Severe degenerative osteoarthritis.

[Warpy]

1. I know what it's like to be an "interesting case" at MGH

with a gaggle of at least 50 med students and newly minted interns staring at you, so I can sympathize there. BTDT. I can relate to the pain, since RA turned out to be one component of my interesting cluster of symptoms.

However, you've got one thing I don't--the fact that only one doc in the US is doing fancy elbow surgery means that other docs are going to have to be trained to do it, and that means that there is a ghost of a chance they'll pick up the tab eventually just for the practice. You might explore things from that angle.

Or you can just wait a year in intractable pain until the ACA is fully implemented and somebody has to insure you and gird your loins for battle with whoever gets stuck with you.

And those 50+ docs and students? Don't worry. They can't pick you out of a crowd afterward. I also worked at MGH and know that for a fact. Once you have clothes on, they'll never be able to recognize you.