Posted by: notdeaddinosaur | August 5, 2011

Great Pun-ishments

You want to see mad? I’ll show you hissing, spitting, pissed-off M*A*D.

Take a self-employed 45-year-old attorney with a symptomatic inguinal hernia. Schedule his hernia repair with the local friendly neighborhood surgeon at the local friendly neighborhood hospital. He spends the next two weeks re-arranging his appointment schedule, his court cases, everything he needs to do to be out of commission for the surgery and recovery.

The day before surgery, he receives a robo-call from the hospital telling him to arrive at 11:45 am; his surgery is scheduled — tentatively, of course — for 1:15 pm. Oh well, he figures; half a day wasted, but worth it to finally get his hernia taken care of.

He arrives at the hospital at 11:15 with his long-suffering wife, who’s vowed to stay there with him through the whole thing. He’s all pre-registered, so at 12:05 he receives his plastic wrist band identifying him as a patient and is told, “The next time you’re called, you will be having your procedure.” He relaxes with the paper, and waits. 12:15 comes and goes; then 12:30. Was the 1:15 scheduled time supposed to be the surgery start time, or did it include all the pre-op stuff?

Now it’s 1:30. 2:00. Somewhat abashed, he sends his wife up to the desk in front of the admissions lounge to make sure they hadn’t forgotten about him. They have not. His surgeon is merely running behind.

At 2:30, a very nice lady in maroon scrubs and a floral shower cap comes out and greets them apologetically, introducing herself as the OR coordinator. They are running way behind schedule. They’re not sure precisely when he’ll have his procedure. They might be able to get him up to start prepping him by about 3:30. Since it’s getting so late, might they have to postpone? No; she is quite certain about that. He will definitely have his surgery today. Not first thing tomorrow morning? No, the surgeon doesn’t have any OR time then. But if they give her a cell phone number, they can leave the admissions lobby. Maybe let the wife have some lunch. Not him, of course; he’s still NPO, fasting before anesthesia. Still, they are grateful just to get out of that room, where by now every other patient who arrived after him has already been taken.

They find a cafe where his wife buys herself a chicken parm sandwich. He is headachy from the fast, but doesn’t begrudge her the meal. At the rate they’re going, he won’t be out of recovery until 8:00 or 9:00 pm, so she’ll be in for a very long day. He, after all, gets to sleep through the hard part.

They return to the admissions lounge around 3:00. 3:30 comes; 3:30 goes. Then, at 3:40, the magic call at last: report to the fourth floor Ambulatory Procedure Receiving unit.

A very nice clerk records the wife’s name and cell phone number. Once more, he is told to sit and wait, though in short order he is called back to the preop area of curtained cubicles, given a shower cap, booties, garment bag emblazoned with the name and logo of the local friendly neighborhood hospital, and a gown, with the requisite reminder that it opens in the back, and told to remove all of his clothes. But wait! Someone else sticks her head around and says, “No, the doctor wants to talk to him first.”

He sits on the stretcher, wondering what time it is. Eventually he sticks out his head and asks the first passing person, “What time is it?” The answer: 4:00 pm. Other heads crane around the curtain from time to time, none of them his doctor. At length, one of them offers to bring his wife back. He accepts. He now has a serious headache, and his anxiety about the lateness of the surgery is waxing. He wants the surgery over and done with, but he’s getting more and more worried about being operated on by a surgeon who’s already done eight hours of surgery that day, and being cared for by tired nurses changing shifts in Recovery.

Now it’s 4:30, and his mind is equal parts blank and frantic.

4:45. What the hell is going on?

5:00. At last, it’s the surgeon…telling him that it’s too late to start his surgery, and they’ll have to postpone it. First thing tomorrow morning, he asks hopefully? No, he only operates on Tuesdays and Wednesdays. It will have to be next week.

The wife drives them home, wisely keeping silent as he rants and raves on his cell phone. Friends and family, insistent on email updates, must now be notified. The schedule of clients, depositions, court dates, all must be re-shuffled yet again.

He breaks his fast with a martini, and goes to bed at 9:00 pm.

Amazingly, by morning he has regained some of his composure. His secretary, who moonlights as a miracle worker, has managed not only to clear the following week for him again but has even managed to book some client appointments for today. He’s still pissed and his hernia still hurts. But he’s ready to laugh.

So when he gets a call from a friend who hadn’t seen the email “Postponed!” asking how it went, he can now say, literally:

The surgery yesterday? There was nothing to it!

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Responses

  1. Interesting tale and not all that unusual. I’ll resist the urge to wisecrack about the fact that the patient was a lawyer but will point out that many a doctor has been inconvenienced by lawyers changing deposition dates, dragging out depositions and trials with irrelevant questions, etc.

    However, I don’t understand why 5 pm is too late to start a hernia operation.

  2. Stories like this are why fees to patients who miss appointments drive me crazy. I get that an unexpected hole in the schedule is costly to the practice. However, there is no reciprocation. If a doctor keeps me waiting 3 hours for an appointment (it’s happened) or as in the case of this attorney, there is no thought to compensate patient for economic harm caused by the delay.

  3. I’ve thought for a long time that there is no thought given to the value of the patient’s time in many medical situations.

    I recently was scheduled for cataract surgery, both eyes, two weeks apart. This was set several months in advance, and I arranged my commitments to suit.

    The second surgery was moved on short notice due to a vacation for the surgeon, and they were absolutely inflexible on the reschedule…a take it or wait months situation. The ensuing rearrangements in my schedule involved inconvenience to about fifteen people, not just me.

    I’m inclined to believe that some schedule slippage is part of the process for office visits (although some physicians seem to keep well to their schedules, some not so much). But really, there needs to be some consideration of the value of the patients time also.

  4. I’m a dentist and just started reading this blog 🙂 I’m a fan! hah.

    I can see your point about “the patient’s time is not respected.”… although in my experience, I have to say that sometimes a procedure can take more time than I expected, or maybe there was an unforseen complication and it takes extra time to deal with it.

    In times like those, I take the extra time to fix the problem and my next patient has to wait. The way I see it, if I were the patient, I would want my doctor to take the time to do the job properly, even if the next patient was being made to wait.

    You also don’t really know the other side of the patient’s story– ie. why was the surgeon late?

    Just giving another view to the discussion.

  5. Thank you so much for posting this story — things like this deserve to be told! I hope the lawyer was able to schedule a lot of client appointments during the week before the re-scheduled surgery, and that he was scheduled for the very first surgery of the day on that second Wednesday. I’m not surprised that he got pissed — he had good reason to. Usually you hear stories about lawyers making their clients wait — you know lawyers!

    Kensington MD

  6. This reminds me of my scheduled c-section with my last child. I went in on January 24th, prepped, catheterized, and all but wheeled into the OR when Doc came in and cancelled the whole thing due to a low grade fever. (Mind you, I have Lupus, so…) The next scheduled week, I got a call stating he’d forgotten and was overbooked. Could I come that Thursday instead? Thursday came and he’d obviously forgotten again. A mid-wife called and found out he was out of town and wanted to re-schedule for that Monday.

    In any event, I ended up with a Dr. I’d never met before and my baby was delivered on FEBRUARY 2nd!

    Bless this poor attorney’s heart. He and his wife were very patient and civilized. Imagine starving that long–to no avail!

  7. If the lawyer had NEVER changed a deposition date at the last minute or summoned a witness to court for days on end to sit and wait to testify, he had a right to be pissed; otherwise, he should shut up.


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