When I knew I was leaving Lawn Guyland, I visited my long time dentist for the last time. This man had done all my dental work since the early Reagan Administration. My union dental coverage had purchased him numerous fine German and, later, Japanese cars over the years. He used to say that when I came into his office, he could hear the revving of new engines instead of air drills.

The O.C.D. dentist I called him, as he was a true perfectionist. His work with crowns was so good, none of it ever had to be redone, even after nearly 30 years.

At my last appointment, I said to him,”So, Doc, when I move to Aridzona I want to look up your organization, so as to find a dentist as good as you.”

“What organization?” he replied.

“Oh, you know, the A.R.J.D.A.”

“What’s that?” he asked.

With a wink to his assistant, I said “Anal-Retentive Jewish Dentists of America!”

We all laughed, but I had the sinking feeling I was gonna miss him. Boy, was I ever right.

With the Valley of the Sun in my sights, I moved to a little cotton field west of Phoenix. A “city” they called it. Not like any city I’ve ever seen, more like a “town”. After taking four months off to, well, play hooky—after all, I had been working nonstop since I was eight—eventually my wife and I decided to find jobs. Hers would have to have health bennies. Only a blind man would give me any health benefits. Once that was settled, I went about the task of visiting doctors and dentists within our plan’s network.

Within a year, I realized there are 20 ‘truths’ concerning healthcare in ‘The Valley’ as everyone calls it. I will now recite these 20 Commandments:

1. There is a damn good reason your doctor or dentist isn’t in New York or L.A. Look up the term “Goober” in the dictionary. There’s his/her picture.
   
2. If you are waiting to see your doctor or dentist for way too long, and his waiting room is empty, he can usually be found in his office on his laptop, on E*Trade checking his retirement portfolio, or on the phone talking to the guy he’s got rehabbing foreclosures.
3. Dentists in The Valley do not like doing standard dentistry. If it doesn’t involve use of a blue light, and include the terms ‘Brite Smile’, or “porcelain veneers’, it’s beyond his/her scope of practice.
4. No matter how competent the doctor is, his office personnel will surely give a whole new meaning to the term “asleep at the wheel.”
5. Messages between the doctor and office personnel will get lost/changed/forgotten during its arduous six-foot journey from counter to computer.
6. Be prepared to get all of your information paperwork from the office personnel in Spanish, whether or not you even speak Spanish. Qué?
7. Referrals take years.
8. Test results always take until the day before your next test (Quantum Faxing?)
9. If you really like your physician, just wait, he will be moving back to his home state soon enough.
10. Check to see if their degree came from a degree mill, such as the Arizona School of Medicine and Animal Husbandry. Red flag: look out for the pictures of horses in the waiting room. On a related note, never say “Blücher” out loud. They hate that.
11. Nothing is permanent. Nothing. Any tooth repair, any surgery, any prescription for a problem, all will only work for six to eight weeks, then fall-out/drop/swell/delaminate/leak/become infected/hurt like a biatch and then you can start with the word “fall-out” again and reread that list. At that point you will be asked if you want the upgraded version at no charge. He will then redo what he’s already done poorly—poorly once again—and gets to bill your insurance company twice.
12. No matter what the problem is, do not ever interrupt the office girls personal phone calls. You have no idea how long you can be made to wait, or how fucked up your paperwork can get. Oh, and it’s no fun getting an imaginary molar removed from your testicles.
13. Appointments in Arizona are merely suggestions.
14. If you make an appointment, call back in an hour and ask if you made an appointment. You will be told “no” …at which time you can remake your appointment. This increases your chances of making the schedule, albeit only slightly.
15. Get a second opinion, like your life depended on it. It does. And maybe a third just for shits-n-giggles.
16. If your Doctor says to you, “What you have is inoperable/unfixable/terminal, what he means is it’s above his pay grade and he’s too fucking embarrassed to refer you to a physician that can do it.
17. Get to know all the Hindu holidays’ time tables, your doctor will be unavailable at these times.
18. Before your first visit to your physician, always go to his website and fill out all the pre-visit forms online. It won’t save you any time, as they will have lost them when you get there, but you have practiced and can now fill them out more efficiently whilst balancing the clipboard on your knee and talking on the phone simultaneously. This will also not help the wait, because you will finish the forms six to seven months before you will be seen. Luckily, all dentist and doctor offices in AZ are equipped with cafeterias for this reason.
19. “We do take your insurance plan” can be a deceiving statement. What it means is this: “It’s ok for you to do all the paperwork for us after we fuck it all up. It’s also OK for them to pay us, and for us to say we never got the payment.”
20. Win the lottery and pull an Elvis. When you’re sick or have a toothache just get on a plane to NY.