A Country Doctor Writes:

Leslie Dubrovnik turned sixty-five a few months ago. She has been an infrequent visitor at our clinic because of her lack of health insurance. Her husband is a disabled veteran, who runs a small used car dealership in the next town, and although they seemed fairly well off, she was always very cost conscious about her health care. She would come in once a year for a routine physical and she always got her mammogram, but when I suggested big-ticket items like a screening colonoscopy, she always declined.

“I’ll wait until I’m sixty-five”, she would always say.

At age sixty-five in the U.S., you qualify for Medicare, the government-sponsored health insurance. For many non-working and self-employed Americans, this is the only option for affordable health insurance. Many, like Leslie Dubrovnik, hold out until their Medicare benefits take effect. Soon after she turned sixty-five we scheduled her colonoscopy.

Tuesday I got Leslie’s report in the mail. She had a 3 cm tumor in her proximal colon. Thursday afternoon I got a call from the gastroenterologist who had done Leslie’s colonoscopy.

“I got the pathology report”, he said, “and it’s an adenocarcinoma. I’ve ordered her CT scans and I’ll have Dr. Beach see her for the surgery, but I thought I’d let you know right away so you can get her set up with oncology for possible adjuvant therapy.”

I called her up to go over what needed to happen. She sounded shaken, but okay.

“Doctor,” she said, “I want to thank you for nagging me about having a colonoscopy. Do you think I waited too long?”