Wednesday, June 30, 2010

MEDICAL CARE FROM HELL, Part II

In awhile Nicole, ashen-faced, called us into her office. "Oh, my God," I thought. "I have even less time than I thought." Very grim, she faced my sister and me and announced, "There's nothing there, Ellen. Nothing at all."

At first Sandy and I were sure that we had heard her incorrectly because she was so unhappy. Confused, we looked at each other and cried in unison, "But that's good, isn't it, Nicole?" And we grabbed her, hugged her and couldn't stop laughing hysterically.

Incredibly, Nicole could not share our joy. Pulling away, she said,"Well, I always take the negative approach. You have more tests to take - your fluid has to be taken out and sent to the lab - and if it's ok, I shall be pleasantly surprised."

What was so mind-boggling was Nicole's misery. She looked devastated. Thus, the most horrible thought crossed my mind - and I could not believe that I was thinking this way:

Nicole's mistake had completely crushed her. Until now she had viewed herself as a superior being because she was a Harvard doctor. Now she saw that she was not so perfect and she could not cope with it. It would have been better for her if she had been right, even though that would have meant a death sentence for me. But then, I reasoned, no physicians would feel that way. Or would they?

Moreover, Nicole had categorically stated that my fluid could only be from cancer. Later when I talked to more doctors, I found out that fluid can be the result of many things. As my friend, Louise, had known, in my case, it was probably from my recently completed radiation.

Most egregious, though, I learned later that a cancer diagnosis can never be based on a chest x-ray. It can only be detected through a biopsy, which Nicole had never done on me. So, why had she jumped to the conclusion that I had metastasized cancer? Suddenly, I remembered that when Nicole and I were discussing my condition on the phone, I had asked her if she had seen a mass in the x-ray. "Oh, no, Ellen," she had replied. "But I assume one is there."

Now, when I could think clearly, her answer totally dumbfounded me. How could an experienced oncologist, dealing with cancer on a daily basis, reach a conclusion based only on supposition and not on clinical fact? Was Nicole incompetent? Had she lost her mind? What was also shocking was that she never apologized for her egregious behavior. Never once did she tell me that she was sorry for scaring me, my family and friends.

Dismayed by her behavior, my sister and I went to have my fluid removed. Only a little could be taken out on an outpatient basis; the rest would be drawn later in the hospital. On the way, Sandy turned to me and said,"She is really weird, Ellen." Of course, I was in complete agreement.

Brenda, the doctor who would remove the fluid, was upbeat, calm and confident, the opposite of Nicole. Once she had completed the procedure, she told me that I did not have an excessive amount in my body. She said, "Actually, I see this all the time. And I don't think you have cancer, Ellen. Your fluid is clear and cancer fluid is murky."

This information stunned me. If my fluid level was not extraordinary, then why were Nicole and Phyllis so certain that I was going to die? I tried to understand their reasoning, but I was totally exhausted and I just wanted to go home and crawl into bed.

When I called my relatives and friends, they all breathed a sigh of relief. "And you're going to get rid of that terrible Nicole, aren't you, Ellen?" asked Sylvia, my cousin. Bob, my lawyer, had a few thoughts, too. "You've got to sue, Ellen. What she did to you is totally inexcusable." Still a nervous wreck, though, I did not know what I was going to do about Nicole - and, unbeknownst to me, there were more terrible things to come.

On Friday, I went back to the hospital alone to have an echocardiogram. Since Nicole had recommended it, I did not want to take the test. However, to be cautious, I begrudgingly kept the appointment.

While there I ran into Frank, the kind and caring cardiologist who had treated my mother until her death. I had a special fondness for him because of the lovely way in which he had looked after her, as well as his concern for us, her family.

"Why are you here, Ellen?" he asked. "You look too terrific to be taking an echo." I told him my Nicole story and, not surprised, he replied, "Well, it's common knowledge that she is spread too thin. I know your test will be fine because you don't seem to be under any stress at all." A lot that he knew!!!

After the echo, I returned to my sister's house and got ready to go back to the Cape. Ever since the fluid had been removed, my good health had returned and I only wanted to get back to our cottage on our beautiful lake, a place that was nirvana to me. Just to be by myself and not have to think about my health or to have to see any doctors! Who could ask for anything more?

It was not to be, however. As I was saying good-bye to my family, I heard from Nicole via her cell phone,which kept going in and out of service. Didn't she realize that not only was it unnerving for me to receive an unexpected phone call from her, but that, because of poor reception, it was disturbing to hear only bits and pieces of what she was saying?

However, I quickly put those thoughts out of my mind because I remembered that I was dealing with Nicole, a physician who lived in an Alternate Universe. She was completely wrapped up in herself, in her own world, with absolutely no empathy for anyone else, including her patients.

Talking very fast, very loud and completely out of control, she cried,"How do you feel? I want you in the ER immediately! You have a lot of fluid around your heart and that is very dangerous. Anything could happen to you, anything at all!"

Disregarding her instructions - how could I possibly take her seriously after the events of the past week? - I tried to calm her down. Later, when I thought back to this phone call, it amazed me that it was I, the patient, who had to soothe Nicole, my doctor, and not the other way around.
Then I told her that I was leaving for the Cape immediately; that I felt fine; and nothing could stop me. Concluding our conversation, I said, "Let's forget about my heart for a minute, Nicole. Do I have cancer or not?" "Oh, no, Ellen," she cavalierly replied. "Your fluid was perfect. You don't have cancer at all!"

Her insensitivity flabbergasted me! How could she be so casual about these tests when it was she herself who had told me that I was going to die? Was she so dead emotionally that she could not relate to the anxiety that she had caused me? That she really did not comprehend that I needed to know the results as soon as possible? Disgusted, my first impulse was to hang up on her and to ignore her warning about my heart.

Sandy, however, had been listening and she insisted that I go to the ER. "What if Nicole is right this time?" she asked. After much discussion, I called Frank for his input because I had great trust in his judgment. Concerned, he told me that I should listen to Nicole; that he was not on-call that week-end; and he was instructing his colleague, Joe Sears, to monitor my condition. Thus, my sister and I drove quickly to the hospital, convinced that we were living in the Medical Twilight Zone and that this nightmare would never end.

As you would expect, the ER was teeming, frantic with the comings and goings of patients on gurneys, EMT's, nurses, doctors, and all of us sitting for what seemed like hours in the reception area. Even though Frank had called ahead to let the ER know that I would be arriving soon, I still had to wait a long time, a situation which was beginning to panic me. After all that had happened during the week, I was starting to believe that Nicole was correct in believing that my days were numbered.

Finally, a kind nurse led me to a room and I did the usual patient routine. I undressed, put on the johnny and lay on the gurney, terrified of what was coming next. After checking me out, the doctors agreed that I should have another echo. Even though I was feeling fine, this test confirmed what Nicole had told me - that, indeed, there was a great deal of fluid around my heart. Therefore, Frank's colleague recommended that I stay in the hospital over the week-end so that the doctors could watch me.

There was one glitch, however - would they never end? I was told that because there were very few available beds,I would have to go to Franklin 3, a cardiology floor. "Oh, no," I cried. "My mother died on that floor twenty months ago! It would totally freak me out to spend any time there!" "Well," they said. "If you don't go to that floor, you'll have to stay in the ER all week-end!"

What a choice, I thought to myself. After having planned to be at my heavenly cottage at the Cape for the next few days, I was now reduced to the options of either lying on a gurney in a hallway of the ER, where I would see all kinds of disasters for a whole week-end, or I could go to the very floor that held painful memories of Mom's death.

In trying to decide what to do, I thought about how terrible it was for me and my family when my mother had finally left us. I could not believe that it had happened and I kept talking to her as if she were still there. Finally, Sandy had to make me understand that Mom was dead and it was pointless for me to carry on a conversation with her.

And I remembered how my whole family and I congregated in a meeting room with the doctors who had cared for her, as if our discussion was about everyday events. The shock had been overwhelming and I had vowed that I would never enter that building again, never mind the floor on which she had died.

Nevertheless, I decided to go to Franklin 3 because it seemed like the lesser of two evils. It was unbelievable, though, that I was being put in this position because Franklin 3 was not like a regular hospital floor, which, typically, is very long, seeming to go on forever. No, Franklin 3 was so short that no matter where I slept, I would be very close to where my Mom's life had ended.

Pretty soon some very nice guy came to wheel me up, and, lo and behold, not only was I on Franklin 3, but they had also taken me to the same room and bed in which my mother had died! It was incredible! It was too much to take in! Was this really happening to me?

Later my friends asked me why I did not object and demand to be taken to another room and bed. To tell you the truth, by this time I was so traumatized that I could not open my mouth even if I tried, which is saying a lot, because, normally, I am a very gregarious person.

Moreover, I was certain that my end had come. Why else was I being put into my late mother's bed, her last stop before her grave? So, the attendants left me and I called my sister and her family. Everyone was speechless. They could not believe what was taking place. It felt as if we were in some weird Halloween movie and the ghouls were circling around.

Let me tell you. Getting into that bed took a lot of doing. I tried to hold myself together by believing that my mother was putting her arms around me and taking me to the beyond. I never thought I would wake up and I was ready to see her and my late father, gone for twenty-eight years. I figured that we were going to have a happy family reunion, so I closed my eyes, pretended that my Mom was holding me, and I prepared for entry into my final destination.

Surprise, surprise, though! The next morning I actually opened my eyes and was stunned to find that I was still in the land of the living. In fact, I was feeling so well that I was ready to go home. It seemed ridiculous to me to stay in the hospital for a whole week-end when I was the exact opposite of a sick or a dead person. To the contrary. I was ready to take on the world. However, I decided to stick out the week-end because Frank's colleague had prescribed it. In my opinion, Frank was a great physician and I knew his associate was of the same caliber.

Soon the nurses stopped by and were incredulous to see me in this particular room and bed. They knew me from when I was caring for my mother during her last illness and they remembered my pain when she had died. They could not understand why I had been put there, "especially," said Sherry, "since we have another available room down the hall!"

The fact that I could have slept somewhere else - and not in my mother's deathbed - did not phase me at all. In my view, ever since Dr. Segel and Nicole had misdiagnosed me, I had been in the Medical Twilight Zone, where only glitches and weirdnesses were the norm. So, why should I be surprised at this mistake? It seemed like the natural order of things for me now.

The nurses moved me very quickly and I started to feel a little happier. Frank's colleague came to see me, too. Dr. Sears was a friendly guy and very easygoing. He checked my chart, looked me over, and said, "Well, Ellen, you certainly are a mystery case because you look perfectly fine to me. Your color is good. Your energy is fine. I can't imagine why you are here. So, if you have time, come to see me when this is over. I'd like to have a second look and figure out what is going on with you."

TO BE CONTINUED....

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