(16-04-12) Radiation Consultation

Sometimes I think doctors lose perspective that we are their clients.  They’ve spent all these years being super smart and pushing themselves through college, then the MCAT, then medical school, then a residency program, then licensure, then certification.  By the time they’re finished, they have used up over a decade of their lives and likely incurred a massive debt.  So, i get it: They probably feel a little entitled.  They worked hard to get where they’re at, and they want the satisfaction of knowing how much others respect, appreciate, and value them.

Hey, doctors.  I respect, appreciate, and value you.  I have no where *close* to what it takes to become a doctor.  I don’t have the brain, the patience, the funds, OR the stomach to do what you do.  Plus, I need you on a regular basis – now more than ever.  You make living more comfortable for me; in fact, you make living POSSIBLE for me right now.

… but sometimes I think you forget that you need me, too.  You need clients who choose to go to you.  You need clients to pay your fees (or, in my case, authorize an insurance company to pay your fees).  I don’t *have* to choose you.  Members of your profession are spread all over the city, the county, the state, and the country.  I have options; I can choose someone else.  So, when I *choose* you, maybe you could step down off your high horse and appreciate me like i appreciate you.

These thoughts were running through my mind as i sat in the waiting room of the Arizona Center for Cancer Care today.  My appointment was scheduled for 1:30.  I had to leave work early and drive 40 minutes to cross from Phoenix to Scottsdale.  I arrived 12 minutes early, my new patient paperwork and my ultrasound pictures in hand (as promised).  I checked in, showed my ID’s, and sat down to wait.

and wait

and wait

At 2:20, i approached the front desk.  “Could you let me know when I am going to be seen?  My appointment was scheduled for 50 minutes ago.”

I was assured that i was next to be called back, so i returned to my seat.  True to word, my name was called 5 minutes later, and i headed back with the nurse.  Standard procedure: weight check (129), blood pressure (116 over 78), temperature (97.3).  The nurse pointed to the pink paper gown, and i quickly changed into it as soon as she left the room.  I am always afraid i am going to still be changing when the doctor comes in, so i play this game of timing myself.  48 seconds to change into the gown and hide my bra/underwear underneath my pants and shirt.  I even sniffed my shoes to see if they smelled.  All good in the hood.

At 2:45, i opened up the door and stared nurses down until someone asked me if i needed anything.

“Do you know where my doctor is?  My appointment was 75 minutes ago, and I still haven’t been seen.”

They told me he’d be right there.  I ignored the unspoken directive to go back into my room and wait some more; instead, i remained in the doorway and watched them.  Someone must have gone to fetch the doctor because he was there a few minutes later.

“How are you today?”

“I’m a little annoyed.”

He looked surprised.  “Why?”

“Well, my appointment was at 1:30, and it’s 2:48.”

I couldn’t help but notice the LACK of apology.  “Well, I’ve been taking copious notes on your case.”  He held up a 1-page sheet filled with handwritten notes.  I’m not sure if i was supposed to be impressed.  I looked at this older man and wondered if he realized it was the year 2016, and handwritten notes have long been considered obsolete in the medical industry.  Even my general care practitioner and her medical assistant record all their notes on I-Pads and laptops.

“So… Tarah.  That’s an interesting name.”

I stared unblinkingly.  “I guess.”

“Where did that come from?”

“My parents.”

“What made them choose that name?”

“I don’t know.”  That was a lie.  I was named after a painting on my mother’s wall; the artist’s name was Tara.

“And you teach?  At a jail?”

“Yes.”

“What’s that like?”

I had already had enough.  “I don’t want to talk about my name or my job.  I would like to discuss my radiation.”

“Okaaaay….”   His tone indicated that he was slightly offended.  I didn’t care.

From there, he pulled out this sheet of paper from a folder.

image from radiologist

He proceeds to spend i-don’t-know-how-many minutes breaking down every T2 and N3A and UOQ and BRCA(-) displayed in the notes.  The longer he talks, the more infuriated i become.  Um, sir?  I have known about my breast cancer since October.  I have gone to ultrasound technicians, my primary care physician, a breast surgeon, a reconstructive surgeon, an oncologist, half a dozen LabCorp techs, and a cardiologist NUMEROUS times over the past six months to get treatment for my cancer.  I have been hospitalized twice to have my breasts removed and a port implanted.  IF I DON’T UNDERSTAND MY BREAST CANCER SITUATION AT THIS POINT, I’M CERTAINLY NOT GOING TO FIGURE IT OUT BY LISTENING TO YOU DRONE ON AND ON ABOUT MEDICAL ABBREVIATIONS.

By now, my eyes are dry and itchy.  I know it’s because i am forgetting to blink as i stare this man down.  He seems completely oblivious to my growing fury and pulls out another paper to further help his CLEARLY IGNORANT patient understand that she has breast cancer.

image from radioloist 2006

“Now according to this, it’s unclear what your survival rate is, but if you look closely at the numbers above and below your cancer stage, you can guess that it’s somewhere between 20 and 54% … Luckily, you’re in my hands.  I’m internationally known for my work with breast cancer and have won awards for some of my research, so your chances for success are definitely higher with me as your doctor.”

How lucky for me.  By the way, I have a 47-48% chance of survival after going through the mastectomy, the chemo, the radiation, and the hormone therapy … but um, thanks for that “figures not available” statistic that you circled above.  That was immensely helpful.  What would i do without you, doc?

By now, it is well after 2:00, and we haven’t even started discussing the details of my radiation treatment.  That’s okay.  I already know i am never coming back to see him.  I go through the motions, though.  I get on the table and lay back as his hands explore my palms, arms, breasts, glands, and surgery scars.  He measures my scars and infections with a brown, wood ruler.  He talks to his assistant like i’m not even in the room.  I start to get irrationally upset about his old White man putting his hands all over me, so i dissociate until i hear him tell me i can sit up.  Another doctor opens up the door, looks at us in surprise, mutters a quick apology, and promptly shuts the door.  I look down.  One of my breasts is hanging out of the gown.  That’s okay, i tell myself.  It’s not real, anyway.

The oncologist finally starts discussing radiation side effects.  He intersperses this long-awaited information with more self-accolades.  Apparently, he pioneered some research on alternative radiation treatment for people who have early stages of breast cancer – in other words, for people who are NOT me.  Sometime during this monologue, he finally issues an apology for making me wait so long in the beginning.  I barely respond.  Another staff member knocks on the door, opens it, and tells the oncologist that his presence is needed in a meeting.  He finishes up whatever he’s saying (by now, i’m not even listening), gets up, and leaves me in the hands of his assistant.  I tune in long enough to hear her tell me that i can’t wear aluminum-based deodorant on the days i have radiation.  I laugh at her.  It’s about to be May … in Phoenix, AZ.  No deodorant?  No thanks.

Two hours later, here is a summary of the details i learned about my upcoming radiation:

  • I will have it daily for 6.5-7 weeks.  (already knew that)
  • Radiation will take approximately half an hour each day. (knew that, too)
  • I can’t schedule my radiation mapping until after I have my final appointment with Dr. Walsh.  (also not new … but, for the record, why am i even HERE today then?)
  • Radiation there can be scheduled as early as 7:30 or as late as 4.  (no longer matters)
  • One-third of radiation patients experience fatigue.  It will not be as severe as it has been during my chemo, if I do get it.  (a silver lining, admittedly)
  • The most common side effect is sunburn.  It will begin around the 3rd week and crescendo into the last week of radiation.  It will look and feel like a “Jamaican sunburn.”  (I don’t know what that means.)
  • I will likely experience hardening all around my expanders; this is from scar tissue.  (According to Dr. Kuske, OTHER oncologists will cause more scar tissue than he will, but HIS scar tissue will be minimized because he blah-blah-blah.)
  • I may also experience rib pain.  This is normal.  I should not be concerned, unless i start having trouble breathing.  (Seriously, man?  Do you think i have mild mental retardation or something?)

Basically, this was the biggest fucking waste of time.  They never looked at my ultrasound pictures, and they forgot to give me my doctor’s note.  The two hours spent did not tell me much i didn’t already know, and it didn’t get me any closer to actually starting the process of radiation.  I left the office and immediately called Dr. Curley to request another recommendation.  I’m surprised he referred me to this narcissistic tool.  Dr. Kuske may be on point with his knowledge and his research and his pioneering efforts to start the first radiation-oncology clinic that solely focuses on breast cancer … but he SUCKS when it comes to customer service.

So.. yeah.  Radiation is currently on hold until i find a doctor whom i don’t want to punch in the face after spending an hour with him.

 

Author: breastcancerat35

I was diagnosed with Stage 3C Invasive Breast Cancer in October/November, 2015. This blog is my way to process my experience and allow my loved ones to have ongoing updates about my journey.

4 thoughts on “(16-04-12) Radiation Consultation”

  1. 😲, what the heck. I’m glad you are looking for another Doctor. Me and mom mom laughed our asses of at this. But some docs do feel entitled. And as for the Jamaican sunburn I know all about that. I’ll talk to you about it later. Love you my sweet baby girl.

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  2. I know that sucked for you…but that descriptive blog just made me laugh the whole way through! I now know I am not the only one who covers their clothes & sniffs their shoes!!

    Like

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