown—for patients over the age of 30; I’d braved my 30th birthday a few years prior. Apparently public aid policy-makers had reasoned that anybody who dares linger on the planet after three decades is washed up and has no reason to give a toss about their appearance.

By the way, I completely understand the concepts of triage and appropriate money management. But given the manner in which every branch of the medical establishment treated me, I’d be remiss to shirk conclusions because they’re unpopular and/or hard to swallow.

After poking around in my yawning trap, a state-sanctioned dentist explained public aid policy regarding cosmetic dental procedures. The good news: only a portion of the bridge needed repair. The bad news: public aid likely wouldn’t foot the (decidedly inflated) bill. But, he said, he’d tackle the paperwork and submit it; he shrugged: “No harm in trying.”

The final paragraph of the rejection letter I received informed me that if I didn’t agree with the decision, I had the right to appeal. The dentist who sent the request had cautioned that infection might set in if I left the damaged section unrepaired. I phoned some agency—probably the Department of Human Services—and scheduled an appeal. I expected a committee of several stern people, sitting erect behind a huge bench that dwarfed me as I stated my case, my tiny voice ricocheting off the walls of the cavernous chamber. Instead I met with a lone condescending dumbass in his modest office.

Every Saturday afternoon for a couple of months I heard scattered “Charge” bugle calls coming from the dayroom, though the constantly-blaring idiot box wasn’t broadcasting reruns of F Troop. (To this day I have no idea of the source.) The calls reminded me of people with backbone.

At the warehouse, CNA’s routinely treated the adult residents like slow children. Especially ignorant CNA’s referred to them as ”babies”; I guarantee they weren’t using urban vernacular. Cardboard laughing clown heads—the type you might find thumbtacked to the corkboard in a first grade classroom—decorated the door to the activities office. The activities staff had adorned the bulletin boards across from the elevators, and the doors to resident’s rooms with similar juvenile crap. Of course patients afflicted by dementia or brain damage only understood simple language delivered with exaggerated gestures, but CNA’s baby-talked at all the residents regardless of their condition. Grand Poobah scholars call this elderspeak.

Joy Simpson, a member of the National Association of Science Writers, accurately describes the strategies used by most people when addressing an elder (or, for that matter, anybody who uses a mobility device):

• Using a singsong voice, changing pitch and tone, exaggerating words.
• Simplifying the length and complexity of sentences.
• Speaking more slowly.
• Using limited vocabulary.
• Repeating or paraphrasing what has just been said.
• Using terms like “honey” or “dear.”
• Using statements that sound like questions.

She forgot one of my favorites: Using plural pronouns when addressing an individual e.g. “How are we today?” “Did we take our medicine?”

Elderspeak assumes incompetence and erodes self-esteem. But a gaggle of researchers—who’ve likely never lived in a warehouse—assert that elderspeak no longer outrages residents because they’ve learned to accommodate its habitual use. The milquetoast-pawn behavior I observed in other residents confirmed this.

Emotionally retarded nanowits, who realize in the back of their tiny minds that they’ll always be dump trucks of failure, feel the need to bully those weaker than them into submission. Typically, many nursing homes employ such subhumans. But mentally competent residents have the personal responsibility to stand up for themselves and not tolerate the patronizing bullshit dished out by soap-dodging mouth-breathing lowlifes. (Don’t allow shiny chirpy do-gooders to fool you—they’re just as bad.) It appeared that nobody living in the warehouse got the memo.