Yes, you read that correctly. The first question I ask every doctor when interviewing them to join my medical team is whether their BM stinks. Before I will put any doctor on my medical team, they must answer this simple question. The answer to this question determines whether my response is a curt “ok, thanks for your time” or “great, now lets talk about your background”. Now, while I am completely comfortable discussing shit with anyone, that is not what I am asking the doctor about. I couldn’t care less if their actual shit stinks. My question is about their bedside manner. See, to me, bedside manner and clinical expertise are equally important. So, great skills in one area will not compensate for terrible skills in the other. Hopefully, you are paying attention to your doctor’s BM.
Just to be clear, when I say “BM or bedside manner”, I am talking about how a physician treats their patients overall. I am looking at whether the physician is late for appointments, how long he or she spends talking to their patients during office visits, how they communicate lab results or medication changes, how responsive they are to questions and phone calls, whether they can communicate with patients in plain english rather than medical-ease, and how they ensure the patient is effectively participating in and contributing to their own medical care. Again, in my book, these things are just as important as clinical expertise. Frankly, clinical expertise has already been established for me to even be considering adding a physician to my medical team.
You know what grinds my gears? When you rush to make it to your doctor’s office on time for an appointment, but they stroll in an hour after your scheduled time. It annoys my soul when you patiently wait for hours to see your doctor, and they finally enter the room and seem too busy to even have a seat. They talk fast, don’t have time for questions, and leave before you can even get a good enough look to remember their face. Most people probably couldn’t pick their physicians out of a lineup if they had too. Oh, a new physician behavior that grinds my gears and is now my personal favorite, is when I show up to have a procedure and the doctor is too busy to speak with me and can only speak bedside in the operating room minutes before the anesthesiologist knocks me out cold. I know, this sounds completely asinine…sadly it’s a real example.
Recently I had my first endoscopy. While I’ve had 5 colonoscopies since my Crohn’s diagnosis in 2011, this was my first endoscopy. Now, I will start this reflection off by saying when it comes to medical procedures I am a complete weenie. Yep, I own it. But, if you keep reading, my weenieness (yep I totally made up a word but it works) makes perfect sense given my Type A control freak tendencies. Anytime I have to be put to sleep (SEE, lack of control), even if only in a twilight state, I am a nervous wreck. I won’t share my thoughts to show why I get nervous, but just trust that for this recent endoscopy I was a nervous wreck. I spent the entire evening before the test stuffing my face with honey buns and lemonade (check out my Night Before post), until I passed out from sheer exhaustion shortly before midnight.
My husband and I arrived to my least favorite hospital at 7am for my 8:30am procedure. The informational paperwork required me to arrive 30 minutes before my procedure, which meant I set a personal goal to arrive an hour early. Don’t judge me. It was actually great that I arrived early. After waiting in the waiting room for about 45 minutes, a nurse took me back to the pre-procedure prep room. If you did the math, I was taken back 15 minutes earlier than the time I was originally scheduled to arrive for the procedure. So ha! But I digress.
After 45 minutes of waiting, I was quickly taken back to a small pre-procedure room. Once we entered the room, the nurse curtly said “ok, I need you to undress and leave nothing on under the gown and have the opening in the front.” I jokingly replied, “I like conversation before I take my clothes off.” Unamused, I guess it was too early because I am freakng hilarious so it was definitely not my joke, she replied “right, everything off”. As she attempted to leave the room, I said “ma’am, sorry you are having a bad morning…I’m nervous. Can you tell me when will I see my GI and the anesthesiologist because I have a few questions”. Her demeanor softened and she replied “let me go check”. Before I could close the door behind her and completely take off all my clothes, a woman with long blond hair wearing a white lab coat entered the room. She said “my name is Dr. Banks, and I will be your anesthesiologist. I see from the chart you are pretty healthy so this should be a pretty straight forward procedure”. Now, I have been called A LOT of things in my lifetime, but NEVER have I been called pretty health. Honestly, I think the last time I was called “healthy” was in the delivery room…when I came into this word. So, at that moment after Dr. Banks’ words, I felt like a woman that was told she was beautiful for the first time. I had to take a pause and enjoy my 10 seconds of being healthy. I soaked up my 10 seconds then faced the doctor and said “please leave. Please go look at my chart and then come back”. Yes, you read that correctly. I calmly told her that. Friends, the look on her face was PRICELESS. But, guess what? She did exactly as I asked.
The doctor slowly left the room, with a shocked and confused look on her face. After 10 minutes, she slowly entered the door for a second time. This time, she softly said “ok, I looked at your chart. It seems your major health issue is hypertension. That is no issue because you will be monitored very closely.” While she never admitted to initially reviewing the wrong chart, it was clear. To match her tone, I softly asked, “great doctor, but who will monitor you”? Completely at a loss at this point, the doctor asked “what do you mean”? To which I replied, “doctor, there is no way you viewed the correct chart. See, I am here for a endoscopy because I have Crohn’s. Of all the conditions I have, it is difficult to say which is my ‘major health issue’. But, I think all my docs would agree that with all I have going on, my hypertension is actually the least of my worries. I will go out on a limb and say pretty healthy people don’t have GI, Rheumatologists, Neurologists, a pain management physician, and bone specialists. So, I need to know who will be watching you to make sure you don’t kill me, because I think we can both agree that attention to detail is not really your thing”. As you can image she was completely shocked by my words. Honestly, that was exactly why I said them. It was clear this doctor needed a wake up call…and one that didn’t involve me or someone else dead on a table. After I let the initial sting of my words sink in, the followed up by saying “listen, I am extremely nervous about being put under and want to make sure you are not operating on auto-pilot. I want to make sure you are completely present and aware of my history, conditions, and medication”. I then spent the next 30 minutes giving my medical history, walking her through my medications, and confirming that she was aware of my pain patch affixed to my shoulder blade…she forgot about the pain patch 2 additional times during our conversation. She also admitted to somehow overlooking in my record that I was on 2 biologics.
After I finished with Dr. Banks, the anesthesiologist, I asked again when my GI would be in to see me. By this point, I had been told 3 times that he would see me before the procedure. Given that it was now 8:20, I began to wonder what “before the procedure” meant. I was anxious to see my GI because I have not been under his care that long, and needed to feel comfortable before he got all intimate with my guts. My initial GI retired from seeing patients, and this meeting before my procedure would’ve been only the 2nd time I spoke with my new GI face to face. Well, while I did speak with him “before the procedure”, let’s just say this encounter left something to be desired. As Dr. Banks was leaving my room to head to the operating room for my procedure, she said “oh, I forgot, your GI will speak to you in the operating room before I put you under”. Now, as you would image, I immediately got upset. Lots of thoughts ran through my mind, but the recurring one was how dare this arrogant jerk act as if he is too busy to be bothered. Before Dr. Banks could exit the room, I sternly said “you let him know that I want to speak with him before I am sleep and 5 minutes will not be sufficient.”
Once I was rolled into the operating room, my GI was sitting at a computer catching up on my chart. He spun around from his chair and said “can you tell me why we are doing this procedure today”? Livid at this point, I snapped “is that a joke”? The GI quickly replied “um, yes and no”. To which I replied “you tell me Dr.”. Caught off guard, he stood up and said “I was just making sure you were informed on why we were doing this.” I replied, “I am, now you tell me why we are doing this”. Visibly uncomfortable, he turned around to the computer screen and read me my medical history. Once he finished, I clapped and said “amazing”. I then continued “I am literally in disbelief that you think it’s ok to get up to speed on my chart and the reason for this procedure as I am laying here about to be put under anesthesia”. You can likely imagine how this conversation ended…but you will actually be surprised. I had lots of other words for the GI…I will never disclose them. But, when I finished he apologized and we had a productive conversation that left me comfortable enough to proceed with the endoscopy. In fact, our conversation left me comfortable continuing under his care.
Now, before I continue please let me say that I have the upmost respect for medical professionals. This includes doctors, nurses, nurse practitioners, techs, aides, environmental services workers and everyone else. However, I have zero tolerance for arrogance. Arrogance can cost someone’s life. These two doctors may be great individuals, but their flipid attitude could’ve caused major harm. If I would not have challenged the anesthesiologist, she could’ve missed my pain patch that I was wearing and other meds I was on. Yes, my words seem extreme…but in my opinion they match the ridiculous actions that sparked the words, which was the point. If my over the top reactions woke the doctors up enough to save a life…then I accomplished my goal. When both doctors checked into the situation, my demeanor softened and we had very productive conversations. I am all for speaking up and making sure my medical team is plugged into the situation at hand. But, I will NEVER advocate being rude and abrasive just for the sake of being difficult.