Dear Mr. Sayer,
First off, I will acknowledge that two letters in two days is a lot. I appreciate your attention to this letter—and in fact, if you happen to have my first letter in hand, you can go ahead and recycle it. Or I guess, read it for context but focus on this letter instead, please.
I have now been without my Dexcom for over 24 hours and it has not been fun. Last night my fiancé and I both set our alarms for 3 AM so that I could get up and test. My blood sugar was 304. When I woke up in the morning I was low, having overcorrected at 3, obviously, and felt that fuzzy, sweaty, exhausted feeling you get when your rest has been horribly compromised and your blood sugar horribly unstable.
I spent every free moment I had between work meetings today on the phone. I was done calling Dexcom, and tried instead to focus my attention on the seemingly impossible feat of trying to get Byram Healthcare and United, my insurer, to move faster on getting me a replacement receiver. A seemingly impossible challenge, but honestly I think I was too sleep deprived to realize the futility.
I called Byram. They confirmed once again that the replacement receiver required a prior authorization (mine had expired) from United Healthcare. I called United Healthcare. They told me that in order to process the prior authorization, I needed a new prescription from my doctor. I called Byram again; they assured me that they had gotten everything from my doctor yesterday and sent it—marked urgent—to United. I called United back. They were able to confirm that my case was “pending” with a case manager but couldn’t connect me to a case manager or say if they had everything they needed from Byram, my doctor, whoever.
After lunch, I asked my boss to pick a number, 1 or 2. He picked 2, so I called United back, trying once again to press them to tell me if there was anything else I could do to accelerate my case, and if they had everything they needed from my doctor. This person told me that as far as he could tell, they didn’t have anything that they needed, and I had to call my doctor back and get them to send in a prescription.
I called my doctor’s office, begged to speak to a nurse, was told that they were all busy, and left an urgent message: First I apologized for having her call in all these prescriptions, chart notes and authorizations yesterday, then I asked if she wouldn’t mind doing the exact same thing again—even more urgently, but this time to United Healthcare instead of Byram Healthcare.
I’ll mention too that United Healthcare has the world’s most annoying automated system. It asks you for your birthday, and 95% of the time tells you it “doesn’t understand,” when you respond, forcing you to repeat your birthday over and over again and threatening to disconnect the call because it can’t understand you. When its voice recognition software finally does work, it tries to prompt you to record yourself saying your birthday three times for some kind of security thing so that in the future you can get in more easily. But if you’re standing outside on the street in New York City, its voice recognition software simply cannot understand anything you say, so again it threatens to hang up the call unless you can either be recorded saying your birthday or it can understand you saying “I’ll do this later.” Which I repeatedly had to scream louder and louder in the middle of the street this afternoon until the system finally connected me to a person.
This time, the person I spoke to actually offered to connect me to “a case manager.” I honestly wasn’t sure if that meant my case manager or just any random case manager, but it was such a promising lead that I eagerly agreed. And then, suddenly, I was speaking to a case manager! Magic! Who cared whose cases he was managing—perhaps his affiliation with the type of person I needed to speak to was enough to get me some answers.
“Hello,” he said, “I’m a case manager.” (*This is all real, Mr. Sayer. I am not exaggerating for comic relief.)
I explained my saga to him—actually, I started to, and was about 2 sentences in when he told me to “hold on,”—and suddenly I was back at the beginning of the automated system, a full 45 minutes after I started this particular call, being prompted by a machine to say my birthday.
I think that’s why, when I finally got through to a person (who, like all the others, told me he could not under any circumstances connect me to a case manager), I was no longer holding on to even a shred of my humanity. I insisted that he connect me to a case manager. He responded that he couldn’t, but that he could put me on hold while he spoke to a case manager. Five minutes later, he came back and confirmed that my case was indeed in the review process, my doctor had indeed sent along all the necessary information, and that it was marked urgent.
Do you remember how, in my original letter, I told you that I always felt like Dexcom understood what “urgent” meant, whereas Byram and United did not? Well, here’s the proof: to United Healthcare, “urgent” means that your case will be reviewed with 72 business hours.
To be fair, that’s definitely shorter than the 14 days that it takes a “non urgent” case to be reviewed. However, 72 business hours takes me to Wednesday of next week. Give them another day to send their answer to Byram and for Byram to process it, then give Byram another day to ship the product (assuming the miracle that they choose to overnight ship it), and, best case scenario, I have my new receiver in a week.
Unfortunately for him, the agent ended this explanation with the question, “OK?”
“No,” I answered, (and this, I am proud/horrified to say, is verbatim) “No, it is not OK. I reject that response. I cannot sleep without this product. I cannot go a week without this product. You will send it to me today.”
This, of course, was a lunatic’s response, because United isn’t even shipping the Dexcom, Byram Healthcare is, and by then I had spent my entire day on the phone and it was nearing 5 PM. I guess, after 24 hours of relentless red tape, bureaucratic beat downs, really bad sleep and catastrophic blood sugars (I tested once an hour this afternoon and wasn’t below 275 a single time), I wanted a Hollywood ending.
I wanted to say the one thing that would make one of the over 20 people I’ve spoken to in the last 24 hours think: “Ya know what? Even though my job doesn’t empower me to do so, I’m going to help this girl.” I wanted my lunatic “No” to prompt Nathaniel (I think? I spoke to 1 Nathan and 1 Nathaniel in my 20 odd people, but I think this last one was Nathaniel) to stand up in his cubicle, wherever he was, and shout “The System Is Broken and Today, I’m Going To Fix It!” and then press whatever button he needed to press so that I could get access to the lifesaving medical device I’ve relied on for 2 years.
…That didn’t happen, of course.
Instead, Nathaniel offered to take down any feedback I had for United Healthcare, and then painstakingly transcribed my carefully worded response: “It is disgraceful that your company doesn’t empower its employees to actually help people in urgent situations.”
I should also mention that yesterday, one of my brilliant co-workers scoured the internet for anyone selling a Dexcom receiver. He found two—a guy in the city selling one for 200 bucks, and someone a bit further away selling one for 350. Unfortunately, over the course of the day, 200 dollar guy disappeared, so my only option was $350 guy. I really didn’t want to pay it—obviously that was cheaper than buying out of pocket from Dexcom, but it was still more than the $200 I had resolved myself to spend before $200 guy ghosted.
Many people would wonder at spending so much money if I’m going to get a replacement in 7 days, but I know I don’t need to explain that logic to you. You are the President of Dexcom International. You, above all others, have to understand what your product has given me that diabetes took away. Safety. Security. To me, that’s worth a lot. I just had to figure out if it was worth $350.
And I had just about decided it was when my phone rang and everything changed.
Within 5 seconds, I heard two things that I couldn’t believe.
First, the man introduced himself as the head of Dexcom’s customer service.
Then, he told me he’d read my blog post.
Mr. Sayer, I check my blog’s statistics regularly. I flatter myself that I have a small but devoted group of followers; I have always assumed they were my friends and family. When I hear from someone—usually via email—who has read my blog and who I don’t know, it sort of feels like Christmas, and I have one of those warm, fuzzy, “it’s all been worth it,” kind of moments.
This, however, is unprecedented.
I forced myself out of my stunned silence and began babbling, trying to explain the frustration that your colleague had obviously already read about from both this blog and whatever records you guys keep. I honestly thought I was being called to be reprimanded for posting my letter so publicly, and I was about to offer to take down the post when instead, I was offered an apology.
And a replacement receiver, shipped overnight.
For the umpteenth time, I cried on the phone, but this time it was from the incredible, unadulterated relief that comes when a problem that you have been working so hard on—one that has seemed insurmountable—is suddenly, perfectly, solved. Instantly. I felt like I’ve been pushing against a wall of solid brick for 24 hours and then someone was like “hey actually—watch this” and they tapped it with their pinkie and it dissolved into dust.
In fact, in a 7 minute call, he dissolved so many of the vicious claims I leveled against you and your company yesterday. And, in addition to solving my problem and also singlehandedly reaffirming my faith in humanity, he flattered my writing (always appreciated).
My co-workers, who were unfortunate witnesses to my phone breakdowns yesterday and this ridiculous saga today, gaped at me openmouthed when I told them what happened. My dad, who I immediately called after I hung up the phone, told me he was just sitting there, at his desk, stunned. He couldn’t believe it. No one who I told this to could believe it. Responses ranged from “No freaking way” to “IM LOSING MY MIND OVER HERE!!” (sent via text—again, pardon the curse) to various affirmations of life/humanity/meaning/purpose.
But perhaps the best response came from my fiancé, who is, I’ll lovingly say, something of a cynic: “I’m no believer in miracles,” he said, “but this…”
Thank you, Mr. Sayer. And thank you to Dexcom, and thank you to all of your customer service agents who put up with me, even those who maybe didn’t want to, and didn’t fix my problem. As I mentioned to you, I’ve worked customer service and it’s brutal. It was brutal in the makeup world, where the stakes were comparatively low. I can’t imagine what it’s like in the world of healthcare.
And thank you, so much, so, so, so much, to your company and your colleague for apologizing—and fixing—a problem. I’m sorry to any of your employees who I frightened or subjected to my fear and anxiety.
And thank you to your company for refuting the claim I was most upset to level: that your motivation is capitalism, not compassion. I like to think that there is more to society than profit. And I will be forever grateful not just for access to your incredible product, but for any example that there is good in the world.
I’m posting this on Saturday at 10:30 AM. FedEx just delivered a new receiver and, 10 minutes later, my receiver has begun chugging through its 2 hours of warm up.
Blogging feels a lot like shouting into the void sometimes. That’s good, because it’s allowed me to bare myself in a way I never would have if I could really see the faces of my audience. But I won’t kid myself: the value of my writing is amplified exponentially by the readers who consume it. So thank you to every single one of you for reading: for fighting with me and hurting with me and questioning me and supporting me and challenging me and connecting with me.
It means everything, and that’s not hyperbole.
It means everything.