More shame, at the end of which my heart just breaks

Today I had to check drug levels. This involved a tremendous amount of humiliation. All morning I was angry. Now I am just heartsick.

The doctor tried to do me a favor by talking to the clinical lab director about if they could order the test through the clinic and send it over, saving me from the trip to the hospital with the only lab that does it, as well as it being the hospital where I work. Besides the humiliation, it is damn near impossible to catch both the bloods office and the pharmacology lab open to the public at the same time. You need a fucking Aztec calendar and pyramid to figure it out.

The lab lady said, “No problem. Tuesdays and Thursdays, we send all the stuff that they only do at the hospital over there with all the paperwork.”

I went to the clinic this morning for the blood draw. The male nurse who did it did not speak the language very well, and my idiot of a GP who had sent the official insurance order for the test sort of misspelled the name of the drug. They could not figure out how to draw and transport it. So the nurse gets on the phone to the head of the lab, mispronounces the drug name so badly that she has no idea what he is talking about, and she says to fax him the (misspelled) order so that she can try to figure it out. At no time does anyone think to ask me.

As far as confidentiality, it’s shot. The nurse is yelling on the phone in front of a full clinic. Another nurse there tells me, “You know, you’re just wasting your time. Just go straight to the hospital yourself and do it there. They will probably lose it on the way if you do it here.”

Meanwhile, we’re waiting for the lab lady to get back to them. She doesn’t. Finally, genius that I am, I think, what the fuck? They are sending it to the hospital lab anyway. I bust out my cell phone, call the hospital, get the lab, and ask them, “Hey, what kind of vial do I use for a drug level of xxx?” They tell me. I tell the nurse. They draw the blood. I leave.

I get home, and my phone rings. It’s the nurse, saying that the lab lady can’t figure out what drug it is either. She left me a number to call her and clarify.

I call. She has no idea who I am or what I am talking about, despite the fact that she left the message for me five minutes before. Finally, after many failed attempts at communication, I start at the absolute beginning. I manage to explain that my doctor spoke to her yesterday about sending a blood sample to the hospital. She has no idea what I am talking about, though she has the exact same name as the person the doctor said he spoke with. She also, beyond that, has no idea what drug I mean, even when I spell it out for her in both local and Latin letters, generic and brand name. “It’s not even in the formulary!” (It is.) Then she says, “Oh, well Dr. Shrink didn’t tell me the name of the drug. We don’t send that over. You need to take it yourself. Go back to the clinic, get the blood, and I’ll fax the form for insurance that we’ll pay for it to the clinic. Take them both to the hospital. ”

I go back to the clinic, retrieve the blood from the ice chest. Then I go to ask the secretary if the paperwork got there by fax or email. In the middle of a huge office full of people, including doctors I have worked with, of course. It is not there. I call the woman back. Someone else answers her phone, so I have to launch into the whole story again, in public, until she cuts me off and says, “Stop, I’ll go find the lab lady.” Finally, she sends the referral.

I take the blood, the insurance paper, and the referral and head to the hospital. By this time, it is 11 AM and there is nowhere to park. I drive around in the heat for half an hour looking for parking, watching my watch as the day gets eaten up.

By the time I make it to the hospital’s doors, I am sweating through my shirt from the heat and rage, and I run into a colleague. He tells me, “Hey, you know, we have to go renew our personnel stuff this month.” That stops me dead. Now I am interested. I ask him what that will entail.

“A lot of errands. Oh, and you have to go see a doctor at employee health. They do a bunch of tests and stuff.”

This stops me cold. Tests mean that things go to the lab, which means that when they pull up the results on the hospital computer, the results for blood levels of the oh-you-are-so-fucking-crazy meds will show up.

I don’t think I could face that.

So I get to the main office, and sign in and get called up in front of a bitchy secretary. I tell her what I need, reading off the test billing code number from the insurance form. She starts taking down my details. I give my post office box address, because I live in a rural area where if they send the mail to the house, it never arrives, and even if I give the post office address as a mailing address in addition, they always send shit to the house and I never get it.  She starts screaming at me that I can’t give her a post office box. “Where do you live?” she shrieks. I start to try to explain the intricacies of the rural postal system, but she keeps screaming at me. I realize that no amount of actual, truthful explanation is going to work.

Finally, I just lie, say that I am staying in a local neighborhood with friends and don’t know the address or the street name. She looks at me like I am a small, retarded child, or possibly a criminal trying to steal a blood test. She registers my post office box, but in the local neighborhood and zip code I gave her, thus ensuring that the results will never get to me that way either. She will not accept any attempt to correct this.

I decide that I just can’t, just cannot do this. Cannot be humiliated like this any more. No more yelling. No more explaining. No more apologizing that I am so crazy I need to take medication that requires its levels to be measured. I give her my grandmother’s name, and pay in cash.

Yes, I pay cash, which means that I could have skipped the entire morning fuckaround with the clinic altogether and not have been dragged through the the repeated humiliation, and not had it written on my file at the clinic and with insurance.

Total cost: around $40 USD. I could have made one phone call and asked before going through all of this.

I am such a fucking idiot.

The shrink and the GP have both continually tried to tell me that it isn’t that big a deal. That no one will deny me a license or cause me trouble over this. “Don’t worry,” says the shrink. “I’ll sign that you are fine,” says the GP.

Of course, these are the same two who promised me I could take the bloods at the clinic and sent the unintelligible form, respectively.

And even if no one will make a big deal, I think that the moment they call on me to explain, ask, in that fake-non-judgmental doctor way, “So, what are you taking that for?” I might just fade into another dimension. I might cry. I might just turn around, walk out the door and keep walking miles and miles into some woods lovely, dark and deep and right out onto the frozen fucking lake.

Why can’t I be like this guy? Walk proudly into the emergency room, and explain cheerfully to the staff the exact pharmacology of the overdose that caused his EKG findings? Why can’t I just walk in and ask for what I need, and if it makes them uncomfortable, well, fuck them. This illness is not my fault.

Of course, the problem with this approach is, 1. I don’t think most people care that I am not to blame, and 2. I’m pretty sure that somehow, somewhere, this is my fault.

* * *

I got some positive feedback on the Shrink’s Line of the Day feature. So I’ll add this one, which came up a little bit ago, when I was debating whether or not to bring up crazy behavior #336.

Me: (Friendly, hesitant.) Um, you know, I don’t want this to come back and bite me on the ass when someone sues me for malpractice ten years from now and they pull, oh, everything for the trial. (Pause. Nice, and as nonthreatening as I can be.) Can I ask, what kind of records do you keep? Do you even keep paper records?

Shrink: Don’t worry about it.

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3 Comments

  1. Oh, shit. i’m sorry Sara….i though i was having a crappy time of it. This sounds like the day from Hell. i can only say that i hope things get better, but how does that change anything for you…? Guess what? Unfortunately, it doesn’t. “Don’t w o r r y about it”. Yeah. Right. Easy for him to say. Hugs, dear.

  2. Want to know a secret.

    Being cheerful and hiding behind pharmacological knowledge are very different things. Very different indeed.

    You learn with time to find the right masks.

    Take care

    s

  3. I know. Believe me, I know about the masks. But that is one fucking great story.


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