The inverse of the axiom, “One rotten apple spoils the barrel,” may be “In a whole barrel of rotten apples, one apple may not be spoiled.” This apparent paradox is demonstrated in the performance of a tiny VA clinic in Lancaster, California. While the firestorm scandal rages, indicting the national VA in scores of locations, this one model of medical competence quietly serves its patients.

I bear personal witness to this professionalism as a veteran patient at the Lancaster clinic for the past ten years. My medical needs are promptly addressed by courteous telephone conversants who schedule timely appointment with the audiologist and optometrist, and my personal physician, who also happens to be the Medical Director of the Lancaster facility. Like clockwork, several days before my laboratory appointment, a reminder card comes in the mail telling me when and where to have my blood drawn and urine sampled prior to meeting with my doctor. 

Then when the appointed day comes, I meet with my courteous nurse, who weighs me, checks my vital signs, and counsels me on good health habits. I return to the waiting room for usually less that ten minutes and I am called to see the doctor. I sit in the exam cubicle and read all the posters on the walls explaining various eligibilities, offering a free flu shot, and pleading with depressed vets to seek counselling against suicide. Then, in bustles the doctor with a keyboard cushion to rest his wrists upon while entering my data into the main computer. After a cordial greeting, the keys clatter and he is viewing my profile including the most recent lab work. He says, “Your blood sugar indicates borderline diabetes,” and suggests a therapeutic medication,” which I decline, promising to control it with diet. The doctor smiles and says, “A responsible choice; we’ll check it again next time.”

I have enjoyed many such encounters at the Lancaster VA Clinic, including audiology where I received a $1,900 pair of Siemens hearing aids, ophthalmology where I received the pair of bifocals, which I am now wearing, and urology where I received a cystoscopy and prostate biopsy, benign, thank God. The only delay in receiving an appointment has been with the big VA hospital in Los Angeles. At Lancaster, I have never waited more than a week for an appointment.

If I have anything negative to report about the Lancaster VA Clinic, it is that they still display pictures of President Obama and Secretary Shinseki in the waiting room.

A good apple may indeed flourish in a rotten barrel.