Thursday, May 20, 2010

Uncharted Territory

What I've been doing, today and tomorrow. Not already set-up bad computer system territory. It's completely uncharted.

Off site, but close by. This morning, I set up a new dictation system, developed ways to get special stains ordered, and started working on a backlog of cases that might take days to catch up on. I wasn't really targeted for this job - it was by default. A paperwork glitch. No one knew exactly what we were getting into. But it was really fun.

All this started at 8:30 a.m., after breast conference. Breast conference was a blast. Here is a highlight:

Breast surgeon: "I think I am going to start walking into the patient room and instead of saying 'How have you been,' I am just going to say, 'How are your breasts?'"

I laughed out loud. This was a response to other clinicians, cancer and surgery specialists, talking about patients that asked for curbside consults during their visit. There were lots of funny examples. My favorite: "Doc, can you pull my wisdom tooth?" Patients are really clueless, about what we do. An oncologist is the very last person (beside myself) that I would want to pull my wisdom tooth.

One of the older, more experienced, quietly serene but occasionally dry and funny as hell breast surgeons voiced her solution. "You are just a pup. You still have hope. I give my patients a video to watch. Of me. Whenever they have a question, I say, 'Watch the video. If it doesn't contain an answer, then call me.'" She added, "The older you get, the more efficient you become with your time. Time is golden."

I met lots of cool people at our new work site today. My favorites were nurses. One was a personal assistant to the head doc. Another assistant told me over lunch in the break room, "You've got to get in good with her. She teaches us how to cuss in Arabic. Our favorite Arabic cuss word is what we call the boss. He still doesn't know what it means." The boss was at the head of the table, eating bacon burgers and onion rings, listening without judgement. I remarked on his meal - he was very in shape. "You must work out a lot, to be able to eat like that at lunch. How do you not fall asleep for afternoon clinic?"

Another nurse showered me with funny clinic anecdotes during my mid-morning break. She was verbose, and hyper - I learned at lunch that she was on steroids for a latex allergy and wasn't usually this on.

"You know doc? He has a lot of followers. Girls that come in short mini's with garter belts and fishnet hose. For their colonoscope. Can you imagine?"

"Is he married?"

"Yes! Happily so. He is one of the good ones. Has two kids. That makes his groupies all the more hungry. I have to turn them away. I told one of them - you are overdressed, for your procedure! Go home and change into something more decent."

"Did she?"

"Darn right she did. Would you disobey me?"

I looked up at the fiery, steroid-laden redhead. "No. Never."

Got another wonderful personal story, in the afternoon. It was a birth experience, in 1973 - the year I was born. It was her first son.

"The anesthesiologist ignored me, when I told him the epidural wasn't working. I had a curved spine, see (I thought yes - kyphosis)? No one had diagnosed it. When I was screaming in pain, they said it was my fault. I tore, big time. My OB, he's a great guy, didn't show up until the damage had been done."

I imagined a nightmarish fourth degree episiotomy. A young woman having her first delivery, and experiencing all the pain. A medical team surrounding her, at a loss, blaming her while she was trying to deliver. How awful.

I told her, "It's no different today. I read a blog post the other day by a physician who had a similar birth experience. It gave me goose bumps and nausea - what she went through. It doesn't make it any easier, but you are not alone. It is still happening. I like to think that is why I, and others similar to me, went into medicine. To try to humanize it. An uphill battle, but a noble one."

She said, "Well doctor, you've got a lot of work there. I'd better leave you to it. It's great to meet you. See you in the morning."

I'm really looking forward to it.

No comments: