You think you're something? All that?

You're not.

To prove it, get an appointment at Kaiser Permanente.

Say your elbow hurts. Mine did.

First you have to get the appointment. That will take a while. Never go in person — not if you want to stay employed. Call. Automation will be frustrating (Press 1) But realize that even if you get to a human being that might help you find a time to meet a doctor, your conversation will be monitored for quality control purposes; and it will sound like it. The person talking to you is human — you're pretty sure — but like a machine. Efficient, bloodless, courteous but curt. I was tempted to ask the person who came on the line with me something about their life — their age, where they went to school, what they ate for lunch, but I might have gotten them fired. No nonsense.

I got a call from a robot three days before my appointment telling me, in that slow, methodical robot syntax, who I'd be meeting with. The connection went bad just at the moment I was told my doctor's name. Turns out that wasn't who met with me anyway.

I got there 15 minutes early, as instructed by the robot, and walked into what looked like a big open room; it wasn't big. Or open. It was packed with people. And most of them were younger than 30 — with a few elderly exceptions. There was a line beginning right at the door with flat, black plastic feet on a rubberized walkway indicating where I was to step on my way to the end of the mat and the desk where I was to check in. That means you pay money and prove you're really who you say you are with a photo I.D. — and a Kaiser card that the robotic human being behind the counter swipes into a computer to call up your name and number and records. Your name sort of matters. The number matters more — all the numbers.

Keep in mind, nobody in this entire process has shown any concern for how sick you are, how disabled, whether you're near death. (The robot does give you instructions that if you need to see a doctor because you are, in fact, dying that you should bypass all the robotics and just go to the emergency room. There are robotic human beings there, but there are more of them on any given day —though my wife has learned you have to pick your times carefully. One night she told me she was really in pain and needed to see a doctor. I told her to go at 7 p.m. even though — smart woman that she is — she said she'd wait until 10 p.m. She sat in the waiting room until 10 p.m.)

After the robotic person takes your money and verifies who you are, you go sit in a room with chairs that are very close together, but you can tell someone has done calculations as to how close is too close. It's all very efficient. Nobody has to climb over anybody else — but nearly.

Somebody emerges from a locked door every 10-15 minutes or so and calls a name. Somebody seated next to me yelled, "What?" at one person who emerged from a door across the room. The person repeated the name.

After a while, someone opens the door and says my first name then begins wrestling with the pronunciation of my last name; as she begins, I'm on my feet and headed over.

The key to success in this environment is to be robotic. It's how it's all done anyway. You can't let it get to you. The plasticity, the pre-fabrication, the efficiency in the face of disease, sorrow, dread, even terror — none of it must register on your face. Stifled emotion is the best route. You can't get angry (though I can tell by the looks I get from nurses and even doctors, that some do); you can't laugh. The absurdity will not find shared humor with anyone — well, mostly no one — in this place. Even when you're sitting there for hours. Even when they seat you in a room next to an X-ray machine and make you contort your body to take pictures in just the right way — the robotic way.

"Raise the table," somebody says from a back room. Zing. A moment of glimmering humanity. Someone with more experience is looking through the little window and compassion and logic combine. The older X-ray tech wants to spare me a sore shoulder trying to get the picture this younger tech thinks she needs. MMMMMMMM. The table lowers and I can turn my hand backwards as commanded. Is it compassion or is it another efficiency?

You can't show emotion even when they're asking you things like "Do you exercise?" And when you say yes, they ask "How many days a week?" The temptation is to engage them in conversation. But that's what humans do.

"Would you like to know my mileage each week?" you want to ask. "Want to know my minutes per mile? Does it matter if I'm doing hill repeats and sprint surges 2-3 times a week? Do you want to know how many days I'm lifting and what my reps are on what weights? Does it matter if I cross-train?"

To do that would be an annoyance.

The question isn't coming from them. It's coming from someone in a cubicle — maybe several cubicles — in the Virginia office complex. The cubicle people (trained to act like robots) are assigned to risk management in this health organization. Research by a study group some years past found a statistical probability of less expense (higher profit margin) from enrollees that had a certain number of hours per week of physical exercise. Bam. Make that policy for the entire national organization. It messes up the research to get detailed about what kind of exercise that is for what body density and whether the weight involved is muscle mass or not.

It makes me wonder what they say to the 300 lb. guys (or gals) who waddle in and perch on the chair and the blood pressure cuff barely goes around their arm — and they smell like cigarette smoke.

The PR campaign says they want people to thrive (See the pictures? People are smiling.) The word "thrive" is code for "not costing us money."

I get seated in an examining room and a doctor comes in and apologizes for how long it's taken. He figures out I need physical therapy for my sore elbow. He prescribes it. He also tells me cortisone shots might be needed — but they'd like not to have to do that. (Costs money. Remember, this is about cost efficiency.) He says I'll get a band to put around my forearm that will help.

Then he leaves.

I'm taken to another room.

The nurse puts all the data in the computer and she says someone will be coming in to help me with the arm band.

At this point, humor almost enters the equation.

A burly guy comes in wearing the scrubs that all nurses and doctors wear but I can tell he's not a doctor. He asks me where it hurts and I tell him. He grins. Tennis elbow on the outside, golf elbow on the inside. He puts it on me and explains how to tighten it up. It's almost as if he sees the inanity of my waiting for him to come in and show me what I could have figured out by opening the box and reading the directions.

"Any questions?" he asks, looking bored and a little amused.

Yes, I have one. Do I wear it at night?

He stops smiling.

"I don't have authorization — I'm not a provider. Uh, let me go ask."

He goes and finds the apologetic doctor. And it takes a few minutes.

"I got your answer," he says. "You don't wear it at night. Give it a rest."

He looks relieved and he's back to his still bored and a little bit amused self.

He points the way out of the labrynth of hallways to the main lobby.

The crowds have thinned out now. Nobody's standing on the plastic feet leading to the front desks with the debit card readers.

You walk out into the vaulted main hallway and realize how truly tangential how you feel is to this whole process.

The best way to get better is to find a way never to have to come back here.