Wednesday, March 07, 2007

The lawyer tax

Deciding to have surgery is only the beginning of the process: Sure, you want the surgery... but does the surgeon want you?

This isn't a matter of likes or dislikes... we're not talking sorority rush here... it's a question of whether you're likely to survive the procedure: Can you tolerate the anesthesia? Will your heart seize up during the course of the operation? (If the anesthesia wore off, you're darn tootin' it would....)

And there was one thing that I for sure wanted. I tried to explain this to the surgeon: You'll recall the story of the three wise men sent to investigate the elephant. The problem with the wise men was that they were all blind... so the one man felt the elephant's side and thought it must be a building... but his colleague grabbed a leg, put his arms around it, and pronounced it a tree... and the third, feeling the moving trunk, determined that they had happened on a snake. Well, I wanted to make sure that this business in the colon was the proper focus of our our inquiry: I wanted to be certain we had the entire elephant in view!

Dr. P. was way ahead of me (once he finally figured out what the heck I was talking about); he'd already prescribed a full abdomen and pelvic CT scan. He was quite confident that it would turn up nothing new or unsuspected... but this would provide reassurance about this elephant thing.

All of these tests had to be done by the Monday before the scheduled February 28 surgery; otherwise the surgery would be put off.

So the CT scan was duly scheduled for Tuesday morning, February 20, and my physical for the evening of the same day. Dr. P. also specified an additional blood test he wanted the internist to run and, as luck had it, the internist has a phlebotomist available on Tuesday mornings for blood draws. So I'd go from the hospital to the internist's office for the blood draw... then to work... and back to the internist, this time with Long Suffering Spouse in tow, to get the physical and discuss the outcome of the CT scan and the various blood work.

With one predictable exception, it all worked without a hitch. I fasted as required for the CT scan, drank the required fluids at the prescribed times, and left the house within a few minutes of when I was supposed to leave... all because this was carefully overseen by Long Suffering Spouse.

I had no particular difficulty with the CT scan itself. Some people become apprehensive at being slid into the giant donut shaped machine. I, on the other hand, having been offered a place to lay down, am far more likely to sleep than fret about it. However, I'd been warned that when something -- a dye, I presume, or a reactive agent that turned the mass quantities of stuff they'd made me consume into a dye -- was 'infused' through my IV I might feel a strong urge to urinate.

Actually, I hadn't drunk so much liquid in so compressed a time frame since my nightclubbing days -- and the technician handed me still another dose as I sat down on the bed of the machine -- I thought I already had an overwhelming urge.

In this, as in so much else in the days to come, I was mistaken. Thankfully, the timely warning (both from the technician and from Older Daughter the night before -- she has a friend who's recently undergone this under far more serious circumstances than my own) provided me with just barely enough resolve to complete the procedure without committing a serious breach of social etiquette.

I left for the internist's office as soon as I could, pausing only to... well, I left as soon as I could focus on something other than finding the nearest comfort station.

I left so quickly, in fact, that I momentarily forgot my promise to Long Suffering Spouse. To induce her to go to school that morning -- she'd been reluctant to let me go by myself even when I reminded her she'd soon be taking lots of time off on my account -- I had solemnly assured her I'd call as soon as I was done with the CT scan.

It's not that I didn't remember entirely. It's just that when I got into the car, it was after 8:00. I didn't remember that she'd told me I could call until 8:15 when her first class came in; I just remembered that school starts at 8:00. It would be alright, I rationalized to myself; we'd talk during her lunch break and I'd fill her in then.

So I got my blood drawn and left the testing instructions for the internist so that he'd have them for our evening appointment. Then... I stopped home... it was on the way... and before pouring my morning coffee and hitting the road for the Loop, I stopped for a moment's private contemplation with the morning paper.

The phone soon disturbed my reverie. We have it rigged so an answering machine cuts in after the fourth ring, so I was unsurprised when the clanging subsided. I was surprised when the ringing immediately started up again. And again. The germ of an idea began to form... I did what was necessary to be ready to answer the phone the next time it rang... mere seconds later, as I'd reluctantly predicted.

I didn't say hello when I picked up the receiver. I said, instead, "I was delayed getting out of the CT scan. It was already too late to call when I got to the car."

Fortunately, I had correctly divined the identity of the caller without even a glance at the Caller ID. She had a break between her first class and her second, and she'd spent nearly all of it on the phone trying to find me.

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Long Suffering Spouse was talking to me again by the time we left for the internist's office that evening. The less said about the four missed calls on the cell phone or the blistering message on my office phone... the better.

The internist, for his part, was very upbeat... when we finally got to see him. We were shoehorned into an already busy evening call. We went through the requisite items on the physical in no time... and then Long Suffering Spouse moved the conversation to the outcome of the CT scan. Had he seen results yet?

Indeed he had, the internist said, and everything was fine. He pulled the chart open and read from the report. There were just these two little spots on the liver, he said. Tiny, he said, indicating with his fingers for emphasis. They're probably nothing, he said, which prompted the immediate question in my wife's mind: If they're nothing, then why are they mentioned? I don't think she vocalized this thought at that time... but I heard about it all the way home, especially after the internist suggested how we should investigate this by getting a liver ultrasound. Oh, and a chest x-ray for good measure, he added. I didn't answer my wife's question then.

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So I was back at the hospital Thursday morning for the liver ultrasound and the operator was becoming frustrated. She had a slight East European accent, presumably Polish, but maybe Ukrainian. She was not a rookie at her craft; she told me that she'd read my CT report and looked at the scan in preparation for my visit, but she was having difficulty visualizing the alleged spots. She took photos at various points in the exam; it seemed as though she were taking a number of them.

"How many photos do you take in the course of a regular exam?" I asked.

"Eight or nine," she answered, "or as many as I need."

"Do you edit the photos to a manageable number, or does someone else do that?"

"No, all the photos become part of the report."

"How many photos have you taken here so far?"

"Twenty," she conceded. "But I can not find these spots."

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Soon thereafter I was back in the car -- and, yes, immediately on the phone to Long Suffering Spouse. "So what are the spots?" she asked. "Did they tell you anything?"

I told her what I'd learned.

"So why did they make you go through this?" she asked.

My internist knows what I do for a living, I told her. It's not just him. They either won't touch you or they'll be extra special careful with you. It's just the lawyer's tax.

3 comments:

Lawfrog said...

LOL! The Lawyer Tax...so very, very true. A friend of mine from law school went into the ER one night when we were 1Ls. The doctor on duty asked her what she did for a living and she told him she was a law student. He then proceeded to tell her about the malpractice claims that had been brought against him and what did she think about the case based on his details.

No, I have no idea why he'd bring this up while examining her, but I thought it was funny.

Ellee said...

Take care, I hope you make a good recovery.

Patry Francis said...

Just stopped in and read the details of your ordeal for the for the first time. My good thoughts and Irish prayers are certainly with you. Your good cheer can only help--not to mention that feisty curmudgeon spirit!