Colonoscopy and Other Shit

(I know. I’m still ruminating about Costa Rica even though we’ve moved on. This is more of a rant on how broken the US medical system is.)

People sometimes ask us how we decide where we’re going. In the case of our January trip to Costa Rica, the motivation was an airfare credit with JetBlue that just had to be spent before November. As it turns out, I needed to have a crown replaced and since we had to go somewhere, we thought we’d try Costa Rica for dentistry which I’d heard was excellent and inexpensive.

A crown replacement in Florida runs approximately $1500 plus whatever little extras the dentist can tack on, like x-rays and sterilization fees. Upon the recommendation of expat friends who live there, I made an appointment with Dr Alexander Mora in Escazù. This fine doctor replaced my crown for a total of $375. This was total price, inclusive of a x-ray and cleaning up the cavity that had started under the crown.1

A web fare for JetBlue from Florida to Costa Rica might be as low as $400 round trip. Yes, that means that the cost of an airline ticket plus the crown is less than half the price of the same crown in the United States.

Still don’t think the medical system in the US is completely broken? I have more.

Doctors recommend that everyone get a colonoscopy at age 50 and then ten years later if the first one is clean. A colonoscopy in the US costs around $4,000. Under Obamacare, medical insurance is supposed to provide a free one at the recommended interval.

I scheduled my regular diagnostic colonoscopy when we were still living in Fort Lauderdale. The doctor, who was an hour and a half behind schedule and talking on his cell phone in the procedure room, couldn’t finish the operation. This, after horrible preparation2 and wasting the greater part of the day at the hospital. He had no excuse; just said that the instrument would only go about ten percent of the way. Then he tried to sell me a barium enema.

Considering that the test wasn’t done, I tried to get another one from a different doctor. The insurance company claimed that since I’d already had one, I’d have to pay for the second one.

Deena suggested I get my test done in Costa Rica because we were going there anyway. It seemed like less hassle than taking the insurance company to court.

I scheduled a colonoscopy for our first week in Costa Rica. The receptionist didn’t speak much English but the doctor did. It was way more efficient. We walked over to the hospital endoscopy clinic in the morning and were out having a delicious coffee in two hours.3 They gave me a printed report with internal pictures, and were even nice enough to email me the pdf at my request since we’re now paperless.

The cost of the procedure? $380.22 Yes, that’s right: You could fly to Costa Rica, be tested and have a five-star vacation with the remaining $3200 and still not spend as much as the US medical system would like you to pay.

Don’t get me started.


Silently Serving Up Happiness

Ivan and I attended a Vipassana4 10-day silent meditation retreat March 12-23 in Kaufman Texas.

pagoda1On the first day, I volunteered to become a Server, sensing somehow that help was needed. This totally altered the dynamic of my experience of the retreat compared to Ivan’s.

Vipassana means seeing things as they really are. It’s the process of self-purification by self-observation. We begin by observing the natural breath to concentrate the mind. We observe the changing nature of body and mind to experience the universal truths of impermanence, suffering and egolessness. Realization of the “truth” by direct experience is the process of purification. The entire path, Dhamma, is a universal remedy for universal problems.

For me, as a Server, rather than observing noble silence and not even gesturing with fellow students, I was fully immersed and warmly embraced by a committed, hard-working, sensitive, diverse and fully focused group of other volunteer servers whose sole resolve was to serve selflessly the teachers and students. In other words, we talked, we discussed  we laughed and cried and were anything but silent.

I will never forget some of the close attachments I developed. Meanwhile, Ivan meditated most of the day, when he wasn’t eating, sleeping, resting, strolling or listening to discourses. He didn’t open his mouth to speak or even laugh(!!! if you can believe that) for 10 days.  I heard his hoarse voice on day 10 when we were allowed to speak but still were not allowed to touch.

7547832_f520Servers meditated5 during the group sittings. Early morning meditation was also available to some of us some of the days but I was too exhausted to be able to think of rising much earlier than I did. The rest of the time we were cooking, cleaning and serving.

There were a number of precepts6 everyone agrees to adhere to during the retreat; these rules served to help focus us on the meditation technique and practice. There would have been no point in spending 10 days and not learning the technique sufficiently that you would feel confident in being able to practise it when you left.

The daily evening discourse, the only entertainment of the day, is given by Goenka by videotape. His parables are so poignantly and eloquently delivered. I love Indian humor because it makes fun of our own selves rather than laughing at others. Goenka reinforces the purpose and benefit of why we meditate using this technique developed by the Buddha.7

We dine mindfully on vegetarian meals. You notice the feel and taste of everything you eat, which is a contrast from the fast-paced eating that I do where I often don’t remember what I’ve eaten let alone remember savoring the taste of the food. As servers we added a lot of Love, or “Metta”8 in the preparation of the food (everyone made their contributions to the soup pot).

All distractions, including computers, cell phones, texting and even writing in journals or reading books are removed. We can mindfully notice each passing breeze, singing bird each floating cloud. Your heart opens up and it’s almost enough to make you cry.

Sitting 5-10 hours a day without any distractions allows you to get in touch with what is going on in your mind, body and surroundings and can actually cure you of constantly seeking diversions.

It’s a powerful practice. I found joy welling up from within my heart as I tapped into my true “Buddha nature,” which is love. I felt sweet, pure, free-flowing, and vast love for all beings.

This was my second 10-day Vipassana and it brought me a completely different realization about my life each time. My first one was totally overwhelming. I clearly saw  how I needed to see “things as they are”.  I saw that I couldn’t control everything, and learned to love my life exactly as it was. I rid myself of the scramble of incessant self-admonishing circling around and around in my head. I emerged feeling positively joyful.

This  retreat brought me wisdom to realize that I needed to forgive myself for mistakes I had made. I find that I judge myself much more harshly than I would ever judge others. Likewise, I found that it was much more difficult to send myself loving-kindness than to send it to others.

I’ve been ever so fortunate to have met Ivan, the love of my life. But while meditating in silence, I felt the intensity of my love and devotion to  him.  As a bird knows that it needs to sing,  I knew that love is the truth we all must share with the world.

 “When one experiences truth, the madness of finding fault with others disappears.” ― S.N. Goenka


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