And the Doctor Never Called

A few weeks ago I was having trouble with a cough that wouldn’t go away. I let it carry on a while thinking it would just go away but when I became increasingly fatigued and continued to feel really lousy for a few days I relented and made an appointment to see a doctor. I have been bad about seeing one doctor consistently in recent years. I typically go to the same practice for all of my health needs but I have not attached myself to one primary care physician, mostly because I simply haven’t found one that I like that much or that seems to take enough interest in my long term care for me to feel any desire to “sign up” per se. My recent experience only reinforces that, and well, I guess I need to do some doctor shopping now.

As a person living with a few chronic health issues it would be wise to get connected to one doctor that I felt comfortable with and could trust. But that is a completely different topic, I’m off track.

I made an appointment at the health practice I usually visit because of that annoying cough and my general malaise. I’m leaving the practice nameless for now because I don’t want to draw attention to them as much as I want to draw attention for a gaping hole I see in healthcare. I was able to get in to see the doctor pretty quickly, I went to the doctor’s office on a Thursday morning. I don’t normally recall things like that but after my experience, I remember it well. 

After a brief exam with a pretty stoic physician, he said he would like to have some x-rays taken of my lungs, just to make sure there wasn’t any pneumonia or anything like that going on. He thought it was just bronchitis but wanted to make sure. This seemed pretty reasonable to me and the practice has those capabilities in-house, so it was easy peasy to walk around the corner and have the chest films done. After the standard angles were shot I went back to my room and waited. A few minutes later the x-ray tech came and got me and said that the doctor wanted to get another film of a particular angle that she didn’t take before. While standing in the radiology room and turning in a different way than I ever have before for an x-ray, and with my arm raised awkwardly above my head, I became aware that perhaps they were looking for “something”, you know, something ominous. 

  
After that, I sat in the exam room with a little bit of anxiety welling up inside of me. It was a strange sensation really. I tweeted that I was being an “impatient patient” at the doctor’s office and thought to myself, it sure would be strange if this were one of those moments before all things in life change, all perspectives, all gifts becoming more bright, all blessings more vivid…you know, things like that.

When the doctor returned, the first thing he asked me was if I had ever been shot in my chest. I found this pretty strange, to say the least. He said there was an odd shaped abnormality in my left upper lobe that looked to be fairly calcified, almost like scar tissue or a piece of twisted metal. Since I have not ever experienced such an injury, he wanted to have the radiologist look at the films and determine if a CT scan would be needed. He showed me the films and I saw something strange in my lung, something I now have a permanent (perhaps semi-permanent) picture of in my brain because I obsessed over it for many days. 

After waiting over a weekend (which was brutal for obvious reasons) and a couple phone calls on my part to the doctor’s office, I found out that the radiologist recommended a CT scan with contrast. Then, the process of getting approval from my insurance began, which took a few more days. By the end of the week, I had researched sub-centimeter lung nodules extensively online. I found that by and large, they are non-malignant and they are very commonly discovered by accident, much like in my experience. In fact, it’s becoming sort of a “problem” in the medical community because previously these never would have come to anyone’s attention and the use of CT scans and additional methods of testing is sometimes thought to be too extensive and unnecessary. But, like me, patients want to know if these abnormalities are malignant. If they could be or if they might become malignant, it’s kind of important.

So a week and one day later post the initial exam, I had my orders with approval for a CT scan with contrast. I called a highly respected imaging center in town and scheduled my appointment. They were able to get me in the next day, which was a great relief to me. One reason I picked this imaging center was that I knew they had a quick turnaround for providing results to patients and you can pick up your radiology report and images, usually 24 hours after your test. The test itself was fairly uneventful. I got a raging headache from the contrast and the warm sensation that flows through your body when the contrast goes in was nothing short of bizarre, but aside from that all went smooth. Finally, Monday came and my husband picked up the report and my digital record of the films. 

Conclusion: calcified lung nodule. Most likely benign.

Additional note: minimal dependent atelectasis. (That means a small part of my lung was not inflating properly.)

The tech who gave my husband the results told him that usually minimal dependent atelectasis is treated with some medication but we need not be worried about it, it could be treated and follow up should take place with my doctor.

I had my results and I could relax. After 10 days of worry, I could rest and know that chances are really, really good that this lung nodule will never turn into anything. After my research, I also noted in my mind, that my doctor may want to follow up with exams every 6 months for a while to make sure the nodule doesn’t change or do anything funky.

With this information in hand, I waited. I waited for my doctor to call. I waited for the doctor’s office to call to discuss the results, to put my mind at ease. I waited for them to call to discuss the need for treatment for the atelectasis. But guess what? They never called. Never. Not a couple days later. Not a week later. Not even 3 weeks later.

I find this incredibly disturbing and mostly, negligent. I continued to wait because I felt better. I continued to wait because I was reassured by the radiology report that all is fine. I continued to wait because I really just wanted to see if they would ever call. That may or may not have been the best way to handle it and I’m still on the fence about calling that practice at all to let them know that I fell through their cracks. 

The thing is, I wonder how many other people are falling through the cracks, the gaping wide holes and canyons in our healthcare system. If it happened to me, well, I know it’s happening to a lot more people with more important and pressing needs, I’m sure of it. We’re more than a name on a clipboard or an account in a software program aren’t we? We are people with friends and family and co-workers and people who depend on us and need us and our doctors are supposed to be there to help us be as healthy as we can be. But sometimes, they just never call.