Logs:Physicals, Privacy, and Paperwork

Physicals, Privacy, and Paperwork
Dramatis Personae Iolaus, Steve
In Absentia	2019-02-17 Iolaus and Steve meet to discuss his pending mutantcy-exam.
Location <NYC> Mendel Clinic -- Lower East Side
With its sharp crystalline edges and sleek lines knifing up into the sky, this building is one of the most distinctive new additions to the neighborhood. An angular structure in glass and steel, the tall tower has a deceptively slender look to it that is belied by the heavy security as soon as you enter the doors. The front doors are frosted with the Clinic's logo -- a rising sun over a rod of Asclepius -- a motif echoed in many places throughout the building. Visitors to the clinic must first pass through a small mantrap, guarded by some of the Clinic's security guards; once they make it through the metal detector and airlock's double doors they emerge into the much more hospitable lobby. With dark wood floors underneath and comfortable black and red couches at its edges, the high windows give the room an airy feel. A bank of elevators to one side carry visitors to the many destination floors, while the wide welcome desk at the other side is manned by a security guard ready to help point visitors in the right direction. Through security, up the elevator onto the administrative floor where visitor badges are occasionally spotted hanging from around people's necks, the Mendel Clinic's ninth floor is one of the only quiet parts of the building. The offices are small but well-apportioned, lining the hallways with signs like 'Accounts Payable', 'Comptroller', 'Marketing', 'General Counsel'; except for the Mendel Clinic logo on badges and doorsigns, this floor could easily belong to any office at any company. Down the hall, tucked between an accountant and a press officer, one of the door plaques is labeled simply "Founder". It is no larger than the ones next to it, nor is there any special difference once inside -- except for the explosion of papers strewn over the windowsill and the desk and the scribbling of nearly illegible text packed in small rows on the window. The cause of this mess is sitting behind the desk, sorting through piles with a frustrated expression on his face, muttering darkly to himself in Greek that this narrator is too well-mannered to translate. His white coat is hung up on a hook on the back of the door, leaving him in a forest green dress shirt (winkled) tucked into black slacks (fraying along one of the front belt loops). One of the visitor's badges wandering through administration is attached to Steve. He's wearing a light blue dress shirt, charcoal trousers, and a navy peacoat, his red, white, and blue shield slung across his back. Stopping in front of the founder's office door, he raises his hand to knock. Hesitates. Looks almost about to turn and walk away, but then knocks all the same -- firmly, three time -- and enters at Iolaus's acknowledgement. "Good afternoon, Doctor Saavedro." He closes the door behind him and takes in the room. If the mess surprises him, it doesn't show. "Steve Rogers -- we spoke over the telephone." Small frown. "If you're busy right now, I can come back another time..." Iolaus looks up and his face brightens, ushering the other man in with a wave and coming around the table to extend his hand. "Nonsense, come in, Steve. It's a pleasure to have you here; welcome to the Mendel Clinic. Please, come, sit down." Iolaus gestures to the chair across the desk from his own, and hurridly steps forward to remove another pile of papers from the seat and put it on (an increasingly unstable) stack on the windowsill. "I'm sorry about the mess; I'm afraid if I don't keep a close eye on it, my inbox has a tendency to become more of an in-room," Iolaus says, sitting down in his own chair that makes a quiet squeak of complaint. "Though," he adds, glancing around him, "I think most of this is actually studies I had planned to read in some free time..." The doctor shakes his head once, rapidly, as if to clear the thought from his head. "Neither here nor there! Luci and Matt speak very highly of you." Steve looks slightly dubious at the relocation of the papers, but once Iolaus sits back down, he does take the offered chair. "I'm not sure I've given the Messieurs Tessier much cause for praise, but I do appreciate their kindness and generosity." His smile is reserved, maybe a bit self-conscious. "Thank you so much for agreeing to see me on a Sunday -- you don't seem like the kind of man with a /lot/ of free time..." His pale blue eyes take in the reams and reams of papers Iolaus is planning to read. "I am sorry to be so difficult about this, I just haven't experienced a lot in the way of /modern/ medical care and feel very dubious about it. I doubt they told you, but I was...subject to some government medical research." Then hastily adds, "/Voluntary/ research." Iolaus pales slightly at the mention of government research, but he nods along understandingly and looks slightly better once Steve adds the follow up. "It's not a trouble at all; we're happy to help. Many of our patients aren't particularly thrilled at the idea of seeing a doctor for one reason or another -- past abuse, bad experiences, fear of what information they may get, or what the information would be used for." The doctor settles back slightly in his chair and spreads his hands out in a little shrug. "Though, I admit, most don't have your background." Iolaus' glance flits briefly to the shield on Steve's back before returning to his face. "What would you like to know?" Steve shrugs out of the harness for his shield and sets it carefully down beside the chair. "Well, I...hardly know where to start." Unbuttons his coat and slides that off, too. "I think what troubles me most right now about getting a physical examination is not knowing how that information might be used." He looks down at his forearms. "I don't want to be /research/ again." Iolaus leans back in his chair, nodding along with Steve. He is silent for several seconds after Steve has spoken, and when he speaks again, his voice is quiet. "We conduct very little research here that's not directly focused on caring for our patients. Any clinician who wants to use data from patients needs permission from our institutional research board, a sponsor, and the informed consent of every patient whose records would be used. It's a high bar, and it's not something we do lightly." The doctor shifts in his chair, leaning forward. "But I'm not going to lie to you and say that we don't do research at all, nor that we never ask patients whether we can use their records." The doctor's eyes search Steve's face for a moment. "We're a clinical practice first, a charity second, and only a third a research institution. Every single member of this organization knows that, and anyone who does not take our patient's privacy seriously will not remain employed by this institution." Steve listens intently. "That's reassuring. But can the government force you to hand over your patients' information?" He rubs his forehead slowly. "It seems their reach is practically limitless these days." "Legally? No, only in very specific circumstances where all doctors are required to do so. If we believe that a patient is in imminent danger of causing harm to themselves or others, or in the case of certain transmissible diseases. Other than that..." Iolaus shrugs his shoulders, shaking his head. "I have no intention of letting the records of this clinic be used against the patients who have put their trust in us." His voice is steely, face firm. "I suppose whether they they actually /follow/ the law is another question entirely." The corner of Steve's mouth quirks. "Another thing...this is complicated, but is it possible to tell definitively whether I'm a mutant?" This question seems to stump Iolaus for several seconds. His mouth opens and shuts, blinking several times, and then -- with a visible effort -- he pulls himelf together. "Well... yes, actually. We can sequence your DNA and determine whether or not you have any copies of the X-gene, as well as whether or not it's active. That's actually my background; I'm a clinical geneticist." He hesitates for a second. "Just because you have the X-gene doesn't mean that it's necessarily expressed, but, if it is... that's usually strong evidence that you have it. Still, we can confirm." Steve's brows furrow as Iolaus explains. "To be honest, Doctor, I only understood about half of that. But I want to do this sequencing, to find out if I have any...active X-genes." He sounds vaguely embarrassed with his obvious ignorance on the subject. "I doubt I need much actual care in terms of my health, but I would like have a thorough physical examination on record, anyway. I should probably warn you, though, that there is at least one and possibly more government agency that is /very/ interested in all that information, too." "I'm happy to explain in more detail, but, that probably can wait until we get results." Thrumming his fingers along the table, Iolaus considers this for a second. "It's not common, but for a few patients who have... aggressive privacy needs, we have some procedures for numbered medical records that have no name attached. Unfortunately, that means we can't bill insurance, so it's cash only against our sliding scales." "I would say my privacy needs are pretty aggressive, unfortunately," Steve admits. "It's as much for your protection as mine. I don't have health insurance -- at least not yet -- so I would have to pay by your sliding scale anyway. That the Tessiers did explain to me. My last question on the broader topic: I know this clinic is one of the few that will take mutant patients at all, so is there some way I can...take up less in the way of resources meant for them? I am," he adds, as if feeling it needs clarifying, "not a mutant." Iolaus tilts his head slightly to one side, studying the man across the desk from him with a slightly puzzled expression. “This clinic doesn’t only take mutants. Many of their allies also have trouble receiving care elsewhere, or feel more comfortable here.” He shakes his head, his smile slightly wry. “Including most of my staff. But we don’t ration care based on whether someone is a mutant or not; we prioritize cases based on how much our patients need them. The best thing you can do to keep from using up more of the clinic resources is staying healthy. Something I recommend whether or not you care about the clinic’s resources, mind you!” The doctors smile brightens a bit, tone gently teasing. “But if you don’t, that’s what we’re here for as well.” "I know it's not your policy, but still." Steve doesn't follow that part up. "I could probably go to any clinic or hospital. I don't really have a history of making healthy life choices and I'm probably not about to start but, like I said, I doubt I'll be needing much in the way of actual care either way. So..." Steve leans forward, bracing his hands on his knees. "I would like to get a physical, then. I hear this will involve a /lot/ of paperwork..." "Not as much as you might think, if I'm the one taking over your case," Iolaus says, voice soft. "But yes, some, certainly." The doctor turns to the computer next to him and tugs his ID card out from around his neck, inserting it into a small slot in the keyboard under his desk. He opens a drawer next to him and turns to one side, digging through it in a determined fashion. "I know I have a spare one in here somewhere..." This doesn't seem particularly directed at anyone, nor does the soft curse in Greek that follows it. It takes searching two more drawers before Iolaus snaps his fingers and grins widely, tugging out a small card and typing briefly on the keyboard. He slides the card across the table to Steve -- on the back it has a barcode and a number, but the front side is facing up -- and emblazoned with the Mendel Clinic logo. "Don't lose this; it's the only way we have to pull up your file. You can make a copy, but keep it safe." The printer on the side of his desk makes a humming sound, and Iolaus reaches back without looking to pull the sheets that it spat out and slide them over to Steve. "Some homework for you, Captain," he says, grinning. "I promise, we'll keep the paperwork to as much a minimum as possible."