Red Rabbit - Tom Clancy [83]
The bad news was in the physical facilities. Health care in Britain was effectively a government monopoly. Everything was free—and, like everywhere in the world, you got what you paid for. The waiting rooms were far shabbier than Cathy was used to, and she remarked on it.
"I know," Professor Byrd said tiredly. "It's not a priority."
"The third case I saw this morning, Mrs. Dover, she'd been on the waiting list for eleven months—for a cataract evaluation that took me twenty minutes. My God, Albert, at home her family physician just calls my secretary and I see her in three or four days. I work hard at Hopkins, but not that hard."
"What would you charge?"
"For that? Oh… two hundred dollars. Since I'm an assistant professor at Wilmer, I come a little higher than a new resident." But, she didn't add, she was a damned sight smarter than the average resident, more experienced, and a faster worker. "Mrs. Dover is going to need surgery to correct it," she added. "Want me to do it? "
"Complicated?" Byrd asked.
She shook her head. "Routine procedure. About ninety minutes' work because of her age, but it doesn't look as though there should be any complications."
"Well, Mrs. Dover will go on the list."
"How long?"
"It's not an emergency procedure… nine to ten months," Byrd figured.
"You're kidding," Cathy objected. "That long?"
"That's about normal."
"But that's nine or ten months during which she can't see well enough to drive a car!"
"She won't ever see a bill," Byrd pointed out.
"Fine. She can't read the newspapers for the best part of a year. Albert, that's awful!"
"It's our national health-care system," Byrd explained.
"I see," Cathy said. But she didn't really. The surgeons here were proficient enough, but they did only a bit more than half the procedures she and her colleagues did at Hopkins—and she'd never felt overworked in the Maumenee Building. Sure, you worked hard. But people needed you, and her job was to restore and improve the sight of people who required expert medical care—and to Caroline Ryan, M.D., FACS, that was a religious calling. It wasn't that the local docs were lazy, it was just that the system allowed—nay, encouraged—them to take a very laissez-faire attitude toward their work. She'd arrived in a very new medical world, and it wasn't all that brave.
Neither had she seen a CAT scanner. They'd essentially been invented in Britain by EMI, but some bean counter in the British government—the Home Office, they'd told her—had decided that the country only needed a few of them, and so most hospitals lost the lottery. The CAT scan had just come into being a few years before she'd entered the Johns Hopkins University School of Medicine, but in the ensuing decade they'd become as much a part of medicine as the stethoscope. Practically every hospital in America had one. They cost a million dollars apiece, but the patient paid for the use of the things, and they paid themselves off quickly enough. She only rarely needed one—to examine tumors around the eye, for example—but when you did, you damned well needed it right now!
And at Johns Hopkins, the floors were mopped every day.
But the people had the same needs, and she was a doc, and that, Cathy decided, was that. One of her medical school colleagues had gone to Pakistan and come back with the kind of experience in eye pathologies that you couldn't get in a lifetime in American hospitals. Of course, he'd also come back with amoebic dysentery, which was guaranteed to lessen anyone's enthusiasm for foreign travel. At least that wouldn't happen