Friday, March 28, 2014

The Yellowed White Coat

"They'll call when they call," M. informed me, her closed frown underlined by her streaming cold. This was unacceptable, not just because of the meaningless tautology of her non-response, but because M was the nurse sent out to attend to me. She interrupted herself and me several times to blow her nose, her belligerence rock like, a most uncompromising oncos, snarling like a Cerebus.

M. is the face of my nephrologist's office. The office has failed to file the necessary paperwork to follow the next step needed in care of my disease management. The office has been singularly deaf to my protests that I need no referrals or authorizations, that I had confirmed this with my insurance. It seems, as it was with my burnt house, I am doomed to fight for basic rights against an army of scrivening, sniffling bureaucrats, who treat me as though I am an annoying fly in their smooth ointment.

Today, M showed me forms I had filled in, which they had faxed to various people, with the word "URGENT" stamped on four drafts. However, recipients of those faxes are not concerned with what the nephrologist's office is supposed to do, and so these "URGENT" summons go unaddressed. My GP's office called me today to remind me that I hadn't seen them in months, and if I needed help with my kidney disease, I should talk to my nephrologist. Furthermore, if it was "URGENT" that a response be made, then it defies logic that the nephrologist's office refuses to follow protocol and address the urgency of the matter.

I called the nephrologist's office, but then they were closed. They are closed every week day between 12pm and 2pm, and there is no way to leave a message during those times. They do not answer the phones before 9:40am,  or after 3:30pm, so divine intervention would be needed if a caller worked from 9 to 5, even counting for the usual 12-1 lunch break. The only way to reach the office is to take time off from whatever useless profession one pursues, and just arrive, unannounced and unexpected, exhaling fire. Then there is much scurrying and a file emerges.

I asked to see the file, and the first thing that caught my eye was the name of the nephrologist attending my case; it was the wrong practitioner. I asked about it, and M covered the objectionable information with a swollen finger, stabbing at the word "URGENT" repeatedly instead in an excellent demonstration of the Red Herring Logical Fallacy that my Freshman Composition students would immediately recognize.

The doctor's office had drawn blood (after attempts on different arms, resulting in many bruises that spoke horrible lies about my tendency to addictions), but had failed to collect the results in time for my nephrologist appointment a couple of weeks later. The nephrologist is personable and interesting to talk to, and my office visit with him resulted in a rather pleasant conversation without much matter, since the relevant results were not available; it felt like a $35 tea without the tea.

Today, M condescendingly explained (as though to a rather slow four year-old in need of a nap) that without the blood work, there should have been no appointment. I asked her whose fault that was; M blew her nose noisily in response and went back to stabbing the "URGENT" on the file.

I asked, "Do you think that no one will notice if I should die or get really sick because your office did not file this? Why did your office not check if the results were received before confirming the doctor's appointment and assuring me that the results were, indeed, in?"

Her response, patient reader, deserves a concrete description. She stood with one hip jutting out to express her extreme boredom with the situation her virtues were tested in. She sighed and coughed in a single noise, blew her nose again, and cocking her head first northeast, then southwest, and finally northeast again to punctuate each word, she spat, "I don't know."

Then she escalated the voltage of belligerence in her glance and stance, and stared hard at me, pursing her lips so tightly that her lips completely disappeared and caused a little balloon to blossom underneath her flaring nostrils. Had I stayed farther, she would have been unable to stop the raspberry that was so obviously blooming.

Stress aggravates my disease, an obvious observation, considering the sudden plummeting of my health after my home burned. I regularly practice stress management techniques and common sense assures that my medical team's constant vigilance should decrease my stress. However, my dealings with my nephrologist's office might well have taken years off my life, negated many a meditation session and calm morning.

There is a vertical frown above my eyebrows. It reminds me of Shiva's third eye, the one that opens when Shiva becomes Rudra, the angry deity whose dance brings on the end of a world. However, unlike the god, I am of mortal flesh and do not have the skill to the burn a world without killing myself first. But I know the shape of that third eye too well. If I could control mine, it would burn off the consummate indifference and its attendant belligerence radiating from self-aggrandized care givers who remain convinced of the need to keep the sick from their hallowed halls, to keep the diseased fettered in reams of indefatigable bureaucracy.


  1. I'm so sorry, Mommy. I wish I could help somehow :(

  2. I am convinced that our Third World country is much advanced in serving the patients than the arrogant First World country. I am horrified to know how efficient your nephrologist's office is. You must send this experience to the Medical Council and ask them to take some action against such offices. I am so sorry to read about the torture that you have to suffer. I wish, in course of time, you are able to find a better nephrologist and a more efficient office to work with.

  3. I am late to reading this, and late to wishing that I could alleviate every stress you suffer! But regardless of timing, I do wish I had the magical power not to burn a world, but to restore you to vibrant health.