Sunday, December 14, 2014

Dr. Hackenbush! Calling Dr. Hackenbush!

Originally published back in the holiday season of 2008, shortly after our summer discovery that my prosthetic shoulders were harboring pathogens, this piece returns as a 2014 holiday tribute to the medical nitwits currently in my life. Among the nitwits this go-'round? Auxiliary personnel in the billing department of the same hospital depicted below. Also, the various board-certified neurologists who are gleefully passing the buck to their neurosurgical colleagues. Again, this is a repost, Dear Reader, as the Surgical Shoulder Wars are now ended, the bacteria having defeated even the inimitable and marvelous Doctor ShoulderMan.  But the hilarious conversations with medical professionals continue, even if the laughter has become markedly insincere.


Fred drove through driving rain and piles of slick wet leaves late yesterday (early for us!), so as to get me to the pre-admission registration process at the hospital -- before they stopped taking patients for the day.

No problem. Ruby the Honda CR-V putt-putted happily, veering down the hilly streets, passing the elegant homes on the tree-lined way.

We even managed to snag the premier gimp parking space, and this at a parking deck notorious for being full -- and gimp spaces usually taken by remarkably spry looking folk, and cars without placard or "disabled" license plate. Okay, okay, the correct line is supposed to be something like: "You can't tell by looking!" (Shit, you sure can... It takes a gimp to know a gimp.)

So, Dear Reader, what am I supposed to do when, despite my best efforts... Okay, okay, jeez, you are a tough one, Dear Reader. What am I supposed to do when, after a few lame attempts to keep things on the straight and narrow, the nurse in charge of registering me for Monday's major surgery makes mistake after mistake?

Here is a sample of our stellar communication, verbatim:

The Nurse: When did you last have an EKG?
Me: In August, the last time I was here.
The Nurse: And when was that?
Me: In August.
The Nurse: And where can we get a record of that?
Me: Ummm, here? In my medical records? (See? She managed to get to me -- my "intonation ascendante" is a dead give-away. Ar! I used to get hit on the head with a ruler whenever my "intonation ascendante" gave way. What was that dear old teacher's name? I can't remember, in large part due to his pedagogical concussing, but I loved him.)

[Choo choo! Train of thought! Choo... Back to the scene of the crime... ]

Me: Ummm, here? In my medical records?
The Nurse: Hmmm. Maybe in your medical records.

Then we tried to exchange the information about my last echocardiogram. Should be simple enough. Doctor's name, address, phone and fax numbers, date of the test.

And I have to say that it sort of mattered a lot to me for this information to be correctly received, given that they discovered an aortic arch aneurysm via that test. I had even had a serious bout of chest pain the night before, during which I was unable to banish the thought that, well, "this could be it." I made it from the bed to the wheelchair and then out to Fred's office, and he got me the under-the-tongue stuff. Three of those, five minutes later, I was fine. Still. I cannot banish that fear, not entirely. And so, I faced The Nurse full of conviction in the wonderful potential of our communication skills.

The Nurse: Where was the echocardiogram performed?
Me: In Dr. Rosenstein's office, as an outpatient. He's in the Doctors' Building over at St. Mellifluous. Anyway, it was August 22. 9:30 AM. It showed my usual aortic insufficiency due to a congenital bicuspid aortic valve. Oh, and they found a... dilation... of the aorta, where the aortic arch attaches... so, yeah, that's Dr. Rosenstein, over at St. Mellifluous. His phone is 555-555-5555 and, surprisingly, that doubles as his fax.
The Nurse: Well, I don't know what to do.
Me: Pardon? Can't he just fax the report to you? That's 555-555-5555...
The Nurse: I hate to be the one to break it to you...
Me: What? Break what to me? Does this mean I can't have the surgery Monday? They went ahead back in August, just 3 days later, on the 25th... Why is it different this time, why? [Blither and blather, generalized anxiety bursts loose and flies around the room, backward.]
The Nurse: Dr. Schrödinger passed away last week.
Me: Who is Dr. Schrödinger? He did?
The Nurse: It was very sudden, a massive heart attack. I am sure all of his patients must be terribly upset.
Me: I'm sorry for your loss? [And there it is again -- she's screwing with my intonation encore une fois, de nouveau.]
The Nurse: So I don't know what has gone on over at his office -- hmm, maybe the staff can dig up your records. I'll give Judy a call.
Me: Judy? No, no, I think we have a misunderstanding. My cardiologist is Dr. Rosenstein. And his nurse is Linda...
The Nurse: Well then, why did you bring up Dr. Schrödinger?

It was a rough afternoon. I will say this for her -- she got my blood on the first stick, for which I remain grateful. A few things worry me -- for instance, she didn't give me the red arm band I usually get -- it has something to do with blood, the blood bank?

Wow, even away from her, she screws up my intonation, long distance.

Also, I did as instructed by Dr. Boutiqueur, and emphasized my need for stress-dose steroids (adrenal insufficiency) pre-op -- intra-op -- and post-op! I don't think it was even received by any of her grey cells. "That's okay," thought I, "I will just bring it up again when I speak with anesthesia."

Except -- I did not get to speak to anesthesia, despite the fact that my intubations have been difficult
-- to the extent that, at this same facility, back in 2005, they broke three of my front teeth trying to get the damned tube in. Yes, that's right. I have had a slight attitude about their anesthesia department ever since. They paid for the dental surgery, and for the very creative partial that had to be created. But I forgot to make any arrangement for the FOUR other partials that have had to be made. Some major, and ill-afforded, pocket change has been thrown at what looks to be a never ending problem.

Also, the good anesthesia rep is supposed to tell me which of my many meds I can take come Monday morning. The Nurse asked me to take whatever I "thought was right." Okie-dokie. So I am going to dig up the green folder from my orthopedic surgeon's office for the last go around, in hopes that I have the notes from the anesthesiologist about meds.

Because I've a sneaking suspicion that what "I think is right" is probably wrong.

I wonder who it was who cleaned out all sorts of unnecessary paperwork from my office a few months back? Ar! Must have been the same idiot who thought ShoulderMan victorious in the Shoulder Wars.

In summation [Oh, sit down and stop clapping.]: Major confusion about the tests done back in August, and from where the results can be obtained -- and whether the ordering physicians are even alive; no blood being readied for surgery, despite the fact that, back in August, I had a hemoglobin of SIX after surgery; no interview with anesthesia about stress-dose steroids and historic difficulty with intubation.

She jumped all over the MRSA in the nares issue, though. Thank goodness. Whew. What a load off...

Good grief! I got MRSA at the hospital to begin with, and the Fredster absolutely refuses to don the yellow dress and blue gloves -- not only do they offend his fashion sensitivities, but he overheats. There is also a tendency on my part to NOT ask for nursing assistance when I really do need it -- I hate to make someone get all that isolation gear on for what can seem awfully minor (bedpans, pain meds, help turning -- hey, you try it without using your shoulders/arms!).

So this weekend, my ID doctor has prescribed some antibacterial ointment that I am to stick up my nose. Excuse me, up my nares.

My question? If this antibacterial ointment kills the MRSA... why is it considered resistant to antibiotics -- or even at all virulent?

I forgot to mention that The Nurse's understanding of CRPS/RSD, which initially seemed quite promising, ended with her asking about the acronym: "How do you get 'RSD' out of rheumatoid arthritis? I usually say 'RA.'"

Me, too, when I am talking about rheumatoid arthritis!

Calling Dr. Hackenbush, calling Dr. Hackenbush!
(Below, please find the lyrics to Dr. Hackenbush, a musical number that was dropped from A Day at the Races due to concerns about the film's length.)

So this is Dr. Hackenbush, the famous medico,
You're welcome, Dr. Hackenbush...

If that's the case, I'll go

Oh, no, you mustn't go...

Who said I mustn't go?
The only reason that I came is so that I can go.

I'm Dr. Hackenbush,
My medical standing's very high,
Well, anyways, ladies and gentlemen, I
am Dr. Hackenbush

He's Dr. Hackenbush...

I'm Dr. Hackenbush,
As a matter of fact, to be exact,
I'm Dr. Hackenbush!

I'm sure that they'd all like to hear,
Some facts about your great career

Although my horn I hate to blow,
There's one thing that you ought to know:

I'm Dr. Hackenbush
Which all my friends will verify
Well, anyways ladies and gentlemen, I
am Dr. Hackenbush

He's Dr. Hackenbush

I'm Dr. Hackenbush,
You never would guess, but nevertheless
I'm Dr. Hackenbush!

For ailments abdominal, my charges are nominal
Though I'm great for I've a rate for tonsillectomy,
Sick and healthy, poor and wealthy, come direct to me
"Oh, God bless you!" they yell
When I send them home well,
But they never, no they never, send a check to me.

I've won acclaim for curing ills, both in the north and south,
You'll find my name just like my pills in everybody's mouth;
I've never lost a case...

He's never lost a case...

I've lost a lot of patients, but I've never lost a case!

My diagnosis never fails, I know just what to do,
Whenever anybody ails, I'm sympathetic too,
My heart within me melts...

His heart within him melts...

No matter what I treat 'em for, they die from something else.

When your nerves start to rock, put your faith in your doc,
When you're sick he will stick to the end,
With the possible exception of your mother,
A doctor's a man's best friend!

Yes, a doctor's a man's best friend!

A doctor's a man's best friend, whoa-oh,
A doctor's a man's best friend,

A doctor is a man's best friend!

Right or wrong, wrong or right,
Night and day, day and night,
On his call you can always depend;
With the possible exception of your mother and your father
And your uncles and your brothers and your nephews and your nieces
And your sisters and your cousins, whom you number by the dozens...

A doctor's a man's best friend!

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