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I feel a personal obligation to write this diary of my recent experience with the corporate health care monopoly. I hope to offer a different view of 'health care reform' by addressing the 'health care' itself. I look at the corporate influence over which care we receive – regardless of who pays for it.

 I acknowledge, from the start, the dedication and competence of the innumerable health care professionals everywhere on our Earth; I applaud them. I do say, with few remarkable exceptions, that the “Health Care Inc.” monopoly subsumes them all. And while I judge no individual, I accuse the corporate control of the system of putting profit before patient. This is my health care version of “J'accuse”.

What follows is my experience in repairing a male inguinal hernia (there are many kinds of hernias). I do not touch on the women's hernia issues; but I hope to invite (if not  incite) some edifying expositions in the comments section. All “hernia” references here are to a male inguinal hernia.

 It all started when I noticed a sub-dermal bulge my in abdomen above my groin. It turned out to be an inguinal hernia: 'a gap' in the muscles holding my intestines inside my body (i.e. my insides were pushing out through a 'hole' in my inner abdominal muscles.

 I was (gleefully) diagnosed with an inguinal hernia, and was 'rushed' to get a mesh implant surgery immediately. It was presented as a common, and trivial procedure. But! Any delay chanced extreme death by strangulated intestines, or worse, an emergency room “visit”.

 To the best of my knowledge the medical monopoly procedure is a mesh (fabric) that is inserted across the opening of your containing muscles and either stitched or stapled in place. For some reason this is necessarily done by snaking a remote controlled optical cable (a laparoscope - a sort of reverse periscope) up through a cut in the groin. With various other insertions surgeons unfold a plastic mesh and secure it in place.

 All this remote control toying is being done less than a half inch under the skin. But the “toy” is inserted through a hole some six inches away. Why? Ostensibly this is done to avoid an open cut through the abdomen (which is acceptable in innumerable Caesarian sections done every day). To me it looked like it was being done to pay for the stupid laparoscope.

 Every insurance plan covers the high cost of this procedure, and the cost to me would be minimal; I just had to hand over my body to the high priests of received wisdom for 'business as usual'. Indeed I found no other choice offered or available.

 I 'ran away' and searched the web.

  I found that the monopoly surgical procedure is statistically regarded “a success” if the patient gets out of the operating theater 'alive' (without complications). At that there is a 5% fail rate. Too often the surgeon bumps into a nerve (or staples it) or some other essential scrotum tube is damaged. And the piece of fabric (mesh) can be misplaced, or move. Surveys that include hernia recurrences and patient post-operative pain report a 30% failure rate. Surveys comparing pain and discomfort between men who have had inguinal hernia mesh implants and those who chose to live with, and manage, their hernia find that the two are comparable (i.e if you can manage to suffer a little, you can do it for free). I didn't feel lucky.

 The causes of an inguinal hernia are not even known. The old canards about lifting too much weight do not address the real causes (e.g. weightlifters usually do not get hernias). I found no research into the causes of inguinal hernia; it is apparently too profitable to cure. I found that hernia surgery is one of the most common surgical procedures performed on the planet; identified as one of the largest money makers. Worldwide laparoscopic/mesh hernia 'repair' surgery is Big Money.

 Consequently, there is a monopoly on the surgical procedure performed. In the spirit of 'Poor Bill Gates'; mesh repairs are a mass marketed flawed procedure requiring many fixes, on which you are the test site; all at your expense.

 I was appalled. I lay prone, I stopped eating (not putting something into me to fall out), I searched the web for alternatives and found none! So I revised my query, I followed web links after links. I found yoga sites, herbal sites, personal testimony sites, but my hernia was still getting worse.

 I found several traditional surgery techniques offered around the world. Evidently; before the 'mesh monopoly', there were many long established hernia surgery procedures. They usually cut you open, pull the gap closed (tension), and stitch you up. I found a Canadian clinic using the Shouldice technique (stainless steel sutures). I made a tentative appointment and continued to search.

 By pure chance (grace?) I fell upon a 'no profit' self help page with a personal testimony of a distinctly different “alternative surgery” method. Indeed this author's personal initiative brought the new 'Desarda' surgery technique (which I eventually received) to the USA. But his site led me to a now defunct clinic in California (which still posts a dead “ghost” url and web page).

 However; I did eventually find the real, one and only, Dr. Mohan Desarda at the Pune Hospital in India. From his desarda.com I learned everything I never wanted to know about inguinal hernias. What Dr. Desarda does differently (by my limited understanding) is to stitch some of part of your openned muscles to a very strong adjacent ligament, then stitch you up 'in place' on that new foundation. The Desarda technique is a 'no laparoscopy, no mesh, no tension, local anesthetic, absorb-able sutures, permanent, painless repair'. The recurrence rate is less than 1%. That's what I wanted.

 At that time I even noticed a link to (the real) “Desarda Center USA” at the Ufirst Health Clinic in Fort Myers Florida; but by that time I had become averse to the chimera of “Health Care Inc. USA”. I asked to be treated by the original master, and was welcomed.

 I planned to fly to India; I booked the operating theater, I booked an Air India flight, renewed my passport, and applied for my visa. Ah; the India Visa Center, those unfathomable circumlocution offices of the Indian version of “how not to get things done”. They stopped time. Suffice to say I never got a visa in time .

 Reassured by Dr. Desarda that Dr. Tomas was equally master of the technique - competent and committed - I overcame my aversion to American medicine in a blink; my hernia was still getting worse. Indeed; the ultra efficiency and speed of the Ufirst clinic services became a welcome comfort.

 I flew to Florida and stayed at a hotel that is a virtual annex to the clinic. The Desarda Center USA has a modest appearance. It is the only doctor's waiting room I have ever been in where the prevailing feeling was relief rather than anxiety (both men and women); Dr Robert Tomas created the general surgery 'Ufirst Health Clinic' together with his wife Dr. Anne Lord-Tomas.

 I walked in for an examination one fine day. The next day I walked in for a bi-lateral (double) hernia surgery and walked out in less than an hour. The next day I took a walk. I dined out for a couple of nights (fearlessly filling my guts). After a post-op examination I flew home. I never once experienced pain or discomfort, then or since.

 This cost a lot; out of pocket. Medicare would have paid for part of the surgery, but only for a displaced “Hospital” surgery that could not include the practiced team at the clinic. My veteran's coverage would have paid for a decent traditional surgery. I got the best help available in the world and I do not care who paid for it. Health Care is not a business, it is a healing art; a human right. A human need.

 The Desarda technique benefits the patient using simple surgical techniques available to any surgeon with the mind and will to advance health care science over corporate profits. This hernia repair technique has been available for decades and has been adopted around the world, but in the USA it is all but invisible. In the USA, no matter who pays for it, you buy only what they're selling, at any price they set.

 Dr. Desarda is a hero of social justice. His perseverance in educating the worldwide medical community has benefited patients around the world. His persistence has been untiring; and his discovery has certainly not made him rich.

 Dr. Tomas' adoption of this technique in the USA should have a seismic impact on USA inguinal hernia repair. He is what I love about us here in the USA; some unanticipated free mind always steps through the veil of monopoly proscriptions and makes a better future real - for us all.

 Nowadays every other man I meet has, or has had, an inguinal hernia. Most are happy with their mesh surgeries (or obediently endure some discomfort). Their eyes assume a ”Manchurian Candidate” glaze as they speak of their doctors as “the kindest, bravest, warmest, most wonderful human being I've ever known in my life...”. Some, however, have been severely damaged by mesh surgery. All are ignorant of any alternatives to using mesh.

 There is no reason for this viable procedure not to be offered to all patients in the USA; we taxpayers are usually paying for it anyhow (one way or another). There is evidently a worldwide epidemic of male inguinal hernias; they should not be cultivated as a renewable revenue stream.

 We talk about the money. We gamble with the odds makers who “sell” insurance. We count the costs. Shouldn't we review the health care that is provided? I do not know anyone who would not welcome a doctor's care in an emergency. I simply ask the question; where art thou 'Health Care Reform', quite apart, and separate from, the circus of 'Health Care Costs Payment Reform'?

 I am well, thank you, and trust you are too.

Brian Hayes

P.S. It occurs to me to make it very clear that the views herein expressed are solely my own. I write it without the consent or knowledge of the doctors mention. I strongly suspect that they might disagree – at least in part - with my characterizations and criticisms. They are  public figures and I mention them as such. My reflexions on my experience are mine alone.

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