Wednesday, February 16, 2005 | A hospital run by the United States government might not be your first choice when it comes to open heart surgery.

In my case, I didn’t have a choice.

When I turned 50 and my health insurance premium turned astronomical, I dropped by the VA Hospital in La Jolla to see if the year I spent in Vietnam playing hide-n-seek with the Viet Cong qualified me for health coverage.

Indeed it did.

So I wrote my last check to Blue Cross and turned the state of my health over to folks on the federal payroll. If I lived in Alabama I might not have picked Uncle Sam as my health care provider.

But I figured the medical attention given veterans here in San Diego must be pretty good since this is the town where admirals and Marine commandants go to die. Retired four stars should get star treatment, right? My hypothesis was put to the test last year when I was diagnosed with a leaky aortic valve. My ticker was starting to feel like a heavy-duty washer doing a load of beach towels. The time had finally come to go in for some new parts.

Had I an extra $200 grand or so, I would have considered buying an overhaul at the Cleveland Clinic. According to my Google research, that’s the top hospital in the U.S. when it comes to broken hearts.

Rather then sell the house, I decided roll the dice with the VA.

The visits I had made to the concrete box sitting above I-5 off La Jolla Village Drive were generally pleasant experiences. The staff was exceptionally polite, my appointments came off on time and the parking was free. (Can you say the same about your HMO, PPO or initials particular to you?)

The real confidence booster in my case were the V.A. cardiologists. I think I got to know at least six of them. Young, sharp, approachable and free of the patronizing attitude of many medical professionals who treat patients like morons. It also boosted my spirits that all of the heart docs at our local VA are part of the UCSD Healthcare System, which has got to be a better training ground than medical schools in Guadalajara.

I especially liked – and am grateful for – the extensive pre-operative testing I was put through at the V.A. One doctor told me she liked practicing at the V.A. because she didn’t have some cost-calculating administrator peering over her charts looking for ways to save a buck. I don’t know this for a fact, but I bet I had more echocardiograms in 2004 than the average heart patient in Cleveland. (Don’t mention this to your

What made this a sure-bet deal for me was the surgeon, Michael Madani. Some people you look at and just trust. He’s one of them. Plus, I liked his hands. I also wanted Dr. Madani to like me. I figured it wouldn’t hurt my chances to have him see the value of my character so I told him something I don’t believe he’s ever heard from a patient before.

“Doctor,” I said, “I understand this is a teaching hospital. If you want to use my surgery as O.J.T. for a talented resident, be my guest. Just don’t step out for coffee during the procedure.”

He liked that.

To cover all of my bases, before I checked into the hospital last November for my ticker overhaul (the second major surgery I’ve had in my life-the first being the vasectomy), I took a big black felt tip pen and wrote an inspiring note for the surgical team on my upper right thigh: “Go Team!”.

Nobody’s going to screw up a guy with a sense of humor, right?

My message worked. I survived.

It’s been 11 weeks since my chest was spliced open, my heart stopped and a new carbon and titanium gizmo replaced my bum aortic valve. The surgery and the recovery were amazingly non-painful. I’ve had worse root canals. Of course, I didn’t get a ten-day supply of Vicodin after the root canals.

My short five-day stay in the hospital was made tolerable by a pleasant staff, not-bad food and some drugs which greatly improved my mood.

Once a month I head back over to La Jolla to get my blood checked. My appointment is usually for 8:50 in the morning. Without exception, they see me exactly at 8:50 a.m. Amazing.

The other thing I like about the VA? All of the staff address you as “Sir”.

Can you imagine that?

And I spent most of my time in the Army as a PFC.

Jim Johnston is a freelance writer (when the mood strikes) with an office in Little Italy.

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