Saturday, 8:00 AM. The lab has been open for an hour, but there's no place to park. There's a crowd of patients milling about outside, and inside, it's not much better. All the seats in the tiny waiting room are occupied, and there is not even any free space along the walls to lean against. Others sit on the floor, listening to their music machines or talking on cell phones. A long line of people waits to pick up forms, which must be meticulously filled out. Another queues up at the sign-in sheet. Occasionally, a voice from behind the counter calls a name in an impenetrable Haitian accent and asks the next patient to go through to the back. The name is marked off the sign-in sheet with yellow highlighter; struggling up to the head of the line to peek at it is the only way you can estimate how long it is before it's your turn. The place has an unmistakeable Third World feel to it, crying babies, thousand yard stares, people reading movie magazines and doing word puzzles. All that's missing is the goats and chickens.

A woman in scrubs walks through, yelling for everyone to have their paperwork ready, "ID, referral, lab request, application form", in the same accent. I have to hear it several times before I understand what she's saying. The man in line next to me talks into his cellphone, all I can catch is "...Obama's an illiterate and Hillary doesn't know what the hell she's doing, maybe Bloomberg will run...". I miss the rest.

Not all that long ago, the staff voices in the waiting rooms used to be Spanish, but now its all Creole, I can't understand them with my rusty college French. The Haitians must be cheaper, but soon they will be replaced by even cheaper immigrants from South or Central America and I can once again eavesdrop on their patter. I wonder who trained those techs back in their home country, state-subsidized universities, NGO programs, foreign aid dollars? I used to get my blood taken by a pretty nurse in the doctor's office, but rising demand and dropping budgets are forcing everyone to make adjustments.

Eventually, I make it into the lab, and a technician expertly takes my blood and urine and shoves me out the door. I'm in there less than three minutes. The lab is clean, efficient and tiny, it reminded me of Sick Bay on a destroyer.
Every square inch of shelf space is covered with papers, blood kits, and sample vials with name tags taped to them.
No one in the back seems to speak English. It's 10:00 AM when I finally get out of there, starving because I needed to be fasting when I gave up my samples.

Next time, I'm taking a day of sick leave and coming on a weekday where I don't have to compete with people who can't afford a take a day off. Let my boss pay for my time, it's just as valuable as his, and besides, rising demand and dropping budgets are forcing everyone to make adjustments.