I Flew 2,500 Miles for a Second Opinion and All I Lost was My Hope in Humanity

And lots of money. And a few oat cakes.

This is the only photo I took on our trip to New York, and I don’t even remember why I took it.

Guinness doesn’t keep records on this, but if they did, I’d definitely be in the running for the largest number of second opinions sought for the same medical condition. After all, some people claim to have achieved remission from chronic migraine disorder—the illness I have. You can’t win if you don’t play, so I have “played”—aka sought a second opinion on why I’m in pain so often—no fewer than fifteen times. (I’ve long since lost count of the non-professional opinions I’ve received, but it’s at least a few hundred.) 

Most of the doctors I’ve talked with for a second opinion have said the same thing: you have chronic migraines because you have migraines, chronically. It is, I think, illegal for a doctor to come out and say “I don’t know.” A few of the doctors have had new theories, however. For example, a doctor in Marin once told me that my patchy eyebrows indicated I have thyroiditis, despite my thyroid tests coming back normal multiple times over. What she didn’t realize is that I’ve never been taught how to properly pluck my eyebrows, so whenever they start scaling my forehead like mountain goats, I pluck and pluck and pluck until they’re a mere shadow of what they once were.

My most recent second opinion, opinion number fifteen, was this past spring. This second opinion was also my first unquestionable act of medical tourism, as the clinic was in New York City. (Medical tourism, for those who are blissfully unaware, is when you travel long distances to receive better and/or cheaper medical care.) 

The founder of this clinic was on a panel at the Migraine World Summit and I found her—dare I say it?—inspiring. Dr. Inspiring talked about things like nutritional and natural remedies for chronic migraine while the other panelist was a proponent of forcing migraines into submission with obscene amounts of Botox (aka a neurotoxin). According to Dr. Inspiring’s website, she was a well-regarded headache specialist who left her job at a much bigger neurology practice in New York in order to open this integrative migraine treatment facility. 

The idea of a western-trained doctor broadening their horizons appealed to me. The long trip to New York did not, but Dr. Inspiring’s clinic in Manhattan wasn’t licensed for virtual visits in California. It seemed like a long way to go for a single appointment, which according to the clinic’s website, would be one hour long. They also didn’t take insurance, any insurance, because, oddly, any clinic that’s worth their snuff in America isn’t going to waste time dealing with insurance companies.

But if I never went, I knew I’d always wonder if I was one trip to New York away from remission. So I decided to eat the exceptionally high out-of-pocket cost along with the cost of plane tickets, saying this would be my last second opinion for a long while. I’d go to New York and I’d maybe, just maybe, have fewer migraines because of it. Maybe I’d get a vacation out of it, too.

When I called Dr. Inspiring’s office to book an appointment, the inspired feeling began to fade.

“I’d like to book a new patient appointment,” I told the receptionist.

“Sure, what insurance do you have?” she replied. This seemed to me a strange question, given the fact they didn’t take insurance.

“I have Medicare.” Medicare is federally-funded health insurance, which I only qualify for because I’m disabled. Disabled implying, perhaps, my greater need for medical treatment than most other people? But perhaps not.

“I see. We do not allow people with Medicare to see Dr. Inspiring. You’ll need to see our other doctor. But don’t worry, she’s just as good.”

“But I’m not using insurance to pay for the appointment…” Specifically, I knew I couldn’t use insurance to pay for the appointment, otherwise I would have.

“Doesn’t matter.”

“But I’m coming to this clinic from San Francisco, can’t I see Dr. Inspiring?”

“First of all, we are NOT a clinic,” the receptionist sneered, “we are a private practice. And second of all, it doesn’t matter how far you’re traveling.”

If I had just lied and told the receptionist I didn’t have insurance, would I have gotten to see Dr. Inspiring? I considered cancelling my appointment, waiting a few weeks, then calling back to schedule again without mentioning Medicare. Maybe the receptionist would have forgotten my name by that point. Or maybe I could change my name temporarily? Would faking a British accent help?

At this point, I probably should have given up on this private practice, but I told myself not to judge a doctor by their administrative red tape. I also told myself that refusing to let someone pay full price to see a doctor just because they had Medicare couldn’t possibly be illegal. What did I have to prove by giving up now, anyway? Given the recent conference publicity, this place probably wasn’t strapped for cash. And what if they had some new insight into my condition that made all of this trouble worthwhile? The only person who I risked disappointing by walking away was myself.

A few months later, when I walked into the New York private practice, I came face-to-face with the receptionist. It was definitely her, the voice sounded the same. She was middle-aged with dark hair, olive skin, and a perfunctory smile. (A no-nonsense New York Italian, maybe.) Did she remember our interaction from months ago, or was I just one of a hundred people she’d disappointed that day? 

“You still have Medicare, correct?” she asked as she handed me some forms, then sat us down on a leather couch facing her desk. Wow, way to rub it in my face, receptionist. But there was no point in lying now, five minutes before my appointment was to begin.

On the high-end coffee table between us was a bamboo tray of “migraine-friendly” snacks. They were oat cakes, individually wrapped. The packaging claimed that the oat cakes were free of all known migraine triggers and likewise gluten- and dairy-free. Having just hauled my special bed pillow and foam pad 2,500 miles to get here, not to mention the miserable jet lag that made me extra migrainey, I felt no shame in stuffing a few of the free oat cakes into my backpack as the receptionist pretended not to watch my every move. Meanwhile, my husband Cory organized his notes for our meeting with the “just as good” doctor.

“I want you to know that I read through all the records you sent over this morning,” said Dr. Justasgood at the beginning of the one-hour appointment, after wasting something like 45 valuable seconds on talking about the weather. It seemed unlikely she’d read all the records I’d sent, given that I’d included some six hundred pages of my medical history. That’s a lot of reading for one morning. But I didn’t question Dr. J. After all, Cory can inhale a book about the failed Whig politics in the election of 1844 faster than most people drink a coffee. 

Despite her having “just read” my entire medical history, Dr. Justasgood requested that I summarize my medical records. I’ve got the shtick basically memorized by now: my first migraine was in August of 2019, it lasted ten months, I’ve tried medications A, B, C, D, E, F, G, H, I, J, K, L, M, N, O, P, Q, R, S, T, U, V, W, X, Y, and Z (“A” is for Almotriptan, “B” is for Botox…“Z” is for Zolmatriptan). Yes, I get all the recommended infusions, both inpatient and outpatient. Yes, I’ve tried ketamine. Cory filled in the cracks, as he usually does, with suitably dramatic recollections of my worst migraines. Aware of the fact that I was paying roughly $15 for every minute of this appointment, I tried to gloss over as many of the details as I could, but Dr. J kept stopping me to ask questions about the order of certain events, or the dates. She wasn’t satisfied until I’d spent a full forty-five minutes talking. Forty-five minutes and forty-five seconds down, fourteen minutes and fifteen seconds to go.

Now, said Dr. Justasgood, it was time for the neurological exam. A neurological exam, for those unfamiliar, is similar to the Macarena. It usually starts with touching your nose, then the doctor’s finger, then your nose, and back and forth like that for a while. Then you close your eyes while holding your arms out in front of you “like you’re holding a pizza box” (every doctor I’ve met describes this move in the way, despite the fact that many migraine sufferers, including myself, can’t eat many pizza ingredients), then you tap one foot, then the other. You tap your index fingers to your thumbs. Sometimes, you stick out your tongue, or squeeze your eyes closed, or kick your legs. Then you turn up the music! It’s all great fun, until the doctor pulls a bright light out of their pocket to burn holes through your eyes straight through to your brain.

(What’s the point of this dance routine, you ask? There isn’t one. Migraines don’t ever show up on neurological exams. Of the eighty-seven neurological exams I’ve done in my lifetime, I’ve passed eighty-seven of them with flying colors.)

What Dr. J did after the neurological exam that NO doctor had ever done before was…actually touch my head. “Wow, it’s tight,” she said. “You should get a massage before traveling back home.”

“I just got one,” I replied, “two hours ago.”

“Huh,” she said.

Dr. Justasgood’s neurological and physical exam took about ten minutes combined, leaving her with four minutes and fifteen seconds to give me what I came for: answers. This is when I expected an “integrative” clinic like this one to really shine by whipping out theories I hadn’t heard of before about what is wrong with me, like the eyebrow thing but more correct. At the very least, I expected her to mention mold poisoning, heavy metal toxicity, and leaky gut, as these three problems are the scapegoat for many a medical malady. I just hoped she would mention these things quickly, or perhaps extend the appointment, so that we could have more time to discuss her findings.

“Well, if you ask me,” Dr. J started out, adjusting her white coat as she turned to face me in her office chair, “you definitely have migraines.” 

A single snort of laughter escaped Cory’s nose. I twitched in my chair like a dilapidated city pigeon.

Dr. J managed to end the appointment with two minutes to spare.

Dr. Justasgood’s diagnosis was the most expensive I’ve ever received. But I’d wanted a second opinion, and that’s exactly what I got. Never mind that I was hoping for a second opinion on the cause of my migraines, not the fact of my migraines. Her primary treatment recommendation was a pain killer, a cousin of Ibuprofen, and her only other recommendation was also a pharmaceutical. (I tried both medications for a while, but noticed no huge difference.)

The moment we left the office, I was feeling pretty low. I had just stumped what I thought was one of the best private practices in the country. Where could I go from here? I’d been so anxious and sick before the appointment, I hadn’t wanted to explore New York City too much. But now, I wanted to explore even less. So we went straight back to our hotel, and Cory ordered takeout while I iced my head. As I waited for dinner, I took the oat cakes out of my bag, intending to soften the blow with a “migraine-friendly” snack. This is when I discovered that the oat cakes contained coconut, a common migraine trigger that I am very sensitive to. 

Cory, always one to help, offered to eat them for me. 🧠

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