Shot in the arm.

I cried yesterday upon leaving the doctor's office.

I know, it sounds melodramatic. Men in our society aren't supposed to cry. It's just that the news was so devastating.

My bill was $120.

I had received "two" injections of cortisone in my left shoulder for tendinitis. (Technically, it was one injection but included a dose of anaesthetic.) Each dose cost $6. That seemed reasonable to me.

But the office visit cost $45 - a bit steep considering the doctor wasn't there for more than three minutes, and a minute of that consisted of his leaving the room to get the hypodermic and medicine. I understand there is a flat fee for office visits; shouldn't there then be a designated minimum amount of time that the doctor spends with each patient? This doctor ignored my questions, handed me the bill, and left while I was still putting on my shirt. Is it right to make me pay for his running behind schedule, when I've paid a fair fee?

As it was, I had waited an hour past my scheduled appointment to see him as it was. Even if I'm just a peon, my time is still worth a good $5.50 an hour. Can't I deduct that?

But the really painful part of the bill was the $63 for actually performing the injection, which lasted all of eight seconds. If I'm paying $63 for his skill, what was the $45 for - his ability to tell me to remove my shirt? (Don't tell me it was for his diagnosis, because he'd made that a month earlier when he gave me my first injection at a cost of $81.)

Basically, since the doctor was only in the room with me for two minutes, at $120 I paid him a dollar a second to see me. At those rates, maybe I should be glad he didn't stay longer.

My shoulder had been hurting for three months before I finally went to the doctor. I'd been hoping it would get better on its own, but when I tried to reach for something and realized I could no longer stretch my left arm as far as my right, I became frightened. I suppose this is the way most poor people let problems develop too far.

I have a couple of friends I take down to charity hospital every few weeks - one for arthritis and another for a shattered bone that won't heal. I took a third friend there when he got the flu. Their waits of four, five, and six hours were demeaning and dehumanizing. Usually (except for the flu), they wouldn't even get to see a doctor but only set up an appointment to see one a month or two down the line. And when they showed up for these appointments, they had another four-to-five-our wait. Then they were diagnosed nosed but often had to return in another few weeks to receive any treatment, with yet another four, to five-our wait ahead of them.

I grew up in a middle-lass home and just couldn't bear to go through all that myself. I am spoiled. I have three college degrees in English and work professionally as a college English instructor, where I earn $6,500 a year, with no benefits. I can't afford insurance. I don't know how I even saved enough for these two office visits, but they are the last.

After I had paid the $120, I walked in a daze to my car. I have finally become a complete nothing, I realized. People with money are everything, and people without it are nothing. It's certainly been said before, but I finally realized what it meant.

I don't expect anyone to feel sorry for me. As someone who frittered away his life on something so frivolous as English, I know exactly what society thinks of me. But as someone who grew up middle class, despite my miserable income of the past several years, I still managed to see myself as part of us, not them.

I, too, looked down on the poor somewhat, as ignorant or lazy or whatever. Oh, it's true that because of my liberal-arts background I was very nice and sensitive to them, but I hung on as long as I could to being part of us, believing I was only an honorary them. I was only clinging to respectability by my fingernails, but that doctor bill ripped my fingernails right off.

I was raised conservative but became much more liberal as an adult. Still, I am an odd mixture and maintain some strong views on both sides. I do think that entitlement programs and welfare too often promote dependence and lack of ambition, as well as punish those who try to escape poverty.

But honestly, how many people are going to say, "You know, the government is paying for my health care, so I think I'll go out and get appendicitis today"? Do people really say, "I hate rich people. I want them to pay more taxes for me. I was going to let that lump in my breast just sit there. but I think I'll go get it checked just to be spiteful"? Has anyone really been heard to remark, "Since I don't have to pay for it, I think I'll go develop some intestinal polyps. A colonoscopy sounds like a lot of fun. It'll liven up my boring, lazy week"?

The fact is that many people will never earn more than minimum wage and will be forever stuck in jobs with no benefits. And most people, even if they do work hard, will never be able to afford health care. If I'd had a torn rotator cuff, my doctor said it could cost a couple of thousand dollars to repair. We dregs of society may deserve to live in cruddy apartments and shop for clothes at thrift stores, but do we really deserve to wait half a year to be treated for something others are cured of in a week? Do only those who are smart enough or talented enough or lucky enough (or brutal enough or avaricious enough) to become wealthy deserve health care?

I've been back at school for a year now, taking my pre-med prerequisites with a grade-point average of 4.0. With or without health-care reform, I'm going to get the health care I deserve. It would be nice to think, though, that maybe the millions of other Americans without health care might get some, too. No matter where we stand as individuals on the issue of reform, it is clear that the health-care care system on some substantial level needs a shot in the arm.

Johnny Townsend is a college English instructor. His work has appeared in Christopher Street, the Progressive, Newsday, and the Washington Post.