The Case Of The Swollen Knee

On October 27, 2025, I was riding my motorcycle down Cerrillos Road when the unthinkable happened: a car attempted a last-second U-turn directly into my path. I struck the rear passenger side of the vehicle at roughly forty miles an hour and became briefly airborne. Fault has no real place in this story, so even though she was entirely responsible, I won’t dwell on that. The collision didn’t just launch me and my bike into the center westbound lane, it launched me headfirst into the modern American medical system.

I became intimately familiar with hospital beds, nurses, wheelchairs, and that ugly word: compliance.

To be clear, the system did exactly what it is designed to do. It handled everything that appeared on a checklist, and ignored everything that did not.

Collapsed lung? Check.

Broken facial bones, including a missing piece of my lower lip? Check.

Brain bleed? Check.

Broken wrist? Check.

Broken foot? Check.

A massively swollen knee? Nope.

A growing fluid collection in my thigh? Nah. “Let’s take a look at that later.”

But don’t worry, bowel movements were monitored religiously. Check, check, and fucking check.

There were surgeries scheduled. Then cancelled. Then scheduled again. Then cancelled again. I was repeatedly reminded not to leave my bed because doing so set off an alarm. Apparently mobility is dangerous, but immobility is… compliant.

Once I was healthy enough to not actively die, it was time to say goodbye.

Because that’s the system’s real job: stabilize, document, bill, discharge. Anything that isn’t immediately life-threatening gets punted down the road for “someone else” to deal with. That someone else, I learned, is usually a primary care physician, assuming the patient is lucky (or naïve) enough to have one.

So there I was: discharged, alive, in a wheelchair. On disability. Armed with a stack of follow-up appointments, none of which addressed my left knee or the expanding mass in my lower thigh. It hurt. It was swollen. It was growing. But I wasn’t dying anymore, so it clearly wasn’t urgent.

Eventually, I secured an appointment at a community clinic to establish primary care. I arrived in a wheelchair. My sister pushed me. I explained that I was recovering from a motorcycle crash and had a worsening knee issue.

The priorities discussed? Colonoscopy scheduling. Lung cancer screening.

The knee received the medical equivalent of a shrug.

Then came two urgent care visits, each of which resulted in a referral to the emergency room. The emergency room, in turn, referred me elsewhere. This is the referral merry-go-round, where ethics and outcomes are flung off by centrifugal force, but billed hours cling tightly to the frame, spinning in perfect synchrony with the patient.

Eventually, I encountered a clinician who looked at my leg and said, essentially, “Yes. This is a problem. And yes, we should fix it.” A can-do attitude, a rare sight in a system that rewards repetition far more than resolution.

The plan was simple: imaging, then drain the fluid.

Except… I have an implanted defibrillator.

When it was installed, the technology was proudly described as MRI-compatible. Turns out that compatibility comes with an asterisk. Modern MRI machines are now considered too powerful unless you use a very specific unit, in a hospital setting, coordinated with cardiology for pre- and post-scan device checks. Never mind that I’d had a device check just two weeks prior, it wasn’t within the window they prefer.

So the MRI was scrapped. A CT scan was ordered instead. That happened quickly, at least.

Which brings us to today.

The problem is now well-documented. The pain is undeniable. The solution is known. And yet, here I sit, waiting again … for authorization, referrals, orders, approvals, and another appointment in another room with another person who may or may not be allowed to actually solve the goddamn problem.

This isn’t a story about malicious doctors or uncaring nurses. Most of the people I encountered were competent, compassionate, and visibly frustrated themselves. This is a story about a system so rigid, so obsessed with process and liability, that it can acknowledge a solvable problem and still refuse to solve it, while billing every step of the indecision.

My knee is still swollen. The case remains open.

Right now, I wait while the powers that be debate the fine distinction between a referral and an order, the former plentiful, the latter rare, and only one of them leading to an actual outcome.

Somewhere along the way, we accepted this.

We accepted that having insurance is the price of admission. So we chase jobs with “good benefits,” pay our premiums every paycheck, swallow deductibles and copays, and congratulate ourselves for being responsible.

Meanwhile, insurers design systems to minimize risk and liability. Hospitals respond with expanding layers of checklists and protocols. Clinicians, many of whom want to help, are trapped inside a maze built to prevent blame rather than deliver care.

The result is a system that can identify a problem, document it, bill for discussing it, and still decline to fix it.

If healthcare reform means anything, it should mean restoring the ability to move directly from problem to solution, without spinning patients endlessly in place while pain is treated as something they must simply comply with.

It’s time we demanded more from the systems we rely on.