For Lindsay, who absolutely can't be kept waiting. -Becca PS: more later. :)
Hospitals are a source of great confusion for many physicians. When you enter medical school, you look upon the hospital as this great white entity that one day you're going to make a huge, mighty difference in. You dream at night of making that brilliant diagnosis that saves the patient just at the 11th hour and the 59th minute. But, as soon as you're on rotation, the hospital becomes a gnawing creature. Its walls hold no comfort as you try and try to help patients, but in spite of your best efforts you sometimes fail. Successes become few and you realize soon enough that you make mistakes and sometimes people pay the price for it.
When you're an attending, however, the hospital takes on a new role altogether. For once in your life you start to feel comfortable. It's sterile walls become warm, inviting. You start to be at peace with the sterile smell of the OR and the warm, musty smell of geriatric wards.
However, in spite of whatever role the hospital might take on to you as a physician, you're never prepared for the day when you become the patient. I feel right now about the hospital the same way I did about my body when I couldn't walk; I feel betrayed. I clutch my husbands warm, solid hand as if I'm afraid of what these walls will hear once Dr. Simon comes in to discuss her tests and scans.
It seems like forever until her office doors open. In a second, I make a silent promise to myself never to keep my patients waiting in angst like we are now. It has to be one of the worst feelings and sometimes I don't think physicians realize, or they don't care about, how their feet-dragging and dilly dallying impacts their patients.
Dr. Simon is around my age, perhaps a little younger. She's petite, with long brown hair and warm brown eyes. At first I was drawn to her, but right now honestly I'm just a little annoyed. I've been torturing myself for weeks now and I just want to know what's going on.
The small woman comes in, white coat blazing behind her and before she can open her mouth I'm on the attack. "Dr. Simon, I'm a physician myself, please just be honest with me and tell me exactly what the detailed scans revealed." I don't mean to be so terse and cutting, but at this point I've worked myself into such a state and I need to hear the cold, hard facts.
"Dr. Picard," she makes a point to say my name. It's almost sneering, as if she thinks that I'm challenging her. "detailed scans reveal a severe aortic coartication just after the branching of the arch of aorta. It's serious and it's rare. It's not genetic, it appears to have a spontaneous origin-"
"What's the treatment?" I cut her off unceremoniously. I don't need to hear literature quoted. I don't need to hear percentages and facts and figures. Just give me the diagnosis and give me the treatment options.
She collects herself, "I am going to advise and endovascular repair. I'm sure you're aware of the latest stents. Unlike the older models, these are life-time guaranteed – if the procedure is done correctly – and it will be – the baby will have no trouble with the stent later in life."
"Will you be doing the repair?"
"No. We have a foetal vascular specialist who will be able to perform the procedure. It's minimally invasive. We'll go in through-"
"The belly button, yes I'm familiar with the procedure. I'm sorry."
Dr. Simon smiles, "it's Okay, Beverly." She says my name softly.
Jean Luc has been quiet for through the whole exchange. I squeeze his hand and look over at him.
He's trying to be brave. This man has taken on countless enemies and he's even faced assimilation by the Borg. He's no stranger to adverse situations, but the thought of his child in danger brings him shuddering to his knees. I don't mean to but I sit and stare at him, marveling that such a wonderful man could exist and that I'm privileged enough to call him mine. I squeeze his hand, "Jean Luc?"
He's roused from his reverie, "Dr. Simon, is there at risk to Beverly in doing this procedure?"
She looks back at me, "No. There is no risk to the mother. It's a very safe operation, Mr. Picard. I assure you."
"When's the soonest it can be done?" He asks tentatively.
Dr. Simon looks back at me, "I'm going to have to say next week at the latest. The problem is that the narrowing is so severe that it's cutting off blood supply to other vital organs. If we let this go anymore, then we're going to risk underdevelopment of the gastrointestinal and biliary system as both are being slowly starved of an adequate blood supply."
I run through the names of the physicians in my head, "It's Dr. Portland who'll be doing the operation, correct?"
"Yes. Do you know him?"
"I operate here twice a month. I've seen his name on the schedule."
"Yes. I'll contact his secretary, Annie, and she'll give you a call this evening to tell you when he's available. On a final note, do you want to know the sex of the baby?"
I look at my husband, "do you, Jean Luc?"
"I… uh… I don't know." He's still nervous and I can't blame him. So am I.
We've been assured that everything is going to go well. But, the thing I've learned over the years with my own medical career is that you can never make assurances. Even with the state of medicine as it is. Even with the inventions of numerous fancy and highly technical medical devices, nothing is fool proof. You should never tell a patient or a family member with 100% certainty that a procedure or operation is going to succeed. Because in the end, God forbid it doesn't.
"No," I respond, "not yet." It's our one last surprise.
"Alright, well. Annie will be in contact with you this evening. Go home, get some rest, and please don't worry. I'm sure that this will work out in the end."
"I hope you're right." I feel my husband – my rock, my strength, my love – I feel his hand tugging mine up out of my seat and to the door. We've dealt with far more daunting situations, but somehow, this feels much worse.