A Day at the Clinic
English is not Dr. A's first language but, in spite of occasionally accenting an unusual syllable, she is easy to understand. Her bedside manner, however, is extremely cold, brusque, and unfriendly, and it may be that there is a cultural barrier to our communication. Also I believe there is strong pressure on the residents to keep clinic appointments well under ten minutes.
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Dr. A: [walks into the exam room brusquely, without greeting me or introducing herself] Where is your port?
Me: What? I don't have a port yet. The surgery to have it installed is scheduled in two weeks.
Dr. A: [studies my chart] This is wrong. You should have started treatment already. I'm going to make an appointment to have a port installed this afternoon.
Me: This afternoon??? Um, I thought that it had to be done by a surgeon? In the surgery department? Operating room? Anesthesia? Kind of a big deal?
Dr. A: [walks out of the exam room without replying; is gone two minutes, then walks back in] The port will be installed in two weeks.
Me: Right. Listen, I have a few questions...
Dr. A: Are you die-ABB-uh-tick?
Me: Die what? Oh, diabetic. No. No I'm not. But I ...
Dr. A: How long have you had that brown rash?
Me: [????] Oh! You mean my freckles? Since I was a small child. My ancestors came from Ireland. But I have a question about...
Dr. A: Open your mouth please.
Me: Nnngh aahhh... About staging. When are the tests going to be done to determine what stage...
Dr. A: You are stage four. Take a deep breath please.
Me: Four. Ah. But how do you KNOW I'm stage four without any tests? There's been no PET scan, no bone marrow biopsy, no...
Dr. A: The cancer has spread. Breathe normally please.
Me: Spread where? How do you KNOW?
Dr. A: Your you-TERR-us is enlarged on the CT scan. Breathe again please.
Me: My what? Oh, my uterus. Yes, it is enlarged but it's benign. I had it checked last week. Did you see the results from my Pap test?
Dr. A: We do not communicate with the gynecology department. [walks out of the exam room]
Dr. A: [walks back in two minutes later] The cancer has spread to your liver. Take this paper to conference room 2 and...
Me: Wait. I know the CT scan showed foci in my liver, but without a biopsy or at least a PET scan how can you be sure that...
Dr. A: It doesn't matter, the treatment is the same anyway. Take this to conference room 2 to schedule your first treatment. [turns to leave]
Me: Wait! Can I talk to you about the pain? I have pretty severe pain in my sternum sometimes, where the mediastinal tumor is pressing against the bone? See how it bulges out? And I...
Dr. A: Yes, that is normal. Please take this paper to conference room 2. [turns to leave]
Me: Wait, just one more question. Shouldn't I have a flu shot before I start treatment?
Dr. A: Why do you ask this? We have never said such a thing.
Me: Well won't my immune system be compromised once I start treatment, putting me at higher risk for flu?
Dr. A: Yes.
Me: So can I get a flu shot here? Do you offer them?
Dr. A: You are free to do as you please. Now go to conference room 2. [walks out closes the door]
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Yes, yes I did: I went straight home and cried.
Stay tuned, more true tales of the damned to come.