Vintery, mintery, cutery, corn, Apple seed and apple thorn;
Wire, briar, limber lock, three geese in a flock;
One flew east, And one flew west, And one flew over the cuckoo's nest. Story Line:
I recently saw a CNN report about hospitals guilty of surgery errors. A person went for eye surgery and came back with his/her tonsils removed. In another case, the surgeon operated on the wrong child, and in the third case, holes were drilled on the wrong side of the patient’s head. According to the report there is a daily dose of such errors across the country.
This report brought back memories of my two experiences (can be termed Near Misses) with the medical system, taking place almost 20 years apart.
In 1980, I had changed my health provider and had made an appointment to see new doctor for a cholesterol related checkup. After describing to the receptionist why I was there, I was asked to be seated. A few minutes later, a lady in white gown appeared and called out my name with a strange pronunciation.
Yep, that’s me. I got up and she asked me to follow her. On the way, she asked me what was I there for, and for the second time, I described the reason for my visit.
As soon as we entered the small room, she gave me a gown and said "Take all your clothes off except your underpants, (reemphasizing) make sure you keep your underpants on, wear this gown and wait for the doctor."
Amused and realizing that she may have missed my reason for visit that I had described on the way to the room, I tried once more to tell her that I was there for Cholesterol Test.
“But Mam” and before I could utter any more words, she interrupted and said in a stern voice, “Wait for the doctor.” Having watched the movie “one flew over the cuckoo’s nest” several times, the memories of Ratched (THE NURSE) came alive and I submitted to her orders without any further protest.
A few minutes later, the door opened and a person came storming in at jet speed. It seemed that his body was ahead and the unbuttoned gown was flying behind; he reminded me of Superman or Flash Gordon. Behind him was THE NURSE with some kind of a checklist and asked “Doctor, one more question, when was the autopsy done?” Doctor gave her the answer and then looked at me and said “That was my last patient.” Seeing my reaction, he smiled indicating that it was just his sense of humor to break the ice.
Then he pulled out a reflexomer from his gown pocket and hit my left knee. My leg showed reaction. He hit it again and my leg moved again. Wondering if he was looking at the wrong knee, he then hit my right knee with reflexomer. And it moved too. (All this time I was wondering if there was a breakthrough in medical technology where they can check cholesterol just by hitting the knee or this person in front of me was a magician instead of a doctor.)
He looks at me and said “There is nothing wrong with your knee.”
I answered, “There was nothing wrong with my knee.”
“Then why are you here?” The Doctor asked.
“I am here for Cholesterol checkup”
“Then why do you have your clothes off?”
“Your NURSE asked me to take them off. I tried to tell her but she did not want to listen”
He went fuming out calling her name. In the meantime, I quickly dressed up and just about the time I was trying to escape, both of them stormed in, the nurse with an open file in her hand.
“Aren’t you Anal Shah?”. she asked (Now before I go any further in this saga, let me assure the readers that “Anal” is an authentic Indian name. It means Fire. But I also know what it means in English.)
“I am Anand Shah, not the name you just said.”
I even joked “Please don’t tell my coworkers what you thought was my name”
Between the closeness of the spellings and accents and unfamiliarity of foreign names this had turned in to Comedy of Errors that could have become tragedy in another circumstance.
Reflection:
Fast Forward 20 years. New Provider. New Hospital System. I went to the receptionist window at specialist office and gave my name.
“Weren’t you just here?”, she asked.
“I wasn’t just here. I am HERE” I answered while wondering if the question was metaphysical or spiritual awakening test or something.
She opens a file and asked, “Same Insurance?”
“Yes” I answered ... but the additional word I said may have prevented the tragedy ... “Cigna”
“So you changed to Cigna?”
“No. I have had Cigna for the last seven years.”
Further investigation revealed that she had a file of another Anand Shah with a different middle initial. One would assume that all that means well should end well.
Two years later, I went for tune up and wear and tear repair for my shoulders. The receptionist at the surgery center asked me to fill up some documents. On one of those she highlighted some information with yellow marker and asked me to check if that information was correct.
The social security number was not mine. She told me to scratch it and pen down my SSN on that paper.
I did. And forever I am wondering if that information is changed in the computer record system or the other Anand Shah will have record of shoulder surgery.
Anyway as my daughter Analisa says, “Everything is OK in the end. If it is not Ok then it is not the end.”
Link to CNN video:
http://www.cnn.com/video/#/video/health/2009/11/04/nr.cohen.medical.mistakes.cnn