Well, that was a hell of an afternoon.
Yesterday I found myself having a hard time focusing at work all morning. I had a lot to do but I just kept getting distracted. Finally I acknowledged to myself that I was anxious about Ernie's appointment with the surgeon's office for his shoulder. I'm not sure even why but I was. Not my most productive day which means I really have to buckle down today to get a project done.
Ernie picked me up at 2:00 and we headed over to Carle. We got called in right away and the Physician's Assistant came in. Not the one we'd seen previously that I liked so much, but right off I really liked him. He was friendly and warm. Well, later Ernie described him as folksy which is actually the perfect word. He went through the x-rays of Ernie's shoulder. He didn't seem to find two of the issues that the radiologist thought were of concern to be problems so that was a relief. He chatted about possible course of treatment and said, (and then his voice got serious and deep) "but of course we need to figure out if he's good candidate for surgery." Ernie and I just blinked at him trying to figure out what he meant. He kept talking and it finally occurred to us that he meant oh yeah, cancer. Now I've spent a fair amount of time in cancer treatment rooms and yeah, there are plenty of folks there that aren't candidates for surgery. But, ummm....have you met Ernie recently? He started saying that they'd have to get the oncologist's thoughts on it. I said, "Of course, you have to do that, but I can assure you that he will think Ernie is a candidate for surgery. He's in the same exact stage, on the same medications as he was when he had the rotator cuff surgery a few years ago and his oncologist was supportive of that. He totally brushed me off and repeated the same thing. So I repeated the same thing. I mean I know they have to go through processes but wouldn't it be helpful for him to know this? Remember my last doctor's appointment when I was told that the patient is their own best record? Well, this time the record starting talking and evidently nobody liked that.
He started talking about a cortisone shot so I said, "So you would do that before getting an MRI?" He said yes so I nodded ok. I asked him if tears could heal on their own and he said sometimes, depending on how bad they are. Ok. He launched into a story about someone that delivered grain and had to keep getting cortisone shots until he could take time off for surgery. I wasn't totally sure of the point of it....I guess that even though he had shots he still had surgery? Whatever.
He said they can do MRI's but and then I don't even know what he said, but I at one point I said, "Well, why can't he get an MRI now?" He seemed vaguely irritated so I leaned forward and said, "If it seems that I'm being kind of pushy about this it's because last time it took a very, very long time for this to get diagnosed because we kept trying different things and he ended up being in pain for a lot longer than he should have been." Now this is where everything went to hell. For the record, what I thought I was doing was ASKING A QUESTION AND GIVING HIM BACKGROUND INFORMATION, EXPLAINING WHY I WAS ASKING THE QUESTION. I wasn't saying "I demand an MRI." I was asking why he couldn't get one right away. IT WAS A QUESTION. At this point he turned to his computer and said in a pissy voice, "Fine, he can have an MRI. You want an MRI, he can have one." and then he said "I don't like pushy patients."
After he said that I waited a couple of beats because I was sure there was going to be another statement.....'but I understand' or he'd laugh...or something. I thought he must be joking. I mean hell, I'm Polly Voelkl's daughter. I was taught to be a nice girl and I have this stupid thing in which I alway want doctors to like me. Has someone ever written a dissertation on this phenomenon? They should. When we were seeing a therapist with the boys at one point Owen used to do imitations of me being the good girl, nodding to everything politely and saying 'uh-huh' in acknowledgement constantly. I was totally shocked when he said that to me. He continued to tap angrily at the computer and I finally said, "Well, I don't like pushy doctors." Ok...probably not my finest moment but I was just so astounded and taken aback. I said, "Well, if you don't think he should have an MRI, then don't give him an MRI.' but he just kept tapping away and shaking his head, "It doesn't matter, it just doesn't matter." Ernie and I kind of looked at each other and he squeezed my leg. Finally I said, "Well, that's comforting." I mean what the fuck, the doctor (well P.A.) is sitting there saying it doesn't matter what treatment the patient gets.
Unfortunately, I got the cry-when-you're-mad gene, so as much as I fought it the tears started rolling down my face. I told him I that I had seen more doctors than he could imagine and that I'd never had one upset me like this, and that I expected to be treated with respect. He asked incredulously how he hadn't been respectful and I said, "Well, when you said to me 'I don't like pushy patients." He said, "Well, YOU were the one that said you were pushy." We went back and forth like that a bit. He said that of course he wanted to help Ernie, he'd want to help him more than other patients." We looked at him in confusion. Huh? Then he said, "Well, of course I want to help all patients" and went on. He rambled on about how you want to say, "How are things" to a patient but sometimes you know they're not good and that he works for a great guy but sometimes they get told they do too many MRI's." Again with the cancer shit. He's worried to ask how Ernie is because he has cancer? And if he's not supposed to do an MRI at this point then why the fuck didn't he say 'we have to do x, y, z before we do an MRI?' He said he had to follow certain protocols and I said, "So one of your protocols is telling me you don't like me because I'm pushy." Then he got all folksy and kind and said, "I never said I didn't like you. I like you." Uhhhh....remember when he said, "I don't like pushy patients" and he was referring to me?
He apologized and said he was sorry he'd upset me. Would I accept his apology. I said yes because hell, you can't really say no. I remember trying to teach the boys when they were little though, that an apology doesn't make the action, or the hurt it caused, go away. Sigh. I just kept sniffing and asking him for tissue. Then he explained to us three times in a row that we would have to get insurance approval and if insurance turned it down we'd have to do something else first. First time I said, "Yes, I understand." Second time I said, "Yes, we understand." Third time I said, "I'm not an idiot." and he again looked at me incredulously. I mean, seriously, if he thinks my husband is at death's door, then shouldn't he expect me to understand fucking insurance? It just petered out from there and I kept getting more tissue to blow my nose. We got the MRI scheduled (one question: why did three different people have to ask some of the same questions? YES he's claustrophobic and YES he wants an open mri. Oh whatever.) and lo and behold it got approved by insurance right away.
I tell you, in ALL the doctor's appointments I've had, all of them with my father and his problems and his end of life, all of them with my mother and her many issues and her end of life, all of them with my sister Judi, and throughout all her cancer, from diagnosis in South Carolina, to surgery at Emory to her end of life here at Carle, all of the ups and downs and many doctors with Ernie, and of course various appointments with the boys, and hell, a few for me....I've NEVER had a doctor upset me in this way. Even when I got so furious with the nurse in the cancer center....at least I knew she wasn't TRYING to upset me. For someone to sit there, look away from and pronounce, "I don't like pushy patients" in a pissed off voice...well, that's someone that's being profoundly disrespectful. I am truly shocked. And it's funny because when people start bitching about Carle, I usually stick up for Carle.
I guess part of the reason I was so upset is that trying to navigate through the medical forest is something that is so important for me to do for those I love. I'm not perfect at it but I do my best. I don't know. I just don't know.
Ernie said the one high point was that it wasn't his fault, he wasn't the one that upset me.