Thursday, September 9, 2021

Dr. Heuristic, Foot Whisperer

Fall has arrived, and the kids are home and back in school. After a four-year slog, last month I finally won the appeal in my lawsuit against the sleazy attorney-investigators who conspired with my former employers to deprive me of my civil rights and to destroy my health and career. Days are filled with hope, work, and productive dog walks. 


As I wrote last year in “First Fall Walk,” I depend on my time on the trails with Bear to get a lot of my thinking and writing done. Buster used to be the weakest link. Unfortunately, now the weakest link is my right foot.

Years ago my Seattle physician referred me to a podiatrist who prescribed custom orthotic inserts for my shoes. By the time I acquired the perfect Comfort Animal and began walking at least ten miles a day, my ancient shoe inserts were in tatters. My feet always hurt. So last summer my doctor gave me a referral to foot specialist.


Sadly, one of the unfortunate consequences of longterm unemployment and disability is having terrible health insurance. No podiatrist within a hundred miles will take me as a patient. I tried salvaging the remaining scraps of shoe insert with duct tape, but that didn’t work. Plus my shoes didn’t fit. By this summer I couldn’t walk any further than Buster without excruciating heel pain. 

My Bellingham physician Dr. Heuristic keeps saving my life. When we met he immediately figured out my weird symptoms added up to Post-Traumatic Stress Disorder. He recognized my underlying problem with codependency and sent me to Codependents Anonymous. He’s much nicer than Dr. House, the abrasive but insightful head of TV’s fictional “Department of Diagnostic Medicine.” Dr. Heuristic doesn’t laugh at my jokes about suing people for malpractice, but doctors never do. 

A “heuristic” is a simple procedure that helps find adequate, though often imperfect, answers to difficult questions. Over the last several years, I’ve figured out my doctor’s heuristic for me. Whenever I show up with some new complaint, he will generally select from a repertoire of three standard responses:


1.       Its just another typical stress response/PTSD symptom.


2.       It’s a common side effect of my medications.


3.    It’s what happens when we get older. (He calls these “barnacles.”)


Dr. Heuristic might as well prepare three tape recordings. Nevertheless, I was encouraged by his visible excitement several years ago when he got to step outside of the box and diagnose me with keyboard-induced Tennis Elbow. Together with Dr. Practical and her colleagues at the Urgent Care Clinic, Dr. Heuristic has guided me through a series of Biblical plagues, including boils, MRSA, tinnitus, and the time a bunch of vicious Canadian drag queens caused me to lose consciousness and fall down the stairs.

At our annual check-in last month, I told Dr. Heuristic about my inability to find a foot doctor willing to take my terrible insurance. Rather than continue my hopeless quest, he told me to go to Fairhaven Runners & Walkers and drop his name. I’m happy to announce I finally have shoes that fit correctly, as well as the appropriate Superfeet inserts, which are manufactured right here in Whatcom County.


During my physical I also described the chronic pain in my right foot. I could tell Dr. Heuristic was ready to interrupt as soon as I reported my heel pain was always worst first thing in the morning. I have “plantar fasciitis,” i.e., inflammation of the plantar fascia, which is the tendon on the bottom of your feet connecting your heel and toes. Dr. Heuristic printed out instructions for simple exercises and told me to apply ice as needed.  

I conscientiously did all the foot exercises on Dr. Heuristic’s instruction sheet several times a day. I iced my heel. I put new inserts in my slippers. (My Canadian sister-in-law’s mother said the worst part of having plantar fasciitis was her doctor made her wear shoes in the house for the first time in her life.) Coincidentally, Bear had recently injured his paws jumping out of a car window, so we both took a break from walks and rested our feet. 


After a few weeks of responsible footcare I could keep up with Buster on the trail. Bear and I could even make the four-mile loop down to the Boardwalk and back. Beyond that the pain was still too much. At this rate I’d never be able to finish all my briefs, blog posts, and book chapters.


Then as I wandered through the foot section of the drugstore I saw a box labeled “Foot Support for Plantar Fasciitis.” The exercise instruction sheet had mentioned something like “Your doctor may prescribe overnight foot splints.” I’d seen similar references in my online research. A night brace keeps the tendon stretched.


I replayed Dr. Heuristic’s diagnosis in my mind:  “You have plantar fasciitis. Some people benefit from a night brace….” Then I heard his unstated “but your insurance probably won’t pay for it.” The box cost $35.


The next day felt like a miracle. Bear and I walked for seven miles. After five miles my other heel started to ache, but only a little. Instead of the piercing heel pain of plantar fasciitis, I’m back to the normal background blisters, aches, and pains of someone who walks a lot and can’t afford to replace his shoes often enough. Bear and I can live with that for now.

After dropping off the kids for their first day back at in-person school, last week the dogs and I stopped in Fairhaven for our short morning walk. (Buster inevitably poops out after a couple of miles, but Bear and I still try to include him once a day.) Near the train station we passed a runner, a lean guy about my age. He stopped, spun around, and said, “Roger, right?”


He looked vaguely familiar, but my PTSD-addled brain couldn’t make the connection. I stared. Then I remembered. One of my original lawyer colleagues in Seattle had the good sense to find a legal job in Bellingham long ago. Amy’s husband Gib is a physician at PeaceHealth Medical Group. When we moved here six years ago, I asked Amy if Gib could suggest a new doctor who would be a good fit for me. That’s how I met Dr. Heuristic, who quickly diagnosed me with PTSD and codependency, and has managed my recovery ever since. 


I stammered “You’re my doctor’s partner.”


Gib laughed, and said “That’s not how I think of myself.”


Nevertheless, that’s how I will always think of Gib. Because I’m grateful for the blessing of healthcare providers who listen. 


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