Monday, May 20, 2013

It's a Wrap

The finger bone's connected to the hand bone,
The hand bone's connected to the arm bone,
The arm bone's connected to the shoulder bone
--Dem Bones

 The world's perverse, 
but it could be worse    
Sonnet for Minimalists, 
Mona Van Duyn

Being a news junkie, it was hard at first having no Internet the past couple of weeks. However, each time I catch some connectivity I become more underwhelmed by that to which I do not have immediate access. When my phone was offline again last week upon my return, I sheepishly smiled as I called in the latest service request; no phone = no DSL = freedom.

Friday was my last pirated connection, and I resolved to speed-read through a few day's worth of heads on a few sites  (The New York Times, Slate and Reader's News Service.) Most of it was boring, biased, stupid and/or irritating, and an hour later I emerged none the wiser for the scan or viewing. The tempo of the news gives one the sense of being on a treadmill, breathless from the barrage, but what has one left with?

So, for the next few weeks we'll go a little more deeply into those things already there, and just do things a little differently. Following are some highlights of my recent small brush with the medical system.

I broke my wrist May 7th through sheer distraction.  The sickening feeling of bones going "splat" as I fell on open hand prompted me to drive to an ambulatory 24-hour care clinic, not wanting to repeat a dire experience some years ago at our local hospital. That time, after sitting in the waiting room for 6 hours with a 103-degree fever and finally walking out, waiting until I could see my doctor Monday (who almost killed me with a misdiagnosis of H1N1 Bird Flu, but that is another story), I learned that one must begin vomiting or keel over in order to be "taken into a room". Since I did not feel like acting nor did I trust what I would be met with in The Room, I figured Physician's First couldn't be worse, and at 8:30 p.m. the parking lot was a lot emptier.

After a few cursory X-rays the assistant announced that it was broken and they would place a temporary splint. The woman who actually wrapped the compression bandage failed to read the big letters -- "This side to skin" -- and so couldn't achieve the attachment of the Velcro; the assistant then brought this to her attention.  When the arm wrapper left the room, the assistant unwrapped it saying, "She's new here -- from another clinic; let's try and do better." Another clinic where perhaps English is not a primary language. The second attempt at least went around the thumb, successfully securing the arm to the splint, though she chose what appeared to be a midget or child's splint, and I suggested we go for the next size up.

Next morning it was a 3-hour drive to one of Florida's better hospitals and an ER intake and some further X-rays. The blase doctor sent the films to orthopedics who verified the fracture, adding on an additional wrist fracture to the radius and ulna. When I asked if ER could make an appointment with ortho for me, he said, "I haven't been able to do that in 30 years." Everyone seemed to lack certain vital skills.

When I asked the woman in the ER wrapping my arm in a new splint to point out the new broken bone on a hard copy scan she could not, saying she "only wrap[ped] the bones", but could not identify them. After the wrap I got the hustle when two women entered the room, one hurriedly throwing a sling over my head and one shoving papers to be signed at me. Also, I was given a beige 1980's-era touchtone phone ("the new ones keep breaking") from which I could call orthopedics if I wanted to try scheduling an appointment.

Ortho was as clueless as ER, and told me I could wait days or even weeks in order to have my bones set. Explaining I would be there for two days and would like to have it looked at, I was told to call back in two days to see if possibly one of their overbooked doctors could fit me in. Why I would wait until Friday to do so was a mystery unexplained. 

My moment of oasis came when I went to the patient representative who made some calls and assured me that someone in the town would be able to consult with me prior to my return to Tallahassee.  That afternoon, I received a rushed call from an irritated-sounding member of Ortho; "Can you come in the next hour?"  I could, and was met with the most intense, most harried doctor I have met in a long time.

Saith he, "I just want to let you know that I think it is very manipulative of you to go to the ER and think that you could be seen by a doctor the same day!" He was red in the face, his eyes were crazed, and he knew he had crossed the line. I said I do not manipulate anyone, and was simply following protocol as I understood it in order to be seen by the appropriate doctor. He left the room and return somewhat composed, apologizing and explaining that he'd been in surgery all day, was strung out and that his partner had decided to absent himself whenever he felt like it. His apology was sincere, acknowledging that I did not deserve that.

What he could not know was that my day had already been filled with strife; not everyone is happy to accommodate a damsel in distress. Adding onto that I had three hours sleep and was in more than a little pain, and the absurdity of the day was almost complete. 

There would be more small unfortunate events to follow, but what struck me most was how difficult it must be for those stricken who are chronically ill, incurious, uninformed and fully at the behest of people who may not want to give them the time of day. Myself, I am grateful to have been seen by a competent doctor and been given the choice to take a conservative route. Of course, we always have the right to decline surgery, but the doctors notes in such events usually betray the antagonist posture of them-versus-us, and "procedures" are money-makers.

Until we fix (smash) our dysfunctional medical system, one's best hope is to attend a hospital where the doctors work on salary and are not profited by extraneous surgery. For that, I am grateful to Mayo clinic.

Addendum: I forgot to mention that the splint applied by the ER "wrapper" was so painful -- the wrist was at such a poor angle -- that I unwrapped it within an hour of leaving.  Thankfully, I listened to the small voice in the gut which said, "Take your old splint with you." I proceeded to re-wrap my arm in that pre-formed splint until that afternoon. Onward and upward!

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Anonymous Anonymous said...

I will say it again... Medicine is practiced differently in Florida than in the rest of the nation.

Jay in N.C.

Monday, May 20, 2013 at 10:08:00 PM GMT-5  
Blogger FDChief said...

And as for the low level of competence of the grunt-level medical people you encountered...well, if an organization is in business of "selling" medical care why should it want to educate it's low-level grunts? Does McDonald's want the fry-pit guy educated in the agronomy of potatoes? The history of deep-fat frying? The art of cooking? Hell, no; it wants the dummy to stay in his lane and do what he's told.

Mind you, you can't DO good medicine that way. But, again, this isn't about doing GOOD medicine; it's about doing profitable medicine.

Sorry to hear of your travails.

Tuesday, May 21, 2013 at 8:29:00 PM GMT-5  
Anonymous Anonymous said...

Lisa, last weekend my young nephew bounced off his trampoline, landing on slightly less bouncy mother Earth & fractured both wrists..have pics if you want them emailed :0)

Wednesday, May 22, 2013 at 9:05:00 AM GMT-5  
Blogger Lisa said...

Chief: You are right -- the considerate evolution of the man is not what the overseers are after.

I had my small brush with this in my first job, working at a smaller branch of a large hardware chain. The old manager trained all us grunts in all manner of things hardware store ... even a cashier could mix paint or understand lumber sales. Alas, upon his retirement, new mgmt. installed a new policy, that each person would remain a grunt unto his own job (cashier, lumber invoicing, etc.), and would learn nothing else.

Instead of a fraternity, the store became a more fragmented and resentful place of rivalry and favoritism as everyone pulled back into their own ghetto-enclaves of the store.

Carl: Ouch! I shall respectfully decline the photos, as they would remind me of the bulging wrist bone which I'd rather not visualize!

Wednesday, May 22, 2013 at 12:35:00 PM GMT-5  

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