107. ‘Medicide’ ꟷ Failure to Make Whitefish Bay (A Fiction)
- T Michael White MD FACP
- 2 hours ago
- 6 min read
Fixing United States Health Care - Letters to the File
Part I. The Hot Mess
Part II. The Solution
by
T Michael White MD FACP
The Realization of Universal Access to ABC-STEEEP
(Affordable, Basic, Compassionate - Safe, Timely, Efficient, Effective, Equitable/Just, Patient-Centered Care)
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107. ‘Medicide’ ꟷ Failure to Make Whitefish Bay (A Fiction)
“But for each of us, isn't life about determining your own finish line?”
Diana Nyad
The WhiteHouse on the Belleair Bluff
Friday, November 28, 2025
Dr. Mike,
A letter to the file…
Some may erroneously conclude that your endeavor to address your grave concern for
our United States Health Care (non) System is a recent undertaking. Au contraire, mon ami. In 2018, you (W Ryder Black MD) published two short stories on the topic. Sharing one here…
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‘Medicide’ ꟷ Failure to Make Whitefish Bay
By W Ryder Black
Saturday evening, the gentleman’s symptoms progressed. Unmistakably, a gallstone had again migrated into his cystic duct. With forbearance, it would dislodge. Pain, nausea and vomiting would abate.
Completing his 60th year, even with the board, he had started anew. Some success, a smidge of glory and much tragic failure were in his rearview mirror. His involuntary step-away awarded freedom of choice and space. Insightfully repentant, humbled, he would make amends.
Understanding the hazards of complexity, he structured simplicity. He pursued but one goal and one wish. These four years later, his eyes remained on the prize.
He lived comfortably in a sparsely furnished studio apartment in a declining Victorian. Turrets, fireplaces, and windows bespoke of prior grandeurs. His landlady, herself anciently elegant, had inherited the massive home and little else. Tolerant of enigma, she was pleased to have this sustaining quiet, reliable gentleman as her lone tenant.
A century before, the mansion had been built to celebrate a trophy wife.
Simultaneously, the homestead and a Donald Ross championship golf course were carved from the edge of the then prosperous semi-rural city. Although time had eroded community, Victorian and club luster, glimpses of past sophistication remained.
Repetition eliminated the perils of variability. His each day repeated the former. Arising when sun and hormones nudged, coffee and stretching woke him. As spirit, soul, mind and body gelled, he wrote — a skill he had begun to master on incarcerated ‘sabbatical.’ Pursuing perfect words and phrases, he transcended time and space.
Each afternoon, he walked uniformed two miles to his fast-food post — his rationalized “daily constitutional.” His employer was elated to engage this elderly conundrum. Worn-out herding and replacing mindless teens, she revered this well-spoken, literate senior. Despite skillful proficient probes, she knew but two things about him: his age (now just shy of Medicare) and his social security number. Mystery cloaked all else.
His reliability, interpersonal communications, grammar and manners were impeccable. Although his mettle was steel, his demeanor was meek. A touch of protective eccentricity signaled rough colleagues and neighborhood toughs to stay in their lanes. Although his gestalt suggested a meaningful past, no trappings of where or what had been were perceptible. To most, he was agreeably invisible. To frustrated curious, he was a story to be told.
The tranquility of his late-evening walks home allowed the good — plans for his next
morning writings; and the bad — repressed rememberings. His had been rising and falling seas: a hard scrabble youth, a college and professional school tsunami, the Doldrums’ stall and then ascension to career success. Dedicated, talented and lucky, he cruised until tragedy struck. He planned. God laughed. Heroics required, he mustered weakness. Foundering, family, friends, career and freedom dissipated. Submerged, the sea would not take him. In tattered shreds, he washed up on this shore to start life again.
Safely home, the late-night internet (his only extravagance) immersed him in literature, cinema, music and sport. Wagering verboten, he fared well against on-line bridge, poker and book-making expertise. Streaming, he found infinite joy in human perfection: word and phrase; dialogue and scene; lyric and melody; executed plays. With a nod to his past, on moonlit nights he and a prehistoric seven-iron trespassed to play one-club golf until the emerging dawn threatened to reveal them.
Friends and family, rightfully done with him, had lost sight of his being. Truth — prior to his debacle, he had served them well — save for one. The youngest daughter — she had come as a gift later in life — had been rocked by catastrophic undoing in her formative years. Her family, friends, home and education had been torn asunder. Although he had no understanding of intervening processes, viewed from a cautious distance, she and her young family appeared happy, prosperous, well-educated and secure. His goal was to pay in arrears for the education he had not been there to provide. His method — as long as circumstances allowed, his trustworthy solicitor would anonymously gift $1,000 per month to her bank account.
Beyond clothes, seven iron and computer, his studio held but one personal effect — a print of the Edmund Fitzgerald hung above his writing desk. Prominent, it was there to remind him of the poet’s words, “The searchers all say they'd have made Whitefish Bay if they'd put fifteen more miles behind her.” It served as a metaphor for his wish — staying healthy until he, uninsured, made it to Medicare.
Living in the wealthiest country on the planet, the math was devastatingly simple.
Working full time, he was not provided health insurance; if he purchased health insurance he would have no funds for his daughter; and if he purchased health insurance and became ill, deductibles would leave him destitute — a humiliation he could not abide. After simple ciphering (insurance $700/month — $8400 per year — would only kick in after $8,000 of deductible expenses), he chose to meet his obligation to his daughter.
Having chosen his ancestors well, he was blessed with good health. Professionally
trained, he adeptly navigated diet, exercise and minor ailments. Late-night warmed lemon water replaced demon rum. Over-the-counter ibuprofen became his aged creaking joints’ best friend. Minor illnesses were bumped through.
Month after month, routine fared him well. Capturing his vast life experiences, his
morning writings were generally proficient and sometimes masterful. Organized as short
vignettes, he amassed several hundred in an ever-expanding desktop folder. As his anthology grew, he recognized increasing value as a source for script writers in search of ideas. His afternoon and evening labors paid bills, moderated obligation and assuaged guilt. Gracefully accepting deserved solitude, joy far surpassed evening loneliness and lament.
An hour in, the pain, nausea and vomiting uncharacteristically intensified. Soon
thereafter, he comprehended agony. Without fear, he perceived that this night he would not make Whitefish Bay. Reviewing his meticulously ordered directives to his solicitor regarding his humble personal effects and treasured anthology, he found peace.
The onset of fever and bed-shaking rigors heralded doom. In most developed nations, he would be ministered safe, effective, compassionate care. In America, he faced and could not endure the shame of being impoverished by exorbitant charges — charges that, just several months hence, would be negotiated, adjudicated and largely paid for by Medicare. His fate decided, as a feint he slipped a note beneath his landlady’s door — he would be away until late Monday. Defeated by nausea and vomiting, he was unable to keep analgesic down. Mercifully, precious, aged single-malt, cracked for “emergency medicinal purposes” (one shot as necessary every 15 minutes), clouding sensorium, alleviated nausea and pain.
Monday, when he failed to present for duty exactly on the dot, alarm was sounded. By Tuesday, his tragic abdominal sepsis demise was sufficiently, for most, explained —
overmedication with scotch impaired judgement. One, his solicitor (with an ancient golf club and a print of a sunken ship as prized remembrances of an admired, cherished friend and instructions to shop his anthology to the benefit of his daughter’s family) fathomed truth — in the wealthiest country in the world, a proud, imperfect, good man, atoned and judged even with the board, had failed by weeks and months to ascend to the privileged class — insured by Medicare. (1185 words)
WRBMD
November 2018
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Respectfully submitted with fondest personal regards,
Dr. Mike
You may leave an anonymous comment without username and email ꟷ please do. Please share your wisdom, insights and perceptions (your reality) about what I have right, wrong and/or omitted. I will be delighted to hear from you as this draft and subsequent chapters will be significantly enhanced.
Dr. Mike
Letters to the File ꟷ Part II
101. Introduction to Part II ꟷ The Solution
102. The United States Health Care System ꟷ Enabling Legislation
103. The United States Health Care System ꟷ View From Space
104. My (Unique and Very Personal) United States Health Care ꟷ Getting Started
105. My Semi-annual Primary Care Team Visit
106. The United States Health Care System ꟷ My Contract
107. ‘Medicide’ ꟷ Failure to Make Whitefish Bay (A Fiction)
(more to follow)
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