Enter Dr. Nelson Greidanus: an award-winning orthopaedic surgeon at Vancouver General Hospital; forty-something, with reddish hair, a stocky torso, and watchful eyes that remind me, in a good way, of Ricky Gervais; reported to go “out on a limb” for his patients.

So far, Greidanus didn’t know me, but I knew him. In fact, I’d accumulated a dossier on the man. The Internet abounds with intelligence, from official biographies with promotional glossies to patient reviews (i.e., ratemymd.ca, doctorscorecard.com) — rough instruments, sure, but they’re a way around the tyranny of professional associations dedicated to the illusion that talent doesn’t matter.

Having cast Greidanus as my man, I set about networking with the enthusiasm of an Avon lady. In Canada, where the degrees of separation are closer to two than six, access to the best health care isn’t so much a function of money but rather who you know, and who they know. So I tapped every medical professional who might have a lead, every school chum and golf partner, my son’s friend’s father, someone in my wife’s running group; I was a proboscis, snouting for influence. And it worked. Soon I found someone who knew the specialist who routinely refers to Greidanus. But even so, the egalitarian aspect of the Canadian system held, for I would have to wait my turn.

It was three miserable months before I sat in the sunny atrium outside Greidanus’s office, and several hours more before I was called in. When he finally whisked into the room, he glanced at my X-ray, let out a kind of snort, and ordered me to walk up and down the hall. I was prepped to tell him my story, but he didn’t care; it didn’t matter now. “You need a new hip,” he announced, then opened a drawer and brought out my options: three metal doorknobs of various sizes, plus one metal mushroom.

In the case of a total hip replacement, he intended to saw off my femur at the head and replace it with a doorknob that would fit into a socket implanted in my pelvis. For hip resurfacing, he would shave the head (“like a sno-cone”) and cap it with a metal mushroom fitted to the socket. In both cases, bone would grow into the implants, making them, effectively, me.

The differences between replacement and resurfacing have to do with range of motion. For most patients, Greidanus explained, the standard, golf ball–sized doorknob would be perfectly adequate. I told him I do yoga, and demonstrated the lotus position; he admitted that with a “total” there would be no more of that. But it was up to me, he emphasized, which I took to mean that the situation called for yet another Internet search.

Hip replacements, it turns out, have been around since the nineteenth century, involving such materials as ivory, glass, plastic, ceramic, steel, chromium, Teflon, titanium, and mysterious alloys meant for outer space. The challenge has always been minimizing friction. In the procedure Greidanus was recommending, a polyethylene socket liner guards against bits of metal grinding their way into my bloodstream. However, in order to fit into the hip the ball itself has to be quite small. And plastic, too, can wear out, necessitating a second operation sometimes called “changing a tire.” Space-age alloys, which up until very recently were assumed to make it safe to dispense with the liner, allow for a bigger doorknob and greater range of motion.

Hip resurfacing, which has been around for about eighteen years, involves less bone and blood loss and offers complete range of motion, amounting to a “superior quality of life,” according to a report co-authored by Greidanus himself. Plus, if the thing failed later on I could still go for a total. If I had a total and it wore out, I’d have less to work with the second time around.

At a cost of around $14,000 for a total and more for resurfacing, there were some 30,000 hip replacements in Canada in 2007; and the market is growing, thanks to the generational bubble that claimed the word “hippie.” (In roughly the same amount of time that has passed since the first hip was resurfaced, roughly one in three Canadians will be over fifty-five.) Medicare has taken the accountant’s way out of this predicament, so with few exceptions only the total involving the small doorknob is fully covered, starting at age fifty-five, and whether the patient is a morbidly obese diabetic or a fifty-six-year-old Ironman doesn’t seem to come into it. At sixty-two, a hip resurfacing would set me back $3,780, of which Greidanus probably wouldn’t get a cent for the additional skills involved.

The way I see it, even if the cost of repairing all these degenerating hips were to increase with better prostheses, given that a coronary bypass can set the taxpayer back $23,000 it seems a good investment to keep the codgers up and running as long as possible. And if such reckoning is beyond policy-makers, they might consider the following: a friend of mine, sixty-three years old, had his hip resurfaced at the Asian Regional Center for Hip Resurfacing in Chennai, on the Bay of Bengal, for $8,000, including rehab, and it went well. In other words, medicare would save far more money by chartering planes and flying the boomers to India.