Honestly, I wanted to believe the ER doc and think everything was fine. Maybe that missing hunk at the front of my armpit was never really there. Maybe it would come back on its own in a few days. It was just scared. You know -- like when you jump into a pool of cold water and your testicles retract into your chest, only to return that afternoon.

This exercise in positive thinking lasted about a day.

You see, I have access the internet and I know the URL for the most awesome search engine in the world. I learned a lot. For example, I learned that a search on "pectoral muscle" will return some useful physiological information and more than a few links to erotic prose.

My left arm was basically useless. Doing anything with it hurt. I had zero pushing strength. To top things off, my wonderful wife was getting tired of me whining, worrying, and moping around. I figured it couldn't hurt to at least visit a specialist.

All of you USians probably already have a good idea what I'm in for now -- the great HMO obstacle course. In order to get to a specialist, I have to first go to a general practitioner. In order to get to a general practitioner, I first have to pick a general practitioner. Being Mr. Health-and-Fitness (instead of Mr. Don't-Do-Stupid-Things), I hadn't been to a doctor in a good long while.

Since an orthopedic specialist was my ultimate goal, I did some asking around and got the name of someone good. Now, for insurance purposes, I had to select my general practitioner. For this, I used a rigorous elimination process.

I grabbed the HMO's Directory and picked the closest guy I could find.

Call. Get the appointment set up (a few days later). Show up. Fill out the "new patient" paperwork. Wait. Finally see doc. The examination went something like this:

Doc: "Hi. What seems to be the problem?"
Me: "Well, I had a skating accident. I think I might have done something bad to my left shoulder."
Doc: "Well, let's take a look."
Me (sticking out my good arm): "You see how at the front of the shoulder there's a stretch of muscle?"
Doc: "Yep." (He went to medical school, you know.)
Me (sticking out my injured arm): "Now see how it's not there on this shoulder? I think I might have torn something."
Doc: "Ok, I'll set you up with an orthopod."
Me: "Great. Can you make it Dr. P?"
Doc: "Sure. Whatever."

That was the entire visit, folks. I have no idea how much the good doctor billed my insurance company for that. I'm sure the number would make me furious if I had to pay it myself. Then again, I didn't make the stupid rule about going to a GP first.

But I had a specialist referral in my hand -- the HMO equivalent of a hall pass. Cool.