Today, Not Feeling Well can Make you Sick

By Roy Klein

The long winding road to seeing a doctor is fraught with voice mails, long waits, and of course, Dr. Clueless.

The 1958 bellyache

Once upon a time (around 1958), a little boy (me, of course) awoke one Saturday night with a bizarre tummy ache. It was worse than one of your average, run-of-the-mill tummy aches. But it wasn’t so severe that my parents considered rushing me to the hospital. Instead, they did what any parent would have done – they picked up the phone and called our family doctor.

My family doctor

Within an hour, he showed up. At our house! Carrying a little black bag containing everything necessary to treat me. He even trudged up the stairs to examine me right in my own bed. Within minutes, he had diagnosed me, prescribed a course of treatment and given my parents his prognosis – I would be fine by Monday morning. And I was.

Last year, (2007) a bizarre stomach ache on Saturday night

This memory came to mind last year when I returned from dinner one Saturday night with a bizarre stomach ache. It was worse than one of your average, run-of-the-mill stomach aches. But it wasn’t so severe that I considered going to the emergency room.

I called my family doctor. Ha!

Instead, I called my family doctor – who, after brief stints as a general practitioner, internist and HMO gatekeeper, was now known as a primary care physician (“PCP”). His voicemail message stated that he was away for the weekend and gave me the number of a covering doctor, whose name was unfamiliar to me. Still, I called that number and left a message with his answering service.

The half asleep covering doctor

Two hours later, the clearly annoyed covering doctor, sounding half-asleep, called back, listened to me describe my symptoms and suggested that I either go to the emergency room or wait until Monday and make an appointment with my doctor. Being the patient, I listened patiently and decided to forget about it and go to sleep.

Sunday, the emergency room

When I woke Sunday morning, though, my stomach still hurt – not a lot, but more than a little. So I decided to go to the local emergency room. There, the very bored triage nurse evaluated me by asking me to describe the location of my stomach ache (“my stomach,” I dutifully replied) and whether the pain was sharp, dull, burning, radiating, constant, intermittent or spasmodic (“yes,” I answered). Then she wanted me to measure my pain on a scale of one to ten. I didn’t have a scale with me, but I estimated the pain at 5.0136

Waiting and waiting in the waiting room

Apparently satisfied with my responses, she dispatched me to the waiting room, where I waited. And waited. And waited some more, while all manner of maimed and injured customers limped and rolled in. Finally, they called me inside, where I waited, and waited, and waited until the resident (who I swear was about 11 years old) came in to ask me the identical questions that the triage nurse had posed.

The “pressing the stomach” examination

Then, he gave me an “examination” by pressing on my stomach, followed by an argument: “Why are you here? This isn’t an emergency.” I apologized, saying that my doctor had told me to come. Seemingly satisfied by that explanation, the resident sent me off for an x-ray. Strange, I thought, since there are no bones in my stomach. Not surprisingly, the x-ray came back negative and the resident released me, telling me to follow up with my PCP.

Monday, following up with my PCP

On Monday, my stomach still hurt, though the pain might have lessened a little (to around 5.0114), so I called my doctor for an appointment. The receptionist told me that the first available opening was two weeks from Thursday. “But my stomach hurts,” I whined. She asked if it was an emergency, so I lied and told her it was. “Then go to the emergency room,” she said. I grudgingly took the appointment.

Waited 2 weeks for an appointment

Over the next two and one-half weeks, I couldn’t tell if I still had a stomach ache or if my mind was playing tricks on me. Every time I considered canceling the appointment, it seemed like my stomach started hurting again. So I decided to keep the appointment.

Three other patients had 11:15 appointments

When the day finally arrived, of course, my stomach felt fine. Still, I didn’t dare cancel, just to be safe. Instead, I showed up five minutes early for my 11:15 appointment, only to find the waiting room full of patients. Three of them also had 11:15 appointments. The others all had earlier appointments. The receptionist estimated my wait to be at least one hour. I guess they don’t call it the waiting room for nothing.

Does any other business in America operate this way? Would you make an appointment for a specified time with any other professional – like a lawyer, accountant, insurance agent, financial planner – and tolerate having to wait for hours? Of course not. But somehow, doctors get away with it.

A sea of coughing, sneezing, wheezing and oozing humanity

Anyway, the waiting room was hot and cramped, without any windows or ventilation. It was a veritable petrie dish for infectious organisms, populated by a sea of coughing, sneezing, wheezing and oozing humanity who looked like they were at Lourdes, hoping for a miracle. If I wasn’t sick now, I certainly would be soon.

The doctor will be in “shortly”

After exactly one hour, I was finally called into the inner sanctum. Now we’re cooking. The nurse escorted me into an examination room and asked why I was there. When I told her, she instructed me to take off all my clothes and put on a gown. “For a stomach ache, I inquired?” She rolled her eyes and said that the doctor would be in to see me shortly.

“Shortly” means 45 minutes

In medical parlance, “shortly” apparently means in about 45 minutes. By the time the doctor showed up, I was so aggravated that my stomach hurt again. The doctor asked me how long I had had this pain. When I answered that it was nearly three weeks, he became visibly upset. “You should have come in sooner.” This moron had no idea how his own office operated.

See a gastroenterologist.

After examining me by pressing on my stomach, he concluded that it was probably nothing but that I should arrange to see a gastroenterologist. The first appointment I could get was in two weeks from next Tuesday. Of course I arrived to find a roomful of waiting patients. I didn’t have to wait this time, though.

OMG, no referral

That’s because I had neglected to get a written referral from my PCP. So I called him for one. But his receptionist told me that it was not the office policy to issue referrals by phone. I would have to make an appointment to see the doctor. I scheduled one for two weeks from next Thursday.

My doctor, Dr. Clueless

Naturally, on the appointed day I waited the obligatory one and three-quarter hours before the doctor came to talk to me. “What did the gastroenterologist say?,” he asked. “I haven’t seen him yet; I’m here for a referral,” I patiently (ever the patient) answered. “Why didn’t you just call the office for one?” Excuse me, Dr. Clueless, but do you ever speak with your staff?

Gastroenterologist recommends a colonoscopy

Armed with my referral, I made an appointment for the specialist two weeks from next Tuesday. He proved to be more efficient than the PCP. I only had to wait for an hour. He examined me by pressing my on my stomach and concluded that it was probably nothing, but that I should go for a colonoscopy. Because I needed pre-authorization from my insurance company for this procedure, it couldn’t be scheduled for three months.

Preparing for the colonoscopy. Don’t ask!

I’m not going to discuss in detail the home preparation required for the colonoscopy. Suffice it to say that, after fasting for a day, you drink a gallon or so of the worst tasting liquid known to man, which causes symptoms far worse than any stomach illness you’ve ever had. After that, the procedure itself is a relative breeze. In my case, of course, my colonoscopy confirmed that I was perfectly healthy.

Seven months later, a conclusion

So it only took seven months for today’s medical experts to reach the same conclusion that my boyhood doctor came to after a five-minute house call. Still, it was comforting to finally know there was nothing seriously wrong with me. I found out on a Friday.

The next day, a bizarre headache

The next day, I awoke with a bizarre headache. It was worse than one of your ordinary run-of-the-mill headaches. But not so bad that I’d consider going to the emergency room. <<

For other articles by Roy Klein visit his website www.RoyKlein.com. For further information on Roy visit the websites for his law practice (Loorak.com) and his arbitrator/mediator practice (Limacs.org).