Sunday, October 2, 2011

...and then I called him a fuckhead.

Batman, sometimes you just need to call people on it when they are being inappropriately crappy. This week, I had the (hopefully rare, ideally one-time) experience of calling a doctor a truly naughty name. Now, as you will soon know, and as my friends and family can surely attest, I am neither an angry nor an aggressive person. In fact, I tend to try to avoid confrontations at all costs, often to a point of accidentally letting myself become a victim because I just hate, hate, hate it when people are upset with me.

This neuroses is especially profound when it comes to anyone in the customer service industry; if it is someone's job to provide me some kind of care or support, I tend to go out of my way to be nice to him or her almost regardless of how poorly that individual is treating me, or how poorly they are doing their job. Receptionists, flight attendants, nurses, and doctors have always been a source of particular anxiety for me, as they legitimately hold a fragment of my fate in their hands. In my head, it is virtually required for me to do anything I can to make any person in one of these positions feel favorably towards me, if not to flat-out like me. This week proved for me that not everyone in these noble and not always appreciated fields is deserving of such esteem. (Don't worry about the flight attendants. They're still cool.)

This Tuesday, I left school about an hour early to make the drive from work back to Portland. Now, most people can leave work an hour early with minimal crisis; my leaving work is a far more complicated endeavor. I need to secure coverage for my end-of-day responsibilities, which effectively boil down to outrageously carefully choreographed cat-herding. Thankfully I was able to do so, and (still stressed about creating any change in routine for my kiddos) I scooted my way to the doctor's office. This was my first appointment with the "high risk" OB/GYN practice that I was told (by the head doctor there, hearafter referred to as Dr. D-Bag) I had to - HAD TO - work with for the remainder of my pregnancy.

Batman, I'm sure you recall earlier posts in which I all but damned the medical institution surrounding maternal care. From all I have read, heard, and seen, there is essentially no consideration for patient needs in this system; doctors do whatever fits their schedule and their (or their practice's) financial desires. Drugs and often superfluous medical interventions are all but forced, and patients are backed into every possible corner with nothing more than the excuse of "this is for the good of your baby" to explain their (often mis-)treatment. Naturally, when you showed up I went running to the most holistic practice I could find. As soon as the diagnosis about your heart came about, Dr. D-Bag told me that I could not - under any circumstances - continue to work with a practice that didn't have as explicit a relationship with "the hospital" as his does. To be fair, this hospital does have a regionally award-winning NICU, and we will be working with a truly exceptional cardiologist based there, but...did I really need to work with a terrifyingly restrictive, conservative, and medicine- (not patient-) oriented practice in order to take advantage of all of these resources? My gut said no.

I showed up at my appointment a responsible fifteen minutes early. Even not being a new patient, I like to show up early to appointments just to show that I am respectful of the practice's time. (Some little part of me wants a receptionist to someday either compliment my timeliness, or better yet, give me some sort of gold star. Maybe they make notes in their records of who shows up early and who doesn't...See? Neuroses!) At 2:30, when my appointment was scheduled, several patients had already been called in. I had not. At 2:45, people who had arrived well after me had been called in. I had not. Come 3:00, I meekly approached the receptionist and asked if she had any idea how much longer I would be waiting. I was told in no uncertain terms that I would be called when it was my turn, and that they were very short-staffed, so she could make no accurate predictions. I muttered something about having come early just to be sure I was ready when it was my time, and was thanked for my patience and asked to continue waiting. In the meantime, several people who had showed up after 2:30 had already been called in to their appointments, and a few of them were already checking out and leaving, having FINISHED their appointments. Still, I was not called in.

Come 3:30, an hour after my scheduled time, my desire to please the receptionist had disintegrated into more or less red-hot rage. I could have not only left school at a normal time, but I could have carpooled that day, saving myself dollars in gas money and however much carbon emission that a second car created. While silently stewing (and watching more and more patients be called in for their appointments, then checking out and leaving), I tried to center myself. Sure, I didn't want to be working with this practice, but it wasn't their fault that I needed their services. Even though I was livid at having so much of my time wasted, I had to walk into this with a positive attitude. Finally, over an hour past my scheduled appointment, the waiting room otherwise completely empty, I was called in by a nurse who immediately set my teeth on edge.

Now, here's some simple advice for all medical professionals: when you first meet a patient, ask "how are you today?" or something of the like. This shows that you are a human being, not some sort of soulless demon with a name tag. This nurse immediately started lecturing me about the need to work with her practice, citing all of my risk factors (which were described so obliquely as to leave me more confused than when I started) and, once she got my chart in front of her, berating me for not seeking their highly-medicalized care the second I got pregnant. I seem to have forgotten many of the details of our conversation in a rage-induced fugue, but here are a few highlights:

Nurse: "I see you were working with a midwife practice. Now, since they aren't really doctors, and really aren't qualified to give you prenatal care, I hope you can appreciate that we need to redo their records."
Me: ...annoyed silence...

Me: "I'm hoping to get a better explanation for why you want to induce me at 39 weeks instead of 40, given that my child's lungs may not be fully developed at that point...also, especially since the doctors I've spoken to want me to have as natural a birth as possible, it seems strange to me to introduce chemicals into my system that will almost definitely require more chemicals being introduced, and increases my chance of a c-section dramatically. Is there any more information you can give me about why this is an appropriate choice for my baby's health?"
Nurse: "I don't appreciate your getting irrational about this."

Nurse: "Our practice has twelve attending physicians or residents, and works with several other practices to cover nights at the hospitals, because our doctors are only available until 5:00PM. Your baby will be delivered by whoever is on call when you go into labor."
Me: "What are the chances of me meeting the doctor who does the delivery?"
Nurse: "In the thirty years I've been a nurse working with maternal-fetal medicine, I've never seen a case of a woman knowing the doctor who delivers her child in advance."
*Note: I actually don't know a single woman who DIDN'T know the doctor who delivered her child in advance, and I've known more than a few families who used this hospital.

Me: "I am really not comfortable having a man deliver my baby. Is there any way to ensure that I work with a female OB?"
Nurse: "That is a completely irrational request, and one that is frankly closed-minded. Again, you don't get any say in or control over who delivers your baby. This is just part of how we guarantee that you receive the best possible care."
*Note: WTF?

After about twenty minutes of this sort of round-about bullshit, and four separate occasions of being called irrational, this nurse clearly realized that I was too irrational for her to handle on her own. I was proud of myself: I stayed calm, collected, and focused on the needs and concerns that your father and I had deliberated and discussed in advance. This nurse left me waiting for almost another half an hour while she got the doctor to "discuss my concerns" with me. It was at this point that I realized that she had only weighed me, taken my blood pressure, and listened to your heartbeat; no actual examination had taken place, and there had been zero conversation about how I have been feeling, whether you were moving around much, if I had been, I dunno, pooping normally...nothing.

Dr. D-Bag comes in and immediately goes on the defensive. I am told - flat-out told - that I am making irrational requests, and that what I "have to understand" is that this is a situation in which I have no control, no choices, and should have no expectation of having any input about my treatment. In the roughly five minutes of face-time he gave me, I was told (again) that no woman he works with ever knows the doctor who delivers her baby, that being induced early is non-negotiable, and that wanting a female obstetrician is a hurtful and irrational desire. It was at this point that I called him a fuckhead.

Now, profanity has a magical influence on people. For some, it is a catalyst for further rage, beginning an escalating spiral of violent language, and often violent behavior. For others, it is a neutralizer, negating any potential further action and stunning the recipient into stunned silence or complacency. For people like me who just flat-out hate confrontation, it typically sways me - usually instantly - towards acquiescing to the profanity-wielder's will.

Apparently for Dr. D-Bag, profanity is some sort of secret key code that releases his patients' true desires from the clutches of his fuckheadedness. The second I showed him just how much he didn't want to deal with me any more, he immediately offered to transfer me to a holistic practice of six women, all of whom I would meet during my pre-natal care, and none of whom "pass off" patients to other practices if one of them isn't available. Turns out that getting exactly what I wanted - what I knew from the beginning to be right for all of our family - was completely an option from the beginning.

Not only was I kept waiting (which is mostly annoying, but ultimately disrespectful of my time, as well), but I was spoken to rudely and condescendingly, lied to, and I would have been denied my rights as a patient had I not acted against my gut instinct and called this guy what he really is. I can't believe I let this wacko perform my amniocentesis, but at that point, I didn't realize just how bad he was. Batman, I hope you can take this as a mark of several important things. First, your mother will kick anyone's ass who stands between her and the best care for her family. Second, there is no such thing as "no choices." There are always choices. Third, and perhaps most importantly, I have one hell of a gut instinct.

Turns out that this fuckhead...I mean douchebag...I mean *ahem* "medical professional" is a lapdog to our insane, scary, dumb-as-toast governor. He (Dr. D-Bag) and his uber-conservative doctor wife have both worked to limit the rights of GLBT patients, from campaigning to allow practices to deny medical care based on sexual orientation, to working to flat-out deny lesbian mothers pre-natal care. I might still technically have to deal with this dude sometimes until you pop out, but I've got another practice full of women who buy in to the same philosophy that I do to back me up, and there will be one hell of an angry letter going to his supervisor as soon as I don't need to deal with him again.

Batman, I've got your back, and anyone who tries to stand in my way is going to see a very ugly side of me.

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