Sunday, September 4, 2011

The Doctor I Will Never Be

Mrs. Unlucky had terrible abdominal pain, but test results were delayed for a long time because she had a prolapsed urethra and we couldn't get any urine on her. The catheter wouldn't pass through the nodule of protruding tissue.

The lack of urine sample was the least of our problems, though. Throughout the day, I took her vital signs, which were normal, every two hours.  Suddenly, in her sixth hour, her temperature shot up to 102.5F.  Her test results confirmed that she had a perforated colon, a dangerous and emergency condition where the bacteria were entering her abdominal cavity and causing a raging infection. All this confused her, as Mrs. Unlucky was a blue-collar worker with very little formal education. All she knew was that she was in pain and she was terrified.  Unfortunately, her problem was one that could only be helped by surgery, and I needed to do a pre-operation EKG, since she was going to go under full anesthesia.  The surgeon came in while I was setting up and stared at me in a patronizing manner. Perhaps he thought I was moving too slowly.  As I placed a sticker on her chest and whispered to her that the EKG wouldn't take long, he stood up straight over me and said nastily, "you need to stop what you're doing." I looked up in surprise. "Why does she need an EKG?" He quizzed me. Because she is going to be admitted for surgery, I wanted to say, but in this instance, I felt uncomfortable answering him.  It was beyond my "scope" to say so as a technician to a surgeon, in any event, and people have been fired for far less than saying things they don't have the authority to say. So instead, I replied simply,
"I was asked to do one."
"You'll need to do it later, then, because this is important," with an ever so slight emphasis on "this." He stared at me and waited for me to leave the room, and I did so without another word, feeling my blood pressure heighten and my face flush.

I had been part of a very nice team of nurses and doctors taking care of Mrs. Unlucky for many hours and now she was subject this surgeon's very different- abrupt and impersonal- care.   After he left, I found her crying, bewildered. The doctor had given her the choice of having a colostomy or an ileostomy, a bag that is connected to the intestines for waste removal, while the surgery site heals.  She didn't want either and didn't really know the difference, but she was pressed to make a decision, since he had to go get set up for her surgery immediately. I understood that he wanted to move quickly, but she was completely overwhelmed by how quickly the transaction came to pass.

May I never be too busy or haughty to intimidate patients or staff. That sort of manner doesn't at all come off as powerful or efficient. Rather, it just makes a person look like a total jerk.


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