I just want to say that after working so many years with the emergency department and after having read so many medical blogs I can appreciate that this doctor may have been having a bad day. I know there are patients who use and abuse the system. And yet... sometimes patients are given labels they don't deserve. And I know I presented somewhat unusually and perhaps that colored this doctor's opinion...I don't know. I do know I went in to that office for help and left feeling worse than when I went in...and THAT is saying a lot. Not only was I still ill with what caused me to go in there in the first place, but now I was emotionally wounded as well.
My exam table was in the center of the room and so I think added to that free falling feeling. If it had been near a wall I might not have felt so dizzy, vulnerable to falling or sick. I chose this picture because the sloppy, jaggedly torn paper just left hanging is symbolic of how I felt after being examined by that doctor.
One day back in March 1992, I had an appointment with a counselor I had been seeing on and off for awhile. (This was an extremely stressful time in our lives because of a legal case my husband was wrongfully involved in and at that time had already been going on for seven months.) This doctor was wonderful! He was so good to me and really cared about me as a patient. He was always accessible by phone and if he couldn't talk then he called me back. He always welcomed my calls. He often scheduled me as the last patient at the end of the day because he gave me extended time for which he never charged me. He did participate with my insurance and took my balances too. Although, sometimes I was not able to pay and so was going to drop out, but he told me not to worry about it. One day while on the phone with him, I asked him how much money I actually owed because it was a couple of years worth at that time. He chuckled and he said, "Oh-h-h...an amount somewhere between the cost of a used Volkswagon and a Porshe." I pressed him for how much and he said we'll talk about it but he never did tell me. Obviously this is not the awful doctor who treated me so terribly. Someday I will write a post about this terrific Doctor and the benefits of counseling if you are fortunate enough to work with the right one.
After I left this appointment, I was headed back home when out of nowhere I got this hideously strong and bad migraine. I hadn't had one since my first one in 1987. One second I was fine and the next bam! Not only was the head pain excruciating but the nausea was overwhelming.
I was only a few miles out from his office when this all hit and was coming up on a stretch of road where there are a lot of doctor offices. I just wanted to get home which I am guessing was about 9 or 10 miles away at that point, but I was trying...desperately trying to get there. Then my fingers began tingling as I was trying to steer the wheel and I must've been hyperventilating because I felt that I was going to vomit any second and I felt like I was going to pass out. I was really scared and didn't know what I was going to do and I was thinking that I needed to get help.
There were two medical buildings next to each other and so I did a Mario Andretti turn into the first parking lot, parked the car and flew inside. I immediately ran right up to the reception area and asked to use a bathroom because I was going to be sick. I barely made it in there and sure enough it was quite eventful!
Finally, I was able to wash up a little and went back to the desk and asked to be seen. They wanted to know if I was ever there before and I said not in a long time but I couldn't think how long because my head hurt so badly and I said I had to go sit down.
Someone brought over a clip board with an information sheet to be filled out. I did it but just barely and was very close to lying on the floor when someone came to bring me back into an exam room. I got up on the exam table but then the little room started to feel like it was spinning and the nausea was exacerbating.
I know this next part is going to sound weird. I get that, but I honestly could not help it.
The nurse began asking me questions but I urgently interrupted her to tell her I had to lie down on the floor because being upright was causing me to feel dizzy and I felt like I was going to vomit again. She instructed me to lie back, I complied, but by then I just felt dizzy being up in the air on the exam table and stated that I had to go lie down on the floor. I then got off the table and headed straight for the carpeted floor. I was on my side with my back against the wall and behind the door. She gave me one of those little basins in case I got sick because at this point I felt like I couldn't move. My head was still pounding.
Anyone that knows me, knows I can be quite the little germaphobe and my hospital coworkers used to tease me about throwing out the bloody pens. (I'm not bad-just cautious in medical/bath and cooking environments) There is no way in God's creation I would ever choose to lie down on the floor in a medical environment, but it was a matter of survival. Those thoughts didn't even occur to me at that time.
The nurse was very compassionate. I answered her questions with my eyes closed. I don't know why...but it did help to be on the floor. Then she tried to take my blood pressure but couldn't get a reading with me so low on the floor, so she had me sit up and it still didn't work. She said I was too low and that I would have to get back up so she could take the BP. I got back up on the table and as soon as she was done, got right back down on the floor again. I just stayed real still with my eyes closed.
Then the doctor opened the door to come in, she cautioned him and said that I was down there behind the door. He said something about almost hitting me in the head. And he told me I had to get up on the exam table and so I got back up on it again.
When I saw who it was I felt relieved. It turned out he was the second doctor I had up here. I started with him when I was 15 and stayed with him until just before I got married in the fall of 75. I was 20 the last time I saw him. We had a terrific rapport all those years. Not that I saw him much, but you know routine stuff... flu, bad colds, poison ivy...that kind of thing. He was very happy for me when I told him I was getting married. However, after I got married...I never went back to him. I rarely got sick and when I did, I just went to my husband's doctor who was right near by. I didn't feel any sense of Doctor-patient loyalty, but I was in my twenties. It just never occurred to me.
During the exam I briefly explained what was going on about the case and resulting stress, that I had just come from counseling and was on my way home when this migraine hit. I told him about my symptoms leading up to that moment. He finished his exam and turned his back to me to write in my chart which was on the counter. The nurse was doing something by his side but I don't recall what. They both had their backs to me.
I told him that I was sorry but that I had forgotten my wallet and my insurance card was in the wallet. I said that I had my checkbook though.
With that he turned around and eyes as cold as steel, with utter disdain said to me, "Is your check gonna BOUNCE?" At that point he might as well have plunged a knife into my heart and ended my misery because not only was I so sick and in pain but now he was treating me like a lowlife. He was not the warm, friendly and compassionate doctor I once knew.
I meekly said "No...the check won't bounce." With that he turned back toward the counter, then looked over to the nurse and said, "Cancel that shot!", to which she responded with, "What?" and he again barked "CANCEL THAT SHOT!" She then said, "I thought you were kidding." "NO I'm NOT!" Then he turned to me again and said, "You don't come in here for 17 years (don't know how he knew that but he was right) and now think you can just come in here without insurance and money?!" And then he bolted out the door. I can't even express how embarrassed and hurt I felt. I was thinking he thought I was some lowlife scum not worthy of his respect.
I went back down on the floor. The nurse asked me if anyone could pick me up and she called a friend for me. The doctor came back in but I didn't look at him. I just kept my eyes closed. I don't remember what he said to her but as he was exiting the room he said in frustration, "Why do these things always happen to me on a Thursday?!" I would've given anything to not be there...but it was what it was.
The nurse sweetly said I could stay on the floor until my friends arrived. That was a good thing because I really couldn't do anything. She came in to get me and gave me the script for Darvon and a big garbage bag when my friends arrived. I told her we would be back to get the car in the morning.
My head was still hurting so much and I was vomiting into the garbage bag. My friend's poor husband was driving with the window open. Not a fun ride for any of us that is for sure.
I was never so happy to see my house. My husband was home with the boys but couldn't pick me up because the other car was at the mechanic's garage. I don't remember who got the Darvon, if we stopped at the pharmacy before they brought me home or if he went back out for it.
It didn't work! The Darvon did absolutely nothing for me! I knew from my first migraine experience all I needed to do was fall asleep. (I remembered that the first time I ever got a migraine was 7 years earlier when in desperation I called one of the ER docs I worked with and he asked me if I had any Benadryl in the house. Yes-I did. He said to take 50mg because I just needed to relax and fall asleep. It worked!) So I asked my husband to buy some Benadryl, I took it, fell asleep and woke up feeling fine. Very embarrassed and hurt at what had happened, but most importantly ...I was fine.
The next time I went to work, I told the ED staff what had happened. They were appalled! The ED doc said, "If he was going to withhold treatment on you...I'm surprised he didn't just have them call an ambulance to take you to the hospital." They also thought I should go back to complain.
I never did though. I just wanted to put the whole miserable experience behind me.
You know...I do realize that I didn't present very well to him with my being on the floor like that. I can honestly say that in my twenty years working with the emergency department, that I never once saw am emergency patient on the floor because they were too sick to be in the bed. I get that it looked absurd. If it was a full bed with railings...I would've been fine, but I had this really dizzy, spinning sensation and felt like I was going to fall off because I was going to pass out. That never happened to me before or since then.
Also, about presentation...I was dressed professionally- a suit, nice heels, make-up and hair were all good. I was Clean. I say that because I really felt judged as not being worthy of his effort like I was just trash. No one deserves to be treated that way and certainly not when they sincerely come to you for help when they are sick and in pain. I didn't know he would still be working there. I just had to turn off the road right then and even if it was a grocery store...I would have bolted inside. I needed to get help right then. Ha! Maybe that would've been better because they WOULD HAVE called an ambulance and I WOULD HAVE gotten the help I needed.
And I have since wondered about his remarking about my not coming in for seventeen years. Was he mad at me for that? Did he take it personally? Why even say that? I feel he completely over and under reacted. Is it because in his mind the fact that I mentioned a legal case and I mentioned counseling and I was on the floor that he wrote me off as a loser of sorts? If that was the case...he was so off base, but I'll never know.
I am proud to say that not once, not ever in my 20 years working in ED registration did I ever treat any patient badly. I don't care if the patient was well to do or a dirty homeless person...I always treated (still do) people with compassion, dignity and respect. You know...there is a saying..."But for the grace of God, there go I." I am not saying I agree with lifestyle choices and abuses of the system and every patient certainly isn't wonderful. But I do think that people should be careful how they judge others because unless you are walking in their shoes...you really don't know what is going on in their lives. And I am not condoning the behavior of obnoxious patients...they do need to know that their bad behavior is not appreciated and won't be tolerated when applicable.
Maybe I should have gone back and requested to see the doctor. Just to politely, yet assertively let him know how hurt I felt. I thought about writing a letter to him but just decided to let it go. Shoot! Some people would probably sue over something like that...but that is sooo not me. People make mistakes and boy did he...but I never wanted to hurt him AND... I never wanted to go near the place again.
He had white hair when I met him and he still had the same white hair that day. I am guessing he has long since retired. And I am guessing his Thursdays must've been one hell of a bad day! Kick the dog and all that.