karla

Karla and I spent most of yesterday in Santa Monica, taking the footpath down into Venice Beach. We had planned to walk about five miles each way, but I had pulled a muscle while biking earlier in the morning, so after about a mile or so I began stopping frequently to work the cramps out of my thigh. Karla stayed patient with me, but after about my fourth break I decided there wasn't much point in trying to go further.

I don't know how I'd make it through my current ordeal without Karla. I don't mean that sentimentally, at least not in this instance. But the health care industry no longer seems to be designed with maneuverability in mind, and Karla--a nurse by training, a case manager by profession, and one particular patient's ferocious advocate by a twist of fate--is one of the few people in the country who actually knows her way around the system.

A recent example: Four weeks ago, when the spots on my liver were still considered an anomaly attributable to past health problems, we met with my hepatologist. I was to fly out to Philadelphia the next day for a month-long research trip, so when Dr. Kahn encouraged me to stick around long enough for a biopsy, I held out for further evidence that this step was really necessary.

"If we could at least do an ultrasound," he said, "I'd feel more confident telling you whether you're safe to leave. But we can't schedule it until we get approval, which we can't get in less than 48 hours."

Karla replied, "Let me see what I can do." She pulled out her cell phone, spoke to someone for a couple of minutes, hung up and reported, "Marie says she can get the approval to us in half an hour."

Two hours later, the test was complete and we were all convinced that I needed to postpone my trip.