Professional (Dis?) Courtesy

Ah... so, faithful readers, you have all heard about my tragic intestinal distress. Three weeks of said distress lead me to see my internist about a week ago. My internist was sufficiently concerned to consider hospitalizing me and then said that I needed an urgent colonoscopy, and that she would schedule it. 6 days and 8 phonecalls by me later (please realize that I"m not that excited about a colonoscopy... but I"m really tired of feeling ill), she had still not followed up on the colonoscopy thing. She flaked. Now, I know, we all have things going on in our lives that may affect our ability to get stuff done, but still... I have to work. I"ve been back to work because when I"m resting and have free access to a restroom and to any fluids I care to drink, I do a little better. When I"m at work, I get exhausted and dehydrated, which makes my abdominal pain worse. I"m feeling tired and still somewhat uncomfortable, but not too bad today (having done nothing at work except nap and attempt to deal with my illness).

The mind-numbing fatigue may be related to my having not eaten in 4 days.

Anyway, I may be a bit of a wuss about being sick (I"m very seldomly ill, so I"m not great at coping when I am). But this is still something that needs to be taken care of. I"ve missed a huge part of the last 2 weeks of work. And my doc delayed my treatment by a week.

Oh, and I was scolded by an attending at work yesterday. Something about, "You have to take care of yourself, if you miss a little work to take care of this it"s not a big deal" (For the record, it feels like a big deal right now. I could almost cry when I think about all I"m not getting done). Then she called one of the gi docs. On vacation. As it turns out the international conference of digestive disease starts on Monday. I called a bunch of gi docs, no appointments until the middle or end of June. I can"t be this sick that long.

So... What did I do? I know this probably violates many multitudinous manners manuals, all rules of appropriate behaviour. I paged the gi fellow on call, and I said, "I"m really sorry to bother you, and this is terribly inappropriate, but I"m Midwife W. Knife, I"m a Maternal-Fetal Medicine fellow, and I really need to see a gastroenterologist, I"ve been sick for a month, and I can"t seem to get any appointment any time soon. Can you help me, please? If you don"t feel comfortable with this, that"s fine, I understand". And he said, "Sure. I"ll hook you right up. Let me just finish this consult, and we can meet." So we met. I told him what was going on, and then he arranged for me to have a colonoscopy, first thing Friday morning. He even called me a VIP, and talked the chairman of the GI department into doing the scope. He even said, "This doesn"t sound like it should wait until we get back from DC in a week and a half.". He didn"t question the fact that I called him (and I"d never met him before) to try to work my way through the back door to try to get some appropriate care. He was jolly, helpful, explained things appropriately, and got me all set up. He even did a good job at negotiating that patient-as-doctor sort of thing. He didn"t assume I knew much about guts (which is true). He even said, "If you don"t want me doing your scope [presumably because he"s a fellow], that"s ok, Dr. Chair can do it." (and to that I said, "It"s fine with me if you"d do the scope, if you have time and all.").

I appreciate his help so much. I just need to feel better. The only thing is, though, patients who aren"t doctors who end up in my position just don"t have that option. What do normal people do when their doctors flake? Do they just suffer for weeks-months? Because I think if I felt this bad for another month, I"d likely end up in the hospital, as a patient.

Again, I feel bad for using my status as a physician to expedite treatment. For god"s sake, I had my "preop clinic visit" in my call room! I hope that this doesn"t delay treatment for anybody who used the appropriate channels. But... I got desparate enough that I would have tried almost anything.

Oh, and after this, I will never, ever flake on a patient. I don"t know that I"ve ever done it in the past, but I certainly won"t do it now.