Old Time Music

Without knowing it or looking for it or being aware of it in any fashion, we passed the mystical two-year anniversary in Montpelier. Some friend or aquaintance explained this to me years back. They said that it takes two years in a new location before you really feel part of the community. It takes time to make friends, to get settled in a job, to learn the lay of the land and the local mores.

We must have past it because for the first time I had an honest to God southern old-time jam session in my house. Up until now, my only outlet was to play tunes with my friend, Mark, the assistant attorney-general of the State of Vermont. He would call me up before lunch and invite me to the second floor porch of the downtown Pavilion building for tunes. I would drive down just before noon and show up in my shorts and T-shirt, Tevas and sun hat with a guitar slung over my shoulder in a soft shell case as I signed into the security guard booth.

The porch faces State Street, which is steady with traffic at lunch time, but the second floor is a good thirty feet off the ground and the wide covered porch does an excellent job of shielding the traffic noise from us and vice versa. We have the porch to ourselves because the only way to get to it is through a locked door in the Attourney General’s department. Since the red paint on the floor is constantly peeling, and since there are no chairs or benches out there, it is invariably unoccupied when we arrive. Mark grabs his fiddle and we each take a chair and for an hour we forget about the cares of the world. But it is only an hour, and no more than twice a month if the weather and our schedules cooperate.

Mark is a very fine fiddler in the Kentucky/West Virginia style. He likes to give his tunes breathing space. Like many fiddlers I know, he cannot talk and play at the same time. He cannot even talk while he tries to find the leading notes of a tune. He likes to start a tune with “Oh, here’s a good one. Have you ever heard…” and that as far as he ever gets. He starts carefully pulling notes out of the fiddle as if he were a surgeon extracting shrapnel. They come slowly until he has found the phrase he is looking for. Only then does he launch into it with something like abandon. I won’t get to find out the name of the tune until we are done playing it.

His tunes are often crooked, with odd pieces of phrases duct taped on. It gives his playing, and the genre, a certain primitive charm. Finding the right chords on my guitar and figuring out exactly where they go is often a challenge with the club-footed music, one that I enjoy, and when I finally have one of his tunes down, it is thrilling to keep pace with him. Sometimes he plays a variant of a tune I know, Yellow Rose of Texas or such, and I must sit up and pay attention. Otherwise I will fall into old muscle memory habits, wired into my system from playing the tunes a million times with a different phrasing and chord structure. It helps that, although he does not play sedately, neither does he employ the youthful hormonal rush employed by so many southern old-time fiddlers I know. It’s as if they cannot wait to get to the end of the 64-bar tune merely to begin it again. Not that Mark is often caught playing a straight 64-bar tune.

Despite his skill and genuine friendship, I miss playing with other fiddlers. This was inevitable I suppose. I cut my teeth on Round Peak tunes, which Mark does not really enjoy, so I have gone without it for two years. Not only are southern fiddlers rare in Vermont, as you might guess, but these Yankees have the gall to call their New England style tunes “Old-Time” and refer to the southern tunes, when they mention them at all, as “Old-Timey.” I do not know if there is any slur intended in this expression, and in good faith I assume not, but the confusion this has caused me has wasted a good deal of my time as I have searched for fiddlers.

I was not able to find true southern old-time musicians in Vermont until I attended a fiddle “reunion” in New York. Apparently this was the closest to Vermont one could find such a gathering, and I was pointed to the “Vermont tent”, a blue rain fly under which a half-dozen musicians loitered in the morning chill by a Coleman stove. They drank coffee in canvas chairs, their free hands in the pockets of bright fleece vests. They obviously were quite familiar with each other, a bond forged by their habit in this strange transplanted music. This was their opportunity to rub elbows with their kind in somewhat larger numbers, but they still clung to each other like jittery deer. Even though I was an as-yet-untested guitar player, when they learned I lived in Vermont, they welcomed me with the sincere affinity reserved for a fellow sufferer in the wilderness. It wouldn’t have mattered if I played poorly. The very fact that I knew what this music was and what it wasn’t and that I lived in Vermont was enough for them to allow me to swell their ranks.

I suppose I ought to explain a little something of this music. I believe most people have no notion of authentic American fiddle music. The variety of forms it takes might have even interested Darwin. But to most people it is all bluegrass, if not country, by which they mean the twangy-accented recycled pop music on the radio. They have no notion of multitudinous sects, the Irish, the Scottish, the English, the French Canadians, the Cajun, North Carolina, West Virginia, Oklahoma, Texarcana, to name just a few. The minorities of faithful adherents, each striving to maintain the purity and uniqueness of their own genre. To call this music “southern” as opposed to “northern” is really a gross injustice, no more complete than to say all trees are either leafy or needled. But most fiddlers would know instantly what this means.

Northern fiddle music is in essence classical, and if you were classically trained and could read music, you could play this music in no time. But southern music resists notation and cannot be learned unless you sit and listen to it over and over with a fiddle in your hand. Northern music drinks up harmony like a sponge, whereas Southern music rest on a bed of solid rhythm over which and against which a fiddler can utter phrases sublime or churlish. Northern music knows all meters and embraces hornpipes, airs, waltzes, and schottisches, whereas southern is either straight or crooked. Northern music can be played on just about anything. I have found northern bands with reeds, brass, and all manner of squeeze boxes. Southern music is played entirely on stringed instruments – fiddle, banjo, guitar, bass, with occasional exception made for mouth harp. I love Northern music, have danced to it for years, and find it as beautiful and heady a mixture as anything I could want. But I do not play it often, and when I do, I do so badly. I play southern music mostly.

In southern music, the guitar is not star of the show. That would be the fiddle, with a best-supporting award given to the banjo. To play the guitar in Southern music requires a desire to do something repetitively and simply for a long time. It requires attention and patience and an interest in diminshing your ego so that others can be supported and heard. But like the crust of a pie, it is necessary and important to the end product. If played well, it is almost unnoticed, If played poorly, the pie is ruined.

By now, I have a solid rhythmic guitar style with enough of a floating bass line to maintain some variety and interest, so I am in demand. The fiddle is a ridiculously difficult instrument to play at all, much less tolerably well, and most people haven’t a clue how to get started with a banjo, must less find one. There are scads of babes-in-the-wood who come to this music with their dreadnaught folk guitars, and with no notion of how to play the music, or worse, too much notion.

I am not a professional musician. This has never been more than an avocation for me, but I studied and was patient and asked questions and invited criticism until I understood what was expected of me and then learned to hear the difference. Now I get to play with the big dogs, because a competent guitar player is like a four-leaf clover. It isn’t much to look at compared to a rose or even a dandelion. But it is difficult to come by and you are quite lucky to find one, so you don’t let one get away.

Last week I received a call from a banjo player, a friend of Mark’s I had not met, but who I knew to be a wonderful player. He invited me to join him and a fiddler to play for a square dance, a Waldorf preschool benefit which was likely to pay us in maple syrup if anything at all. But I leaped at the chance to play southern tunes with some fine musicians. I missed my Alaska jam session, and these folks promised to play the Round Peak style I had left behind. They met at my house to practice because I lived halfway between them, and because the banjo’s girlfriend lived in town too. My children were shy as usual, but the fiddler, whom I had been led to believe was taciturn and understated, turned out to be a family man whose children were grown. He enjoyed my family as a grandparent might and was interesting and lively. We all had wonderful time, and I couldn’t wipe the grin from my face, especially when they complemented both my playing and my guitar. The banjo player spent a fair bit of time talking to Dawn, as he is studying to be a physical therapist. The sudden attention and expectation to speak gave her a rash, but she did not hide in her shell. And then we discovered his girlfriend is a Montessori teacher in Rose’s school, though not her teacher.

We all expressed a genuine interest in getting together again, and I seem to have recaptured something I had expected to sacrifice by moving to New England. I feel like I have found a well in the desert. And it only took two years to find it.

Bedtime Ritual

Rose gave Samuel a new nickname tonight. She calls him Cookie. I have no idea where she got this, but after dinner they were chasing each other up and down the hall with calls of “Cookie! Come here!” and screams of delight. Rose has a hard time keeping up with him because she knows (mostly) she must be gentle with him, but he’s fast and strong and not gentle with her. This presents challenges for all of us.

He is no slouch, no limp-rag, beanie baby. This is a toddler who has lots of caloric capital and who intends to use it. He was walking at nine months and running two weeks later. At fifteen months, he had already learned how to jump and could clear two inches off the ground. When he is excited about something, Tigger is no match for him. If you get him a pair of socks, he starts screaming “Out-door! Out-door! Out-door!” punctuating each word with both feet slamming the hardwood floors in unison.

He is also a fearless climber who has been found on the top of the couches, standing in his high chair, and on the surface of various tables. At this stage of growth, he has more cartilage than bone, so if he runs his shin into a piece of heavy wooden furniture or drops a small chair on his foot, it doesn’t slow him down.

By trial and error we have developed certain distraction techniques to keep him still and quiet long enough to change a diaper or get him dressed for bed. These techniques usually involve singing, but I have a special ritual with him at bed time. After his bath, we whisk Samuel onto our bed where we lay him out naked and apply various unguents and ointments. To keep him “on task” I tell him a joke. It’s the same joke every night, but he never tires of it.

Samuel, have I ever told you the story of the WIDE-MOUTHED FROG?

Up until last week, Samuel would stare at me with a look of confused expectation. “Gosh,” he seemed to be saying. “That sounds familiar.” But as of a week ago, something clicked. Some essential neurons connected. Dawn and I decided that before they are connected they aren’t officially neurons; they are more appropriately called morons. So a couple of morons got together, and now Samuel looks me straight in the eye, and says in his loudest indoor voice, “NO!” [See previous posting of the same title].

Dawn snorts at this as she gets a layer of Arnica gel on all his shin and knee bruises.

I haven’t? Really? Well, let me tell you.

It’s important to use your imagination for this. Everytime you see capital letters, imagine my lips spreading apart as far as possible, as if they were oppositely charged poles of a magnet. Think BIG O. Try talking this way for a while and you will appreciate the instant comic effect.

Once upon a time there was a WIDE-MOUTHED FROG, and he was hungry. So he went hopping down the road looking for some food. Hop, hop, hop.

Samuel usually laughs riotously at Hop Hop Hop because my fingers are bouncing up and down on his naked chest and he is ticklish. His laugh is a throaty Heh hehhehhehheh, that sounds devious and maniacal. On the rare occasions when he isn’t feeling ticklish, he at least repeats “Hop Hop Hop.”

Until he came across … a cow. And he said, ‘MRS. COW? WHAT DO YOU LIKE TO EAT?’ And the cow answered, ‘Moo! I like to eat grass.

Moo Moo, says Samuel. Dawn starts applying baby oil from neck to toes. I have a hand on his hips or shoulders in case he decides to suddenly flip himself over, a maneuver he has perfected on the changing table three feet off the ground. At bedtime though, he usually lies still, engrossed in the story, which is fortunate since he gets very slippery with the baby oil.

And the wide-mouthed frog said, ‘OH! THAT’S VERY INTERESTING!’ But he didn’t want to eat grass, so he went hoping down the road some more. Hop Hop Hop!

Evil cackling from Samuel.

Until he came across …

If Rose is awake and in the room, she usually helps out at this point, suggesting such animals as a Hephalump or a Cockatoo. “Don’t you mean a cockatiel?” I suggest. Our friends in Maryland have a cockatiel that sat on Rose’s shoulder the last time we visited. “No Papa! I mean a cockatoo.” She doesn’t say it, but she thinks very loudly “you moron.”

But most nights, Rose is already asleep. She has to get up around 6:30 to be ready in time for preschool. She has already heard her story, drunk her last glass of water, and listened to Mama and Papa sing to her. She is drooling peacefully into her pillow.

Until he came across a squirrel. And he said, ‘MR. SQUIRREL? WHAT DO YOU LIKE TO EAT?'”

If you are reading this out loud to someone, and if you are doing it properly, you should start to feel a slight stretch in the corners of your mouth.

And the squirrel answered, ‘Tch! Tch! Tch! I like to eat nuts and berries. And the wide-mouthed frog answered, ‘OH! THAT’S VERY INTERESTING!’ But he didn’t want to eat nuts and berries, so he went hopping down the road some more. Hop Hop Hop!

Insane roaring follows, but ends the instant my fingers leave his body.

Until he came across … a snake. And he said, ‘MR. SNAKE? WHAT DO YOU LIKE TO EAT?’ And the snake answered, ‘Ssss. I like to eat wide … mouthed … frogs.’ And the frog answered …

Now make your mouth really big and then slowly close it to a tiny sliver as you mumble

oh really?

Every night, no matter how bad a day he has had, no matter how tired, cranky, or hungry he is, Samuel’s mouth will slowly widen into a smile that shows all ten of his teeth. It’s as if he has never heard this joke before, and you can see the little humor gears in his head “getting it”.

At this point, Dawn is done, and we quickly slip him into his footie pajams. Two minutes later he has completely forgotten the joke and is saying “Mama” over and over again, impatient to nurse and go to sleep.

No

Samuel has learned the magic of the word No. He likes to say it the way his big sister Rose does – repeatedly, with a healthy scoop of whining on top. So far, it is still cute.

Many parents fear (before hand) or regret (afterwards) the day their toddler learns this word. It is our own fault, because they learn it from us. “No, don’t touch that. No you may not. No, stop!” One toddler we knew used to ask her Mom for permission by pointing at something and saying, “No, Mommy?”

We knew a Mom in Alaska – a charming, active, funny woman. One day, When she was five months pregnant with her second child, she was in a very large grocery store, when she heard the piercing cry of a toddler a good football field length away scream “NOOOOOOO!” Everyone in the store paused at the sound of it, if they didn’t leap right out of their shoes. This Mom came home and sat her family down and informed them that the word “No” was officially forbidden in the house, and they all had until the baby was born to remove it from their vocabulary. It was difficult, but they somehow managed. Today they proudly announce their now-teenage girl didn’t learn the word “No” until she was five years old.

Personally, I am not that concerned. For starters, Samuel doesn’t really understand the full meaning of the word. He learned it from a book called “Is Your Mama a Llama?” in which a little llama goes around asking all his animals friends if their mother is a llama. They all answer negtively, in perfect dactylic tetrameter (“No I am not, is the answer Dave gave.”) Samuel loves this book. For a week he would carry it to us and hold it up saying, “No! No! No! No!” It took us awhile that understand that he wanted us to read the book to him.

Another reason that his mastery of “No” doesn’t worry me is that I’m far more fearful of his learning “Again.” A child who can say No becomes an adult who can take care of him or herself. Whereas, I still have a twinge in my back and shoulders from when Rose learned to say “Again, Papa!”

Wildlife #2

Ever since we had the back half of the house restructured and we moved our bedrooom to the other side of the house, we have been noticing a lot more wildlife from the windows. I suspect there is a corridor of some sort through the woods on this side. A flock of three wild turkeys came through the last day of August and I tried to get them on camera.

Then the next week, a thin but very active fox appeared and kept showing up on our yard and driveway daily. She even walked halfway up the steps to the front door but then thought better of it. We are not known for giving solicitors a welcoming reception.

She did give us a show though. She stood very still, ears perked and then pounced on something in the tall grass which she snapped up and swallowed. We couldn’t see what it was, but we have found vole’s nests in the rock walls and the telltale signs of a mouse in our house.

Along with the deer, the bear, the groundhog, the hummingbird, and others, we’ve had quite the zoological garden in our small quarter-acre lot. It is far more than we ever saw in Alaska – an occasional moose and once a ptarmigan – that’s all. Were I a farmer, or a serious gardener, I imagine I would find them a bloody nuisance and a plague, but for now I am cheered that there is still a place in America where people can live without driving out all the wild animals.

An Odd Dream

On the advice of my doctor, I started running three times a week. Not that I needed my doctor to tell me I was out of shape, but I did need my doctor to convince Dawn that we needed to prioritize the time. Occasionally I miss a day on the treadmill due to work deadlines, but I always get back on the wagon. I feel better, I sleep better, and perversely, I am even eating better. But I am also remembering my dreams when I wake up. This hasn’t happened since Rose was born over four years ago, and I had the strangest dream two nights ago.

In my dream, Dawn and I had decided that whatever the cost, we had to get out of this house. It’s too small, too expensive, too damp, and it has none of the nice little pluses we really wanted like a porch and a fireplace. So we put it up on the market as a FSBO, and then found ourselves a buyer’s agent to look for a house. We needed a buyer’s agent because the Montpelier housing market is very tight and you can’t find anything decent without contacts. Most houses sell by word of mouth. Well, the agent calls us to say he’s found a great bargain and tells us we have to move quickly if we want it, so even though we haven’t sold our house or seen the new one, we offer a substantial deposit and agree to waive the inspection, etc. When we finally go to see the house it turns out to be … you guessed it … our own home!

I woke up laughing.

Multi-Tasking

Back in days when I had time to surf the web, I came across a set of Buddhist comic strips. I remember thinking what an American concept that was – Buddhist comics – until I discovered they were Australian.

The only one I remember showed a man with robes and shaved head sitting in a lotus position by a computer, his eyes downcast and his face the picture of relaxed concentration. He typed on the keyboard and the caption read, “When you type on the computer, just type on the computer.” In the next frame he was on the phone and the caption read, “When you talk on the phone, just talk on the phone.” And in the final frame he was doing everything at once, typing, talking on the phone, drinking coffee, receiving a fax, etc. The caption read, “But when you are multi-tasking, go for it!”

I remember this because I have lots of opportunities to practice it. I try to do just one thing at a time and pay attention as I do it. This was especially important during Samuel’s first year when I was so sleep-deprived and careless. I banged my head on open cupboard doors more than once and nearly chopped off my thumb cutting vegetables.

Samuel is now 16 months old. He sleeps much better, but he is a dynamo of activity. He has enough words and he knows how to demand what he wants, which is usually “Up!” followed by “Down!” followed by “Play!” At the same time, Rose’s need for attention hasn’t slacked off at all, and I still have my job and my share of the housework to do. So I am often multitasking.

This can be as simple as singing to Samuel while I change his diaper, or as complicated as herding him away from a ledge on a playground while pushing Rose on a swing and trying to maintain a conversation with another parent who is doing the same with her own children.

I always find myself carrying Samuel while I cook, put away dishes, or change the laundry. I have even managed to floss Rose’s molars while holding Samuel in my arm. The mythical Hercules got his strength as a boy by lifting a bull calf every morning and carrying it around the stadium, and it seems I have unintentionally followed this regimen. The problem, of course, is that I am right-handed, so I always carry Samuel in my left arm. My left pectoral muscle is now twice as large as my right, and I look quite deformed in the mirror.

Health Care Financing: A Case Study

Yesterday I received a call from a very nice woman at Central Vermont Medical Center’s Patient Financial Services. I don’t think it prudent to pass on her name, so let’s just make up a name, something young and innocent and ignorant of the destruction she has wrought. Something like Bluebell, Goddess of Chaos. Bluebell wanted to make sure that I understood that Dawn’s surgery next week would be subject to our insurance policy’s deductible.

Because Dawn doesn’t work, and because I work for a very small company, we have individual (non-group), expensive, high-deductible insurance, about the worst kind you can have and still have insurance. This is Vermont, it’s a small insurance market, and we don’t have many options to choose from. There are two companies providing individual non-group health insurance policies in the state, and one charges three times more in premiums than the other.

As it is, with a family of four, our premiums are nearly $950 a month or $11,400 a year. This is more money than a lot of Americans earn in a year. I would be quite upset about it if my boss wasn’t paying for it. It is a significant percentage of my total compensation package. A lot of money is being poured into the coffers of our insurance company. In a healthy year, we get very little of this money back. Regular doctor visits cost $30 a pop in copays plus some portion of the occasional lab work. Are you following this? The insurance company rarely pays more than $1000 of medical bills a year, if we are healthy.

This year, we have not been healthy. Samuel had repeated ear infections which eventually required intubation. Before Samuel’s surgery, I called the doctor’s office and spoke to another very nice woman, Gladys, Queen of Have-a-Nice-Day, in their billing department who was able to give me a rough idea of what the surgery would cost. I think of this like a contractor estimate. A carpenter or plumber never knows what mess they are going to find inside your walls before they begin structural work, and the ENT doctor could say relatively the same thing about my son’s ears. Gladys said it usually comes out to about $4000. That is, $1000 for the facility, $1000 for the anesthesiologist, and $1000 per ear for the surgeon,

The final bill ended up being about $3000 for reasons I will demystify later. For now, just note that we ended up paying all $3000 of the bill. “But,” you cry, “how can that be? Haven’t you already paid your insurance company over $11,000 a year? Didn’t they cover any of it?” Now, now, gentle reader, your outrage on our behalf is appreciated, but you must learn to think like an insurance company. Think of that $11,000 a year as more like … more like … membership dues, yes that’s it. Annual membership dues to belong to a very exclusive club. Perhaps even, yes, Disneyland. When you go to Disneyland, you pay a large amount of money just to have a third-class wizard open a portal to the Magic Kingdom for you. Once inside, you are on your own. You must still pay for food and transportation and just be thankful the toilets and toilet paper are still free. They can’t just let anyone in, you know.

So. Some more numbers. Bear with me. All will be made crystal clear.

Our per person deductible is $5000. That means that after shelling out over $11,000 a year for the family, we still have to pay up to $5000 more if there are any medical bills. That may seem like a lot, but, well, you’re right. It is. On the bright side, if we are healthy we don’t have to pay anything. Heck, we don’t pay anything even if we are sick, as long as we don’t seek medical help.

But that is not all. After that $5000, the insurance company does start to chip in. They call their finance wizard, the great and powerful Oz, who cranks up the engine to produce his glorious smoke and fire. He operates a rather old-fashioned, steam-powered engine which runs at about 80% efficiency. So we pay 20% of any additional medical bills until we reach an out-of-pocket limit of $11,000. At this point, the wizard’s engine is good and warmed up. With much hand-wringing and mumbling about the rising cost of health care and the poor business climate which has been quite damp and rainy and has induced many chills and fevers among the banknotes, the insurance company digs into its pocket and starts to pay the rest.

This is per person mind you. If someone else in the family gets sick, the numbers start again from zero. That’s $5000 deductible for each discrete human entity in my family, no matter how diminutive. So to ease the blow there are some esoteric, mitigating rules.

The family as a whole has similar numbers: $10,000 deductible and a $22,000 limit for the 20% co-pay. If the family as a whole hits these limits, the individual limits are waived. Yahoo! And to be extra nice any deductible we pay from October to December gets double-counted. It is applied to our deductible the following year. Why? I have no idea, and I’m not complaining. Perhaps this is a slow time of year for the insurance company or the hospital. Perhaps they wanted to give us a break, and scratch lottery games on the premium bills were nixed by marketing.

There is one more “nice” thing they do for us. Or rather, for themselves, but we benefit from it. They go to the doctors and the hospitals. They bring along some lawyers and some finance people. They also bring a few large, swarthy men in expensive and ill-fitting suits who stand silently in the background, occasionally cracking their calloused and hairy knuckles while their employers sit down with the providers to “talk.” The result of this talk is a contract. The doctor or hospital agrees to be a preferred provider for the insurance company. It’s a form of protection for them really. Accidents do happen. In return, the insurance company agrees to pay the doctor or hospital a portion of their bill for various services and procedures, a contractual “allowed” amount, and the doctor may not ask for more from anyone. This is how Samuel’s surgeon’s bill was miraculously cut in half.

Next week, we start the process all over again. Dawn had not had a checkup in years, her knee had been bothering for even longer, and I finally convinced her to see a doctor. The doctor ordered an MRI and a consult with an orthopedic surgeon. The MRI revealed “an acute medial meniscus tear (ICD-9 code 836.0).” The surgeon recommended (surprise!) surgery. We scheduled the arthroscopic surgery and asked the grandparents to come help out in the house during recovery time.

A week later a bill arrived for the MRI which was about $1300. Wow. Ouch. Up until then we had spent about $100 towards Dawn’s deductible. This bill was a wake-up bat to my head. I decided to get serious about the financing. I wanted to know exactly how much money we would have to pay out of pocket for this “procedure.” Or at least, I wanted the contractor’s estimate again. The surgeon had already warned Dawn that the MRI showed only so much. Until they got a look inside, they couldn’t be sure what they would find.

So, I got on the phone. I called the surgeon’s office and asked what the charges would be. They said roughly $2000. Great. I called the insurance company and asked what “allowed” amount they had strong-armed the surgeon into. They said that was confidential information, but generally they set the number at a little over $1000. Wonderful! We could cover that.

Then I got the call from Bluebell. I told her I understood that we would be paying the deductible. Could she also remind me how much she thought they would be charging? Sure, she could give me an estimate. I waited on hold while she searched the records.

“About $6,000. Perhaps $13,000. It depends on exactly what surgery is being performed.”

“I’m sorry, could you repeat that?”

She did. We then began an exhaustive discussion about the billing under which certain facts came out. There were likely to be four separate bills issued by four separate players: the surgeon, the anesthesiologist (every time I type this word, my spell checker snickers at me before correcting it), the facility, and the lab. The $6,000 to $13,000 bill is just for the facility. My earlier $2,000 estimate, reduced to $1,000 by my savvy negotiating insurance company, was just for the surgeon’s bill.

I called the surgeon. I called the insurance company. I called the anesthesiologist (snicker, snicker says the computer). I called their billing office, but they were closed until Monday. I called the surgeon’s nurse, and while on hold, I was disconnected, so I called again. Finally, I called Bluebell at Patient Financial Services.

I am still not certain who or what the adjective “Patient” is modifying in “Patient Financial Services,” but I think it ought to be me. After three calls, she has still not answered my simple question what is the allowed amount in your contract with my insurance company for the facility bill? Instead she tells me what they normally bill and that I will be responsible for paying the deductible. I know I am responsible for the deductible, believe me. At this point, I suspect she is really an automaton in need of additional programming. The sad truth was, she didn’t know. The providers have no idea what’s in their contracts. I doubt they have even read their contracts. Who reads their insurance contracts? She guessed the insurance company would cut between 10% and 20% off the bill, but she warned it was only an estimate to begin with. The operating room charges in 15 minute increments, so it depends on how skilled the surgeon is.

So now I will crunch the numbers for you. Keep your eyes open, and don’t blink, because I am going to perform a feat of complex arithmetic that apparently has never been attempted before surgery.

$1050 for the surgeon. $6000 for the facility. The $13,000 quote was only if she had two knees done. Bluebell just phoned me to confirm that this number will be trimmed by 12% once the insurance company sniffs at it. No lab work needed (hallelujah), and the ana… that other doctor can’t be more than the surgeon, so, worse case, allow $1000. Plus don’t forget the $1300 already spent on the MRI, for a grand total of $8630. That brings our out of pocket expenses to $4900 remaining on the deductible plus 20% of the rest.

Five thousand, six hundred, and forty-six dollars.

Approximately.