The telephone game

Remember that childhood game, telephone?  You know, the one where you whisper something in someone’s ear and the message has totally morphed by the time it gets to the person at the end of the line?  Sometimes, it seems to me that health care providers like to play that game.  It certainly seemed that way at my CT scan on Thursday.  After returning to the lobby, I said to my friend who had accompanied me, “Well THAT’S going to make a good blog post!”

I arrived at the Heart and Vascular Institute at 9am, got checked in (by a former student, no less) and then got called back for the test.  My friend and I stood up to go, but they asked her to stay in the lobby since the other waiting room was getting full.  “It should only be about 5 minutes, anyway.”  That should have been my first clue that something was up.  I figured they were planning on getting me ready, then I’d go back to the lobby, then get called to the back again.  I knew it couldn’t be a 5 minute test since the scheduler had said it would take about 25 minutes.  We enter the room, she gets me situated on the platform and says, “This won’t take long at all.”  I thought about just letting that comment slide, but knew that didn’t seem right.  For starters, no-one had started an IV for the contrast, and while medical advances have been vast in the past few decades, I’m pretty sure they haven’t figured out a way to get contrast into your body through osmosis.  So I piped up, “Aren’t you going to use contrast?”  “No, we don’t use contrast for this test.”  Crickets.

“Um, I’m pretty sure the doctor ordered a test with contrast.”  “Really?  Because scanning this part of the body doesn’t generally require contrast.”  I tried to remain calm, even though my blood pressure was already on it’s way up.  I explained the whole situation, including the confusion of the tech, the conversation between the radiologist and the radiation oncologist and the fact that the scheduler, a lovely man named Kelly, had made a point of putting a note in my chart stating that the test had already been verified with the doctor and it was to be the CT scan with and without contrast.  This was all very awkward for me because I was laying on this platform with my head in a supremely uncomfortable head holder thing such that I couldn’t really move my head much to look at the tech.  She thanked me saying, “That was really informative.  I’ll be back.” and suggested that I sit up while I waited.

A few minutes passed, my mind racing the enter time.  She came back in saying that there are protocols for the tests, and using contrast would fall outside of the protocol, so another person would be looking into it with the radiologist and getting back to me.  Again, I was left alone with my racing thoughts.  Just as I had gotten up to send my waiting friend a text message, a lady walked into the room, apologized for the confusion and said they were ready to get started.  Again, I thought about letting the apology go without comment, but then decided that enough was enough.  After asking me a set of standard question (Do you have diabetes?  Are you allergic to Iodine?  etc.), I said I had a question for her.  “I’m just wondering how this whole mix-up even happened.  It was clearly stated in my chart that this was the test the doctor wanted.  Did people not see that message?”  “Well, when we look things over the night before . . . . . . .”  The rest of her words turned into the something very akin to what the adults would say on that kid’s show, whose name I can’t recall.  The Muppet Show, maybe?  . . . . .Wahw wahw wahw wahw wahw .  .. .  I looked away, shrugged my shoulders and said, “Whatever.  I’m still not happy about it.”

I don’t tend to think very quickly on my feet.  I’m forever wishing I would have said this, that or the next thing, making myself out to be much better at arguing with people than I really am.  Fortunately, quick thinking was with me that morning.  I continued, “If I wouldn’t have said anything, you guys would have done the wrong procedure!  I shouldn’t have to check up on everyone to make sure they aren’t screwing up!  I shouldn’t have to advocate for myself, yet here I am and I’m frustrated!  I’m sorry you’re getting the blunt end of my frustration, but this sort of thing has been happening throughout my entire illness and I’m just tired of it!”  She again apologized, stating that she felt especially terrible that she was involved in the mistake.  (She had been the person to review the cases the night before in preparation for the day’s procedures.)  “I’m actually on a committee created to keep this sort of thing from happening and to improve the patient’s experience.  I’ll definitely be taking this situation back to them for review.  My name is Haley, if you ever have any other dealings with this department, please ask for me.  I want to be sure that you have a problem-free experience from here on out.”  Maybe she was just paying me lip service, but I was satisfied with her response.

She went on to try and explain why things had transpired the way they had from her perspective.  I’ll be honest, I wasn’t really listening, because by that point, I didn’t care.  I’d said my piece and was ready to get this stupid test over with.  I do recall her saying something about wanting to be thorough and make sure the radiologist had the correct test to read and to make sure there weren’t any mistakes.  Now that I’m a few days out and have had time to think about it, that last statement is totally ludicrous.  Clearly, their efforts for accuracy caused them to be inaccurate.  I’m still wondering how they a) missed the order which I thought clearly stated “CT scan with and without contrast” and b) how they missed Kelly’s note stating that the test had already been verified as being the correct test.  Was anyone ACTUALLY reading my chart?  According to Haley, my case was outside of the norm and didn’t fit into the protocols, which is why some of the mistakes happened.  Uh, sorry, that doesn’t give you a free pass to go on ahead and screw up.  If you are married to having protocols, you should have one in place to deal with those cases that fall outside of the norm.

Anyway, so the air was cleared and we moved on with the test.  During my entire diatribe, there was this other guy floating about the room busying himself doing who knows what.  At this point, he was introduced to me as someone who was training.  I smirked and said hello.  Maybe, just maybe, he learned a lesson that will improve the care he provides to patients.  Maybe.

The actual procedure was fairly unremarkable.  Haley did an amazing job at inserting the IV.  Seriously, zero pain, which was a first!  The iodine injection was creepily weird.  At first I felt a cool sensation in my veins, and then it was very warm, very quickly rushing through my arm and throughout my entire torso, making me feel like I’d peed my pants.  They did the scan, took out the needle and I was on my way, but not before Haley said two more times that she wanted to be the one handling my care in her department from here on out.

All in all, I guess it turned out fine, thanks to me!  I’ll find out the results of the scan tomorrow.  I have no gut feelings on which way it’s going to go.  I hope that it’s nothing, but am prepared for it to be something.