(This column is for some of Bend's medical practitioners - and for any of you who have experienced insulting behavior as a patient. If you recognize yourself in this story, be you patient, client, nurse, physician's assistant or doctor, consider the implications - and the Hippocratic Oath.)
We'll call my friend Jenny. She's a smart, funny and hugely brave woman. For years she has been in pain from a torn tendon. It was once manageable, is now excruciating. She has done everything possible to find help.
After years of surgeries, massage, exercise, therapy and holistic treatment, she has finally been told that the torn tendon will not respond to anything but ashoulder replacement - and shoulder replacement is not currently a reliable procedure. She will need to have steroid injections four times a year for perhaps a decade - and they may provide negligible relief. She has also had to deal with the whims of the health insurance vampires.
Jenny is now furious. Not with her pain, but with the treatment she recently suffered from a health "care" practitioner. She had been referred to a local pain expert for a steroid injection. She told the doc that she'd had a series of shots in her shoulder from Platelet Replacement and was concerned that her pain would increase. He assured her that it wouldn't be a problem. The injection was excruciating. She immediately felt shaky, cold and nauseated. After the treatment she sat in the lobby crying, then vomited in the women's bathroom. For several days she felt deep bone pain, clammy, and continued to vomit.
Four days after the injection, Jenny called the doc's office and told them that she was experiencing severe pain, weakness and nausea. The woman who answered said, "You should have waited at least 1 week after the injection to call, since sometimes it takes that long for the shot to take effect."
Another four days later, Jenny called the doc's office again. When she hadn't heard back after over an hour, she went to work, then drove to the doc's because she was afraid of facing the long weekend ahead without help. Her next appointment was in early October. Jenny told the receptionist that she was in severe pain and needed to see the doctor. She began to cry. A call was made and she was sent to the waiting room.
A nurse who shall remain nameless came out. "I called earlier," Jenny said, "I'm in severe pain and frightened of spending the holiday weekend without help. I can't lift anything, can't use my arm." The nurse said she'd called back and left a message, and that the doctor didn't prescribe pain medication.
"A physiatrist," Jenny said, "a pain specialist, doesn't prescribe pain meds?" The nurse coldly said no. "If you felt this pain," Jenny said, "you'd be more responsive." The nurse told of instances where she'd had severe pain in her arm, and how her daughter had experienced it too while in a wheelchair.
Jenny got mad. The nurse said she should have called her referring doctor. The physiatrist couldn't prescribe anything since he wasn't scheduled to do Jenny's intake until Oct. 4th. She told Jenny that some patients experience steroid flare after an injection, but that the physiatrist could do nothing, and Jenny should have called the referring doc, who was out of town till after the weekend. Jenny asked the "nurse" how she could have known to call the referring doc if no one told her the rules. "I'm telling you now," the "nurse" said.
Jenny asked for the nurse supervisor, who asked her what the problem was. "I've been trying to reach the physiatrist because I was having severe pain and nausea after the steroid injection he'd given me a week prior, and the nurse told me he couldn't prescribe pain meds for me." The supervisor said that wasn't right and took Jenny to the receptionist for an immediate appointment with the on-call doc.
"It's crazy and cruel," Jenny told me recently, "that I was not given the information that could have saved me over a week of devastating pain. Something is broken in our medical care system - and it isn't us patients."
- Mary Sjourner