Angels and Assholes

Monday, December 28

It's nice to note that the ratio of angels to assholes at United is about 8:1, in favor of angels. Unfortunately, the calibre of assholes encountered is of the spectacular variety. Maybe if they had been simply mediocre, none of this would bother me much. But no. They have to be spectacular in their ass-holiness. Or, maybe it's because my husband has a malignant pelvic tumor that has me a little on edge lately . . .

Bob had his appointment with the neurosurgeon at United Neurosurgery Associates at Nasseff Specialty Clinic, which is attached to United, at 4 p.m. I dropped Bob off at the front doors and then drove around to the back of the clinic where Bob said there was a $2 parking lot. I saw only one lot behind the building, so I pulled in, took my ticket and ran back into the clinic to find Bob. He was already checking in by the time I got up to United Neurosurgery Associates' office.

I had called ahead, before we left, to make arrangements so Bob would be able to lie down while waiting for the doctor. After he was checked in, a nurse led him to an examining room and I followed. I'm glad I had the foresight to call, as it was nearly an hour before Dr. Kennedy finally appeared. Guess I just had an intuition about being that last appointment of the day . . .

Dr. Kennedy eventually entered the room, sporting a uniform of scrubs. He reintroduced himself to Bob, then turned and extended his hand to me. Despite running nearly an hour late, he gave me an immediate sense of calm confidence. A firm handshake and a direct gaze in the eye does that. (Unlike the pulmonologist who treated Bob two years ago at United—that man always looked at the floor or out the window when talking to me. I despised him from the get-go . . .) Despite his demeanor, Dr. Kennedy didn't offer us much more information that what we already knew. He asked if Bob had heard about the results of the biopsy, and Bob said, "Well, yes, Dr. Howe, the oncologist, said the findings were consistent with sarcoma, and that they wanted to send the sample to the Mayo for a second opinion."

Dr. Kennedy said, "Yes, it is a pelvic sarcoma, which is a malignant tumor. Whether or not the results are sent to Mayo at this time isn't our primary concern. You are in immense pain because this malignant tumor is affecting nerves in the pelvic region," he walked over to a diagram on the wall, of the spine and pelvic bones, and pointed to the sacrum, the tailbone. "Right about here is where your tumor is. These nerves that come from the spine run through here and down your leg. We aren't sure right now how the nerves are affected—if the tumor is pressing on the nerves, if it's integrated with the nerves, or if it originated from the nerve tissue itself; knowing how the tumor is in relation to the nerves will depend on how it's treated, whether that be chemo, radiation, surgery, or a combination of treatments."

He asked Bob if he knew what course of action Dr. Howe has recommended. Bob told him none, at this point, that Dr. Howe had set up this appointment, and that he was to contact Dr. Howe after. Dr. Kennedy seemed a little baffled as to why he was the first specialist to be talking to Bob since what Bob has is primarily a malignant tumor, and secondarily a neurological situation; that the approach would be multi-faceted, with oncology, neurology and other specialities all working together, based on their areas of expertise, to remove the tumor, but that oncology should be the first and foremost player in the treatment. "There's really no more I can tell you until the other pieces are in place, " he finally said.

I looked at the doctor in disbelief. So, was this appointment a waste of everyone's time? Why was it even scheduled, I asked, beginning to imagine dragging Bob to all kinds of follow-up appointments to this specialist and that specialist, piecemealing his treatment together. Dear god . . .

As if he read my mind (or maybe because he recognized the "she's about to blow!" look my face), Dr. Kennedy looked at Bob and said, "I think the best thing to do is to have you admitted to United tonight, Bob. That way, we can get everyone we need together tomorrow, in one setting, to figure out how to approach your treatment. That way, everyone comes to you, and you won't have to try to coordinate several appointments. That's our job, not yours. You've been through enough."

He looked at me. "Are you okay with having him admitted this evening?" Okay? I was ecstatic. That was the greatest idea I've heard in a long time. Place Dr. Kennedy in the rank of angels, along with Dr. Shafiq. "I'll send the admitting orders over to United, and I'll have the nurse escort you." With that, he shook our hands again and left. Shortly after, the nurse came in and said we could head over to the hospital. I asked if we could get a stretcher, because Bob can't walk that far.

"We don't have a stretcher." I looked at her. She's gotta be kidding.

"He can't walk that far—you mean, you're right next to the hospital but you don't have a stretcher or anything that he can lie on?"

"We can get him a wheelchair."

"He can't sit, either."

"I'm sorry, we just don't have anything here." I asked if she could call someone to bring something, anything, over to help us get him to the hospital. Again, she said it wasn't possible. Bob said he thought he would be able to get there on his own, if we just take it slowly.

"Well, let's try using a wheelchair like a walker, like you did before, Bob," I said in exasperation. The nurse brought a wheelchair to him, and we started out. I asked how far it was to the hospital, the nurse pointed down a hallway and said, "Not far, just down that way." Not far ended up being about the equivalent of two city blocks. We had to stop many times along the way, so Bob could regroup, get a grip on the pain that was now seething through his body continuously. By the time we got to the hospital check-in, I thought he was going to collapse.

We walked up to the counter and the woman behind the desk barked, "You've got to take a seat over there. I'm checking this patient in."

"He can't sit—we need to get him checked in right away," I said.

"Well then stand over there," she snapped.

"He can't stand either," I said.

"You all need to step away from the desk, I'm working with another patient." By this time, Bob had limped over to a cluster of chairs, and was trying in vain, to find a comfortable position. I looked at the nurse who had escorted us to the hospital and said, "Can't you do something? Find someone to get a stretcher or something over here!" She looked at me with a vacant stare. "I don't work in this area," she responded like a robot. Bob had now found a long footstool and lay face down but it wasn't nearly long enough to give him enough support.

I looked frantically around the lobby. I saw a pile of wheelchairs at the entrance, but nothing that could double as a stretcher. I must have had the same insane look on my face as I did in Dr. Kennedy's office, because suddenly, a man in a suit and black trench coat, carrying a stack of files, appeared in front of me. "Is there something I can help you with?" he asked me very kindly but with authority, looking at the receptionist, the nurse, at Bob and back at me, possibly trying to assess the situation. I launched into a babbling crying session about needing a stretcher because of Bob's condition and we're trying to get him checked into the hospital because he was just diagnosed with cancer and has a tumor pressing on a nerve in his leg and he really can't be standing any longer and no one was helping me, and I'm not really sure what else I said to this poor man who made the fateful decision to step in and help in a crisis when everyone else seemed to just be standing around, with their thumbs up their ass, to use one of my dad's favorite sayings.

"Let me see what I can find, I'll be right back," he said, and vanished in the crowd of people still coming and going in the hospital lobby. I went over to Bob and told him someone was getting something for him to lie on, and what seemed like an eternity but was probably only a few minutes later, a swarm of people buzzed into the lobby, with a hospital bed in tow. They wheeled it over to the registration desk and I heard the receptionist say, "You can't put that thing in here . . ." and someone else say, "Oh, yes we can," and then I figured out that they were there for Bob. I ran over to the group and said, "I think my husband is the one who needs that," and they swarmed over to Bob, who was still lying across the footstool.

They quickly but gently helped get Bob up onto the hospital bed and a woman introduced herself as Mary, saying she was the administrative supervisor of the hospital (I'm not sure about her title; I will have to get back on that), and that she was here to do everything she could to help us. I caught sight of the man who initially came to our rescue and asked who he was, what was his name. He said he was Shane, the manager of the pharmacy. Add another angel to the Dream Team. I thanked him profusely for helping us out before I turned back to follow Bob and his entourage. As they led him out of the lobby and back into a curtained room of the ER, Mary asked me what happened, why Bob was in so much pain and apologized profusely for the experience we just had. She said she would see to it that formal complaints would be filed on both the receptionist and the nurse who failed to help us in any way . . . one more angel . . .

We were eventually checked into the hospital, and I stayed with him until someone finally came in and got Bob hooked up to a morphine pump. It was probably after 9 p.m. by the time I left. I remembered that I'd parked behind the Nasseff Clinic, which was a long creepy walk back through now-darkened corridors, up flights of stairs, along eerily empty hallways, down elevators, till I came to a dead end, a door that was locked. I finally just went out a set of doors that lead out to the street and walked down the sidewalk, around the block and back to the parking lot. My car was the only one left in the lot. It may have been a $2 lot during normal clinic hours, but by the time I pulled out, the attendant was gone and the screen on the ticket checker-outer thingy flashed, "Deposit $15 to exit."

Tuesday, December 29 . . .

I will edit this post later, when I'm home and can sort through it more. I'll be quick to say, Bob was admitted, now has a morphine pump, which is helping his pain immensely, he said he got a pretty good night's sleep and will be meeting with doctors sometime today . . .I made a formal complaint to United's patient rep. department, regarding Bob's experience last night. Lori, the patient representative was incredible. She listened to me, validated our complaints, was mortified at the lack of help by the nurse who had escorted us to the hospital. I said I felt bad, like maybe I should have kicked and screamed and made more of a scene to make something happen, and she said absolutely not—that it's not my job to get these things done; it's the medical personnel who need to be proactive and solve the problems. Lori made a few phone calls, and called me back later to tell me that the nurse could have called transport and had someone bring a stretcher to Bob, that they do that sort of thing all the time. She then called the neuro. clinic and talked to the manager and asked what would normally be done in a situation like that; she said they make calls to transport all the time to accommodate patients. In our case, it looks like it was a nurse who simply wasn't doing her job. At the very least, I hope the phone call lit a fire under that nurse, to make her more aware of her position and responsibilities, and if it keeps one person from experiencing what Bob had to go through, the call was worth it. Made me feel a tad useful, being I was so helpless for him last night. . .