Thursday dawned with great promise. I was up early and ready to go. I got James out the door even a bit early for carpool to pick him up. I was all geared up to spend the day working - first to catch up a bit on grading, then to get a few days of lecture prep caught up, then finally to work on my research project.
Of course, we can't leave an empty day on the calendar. So, we had decided to use this "non-teaching" day to fill in a few errands. We took the van in for an oil change/transmission fluid change/tire rotation, then I dropped Jeremy, Maggie, and John back home and went in to the office, feeling virtuous.
A couple of hours later, I got the call to reverse the process and take everyone back to get the finished van. As always, these things take a few minutes longer than I expect. I had a routine doctor's check-up that I didn't want to be late for, so I was in a bit of a hurry. And the van was parked on a hill, so the door swung open more quickly than I expected. But neither is really an explanation as to why I managed to smack myself soundly in the face with the door when I pulled it open.
Ouch! And then, OUCH! Wow, that really smarts. Still, I was a bit surprised to pull my hand away from my cheek and find it covered in blood. I still don't know if there was something sharp on that door (that I haven't since found) or it was an impressive impact wound (like splitting a melon?). But there was a gash about an inch long across my face, and it was spurting.
So, I was already late to see my doctor - what could I do but press an old McDonald's napkin to my face and drive away? Sounds convenient, but unfortunately, this appointment was with a neurologist. They are apparently not so savvy with trauma wounds. About half-way through the appointment, as he noticed the dripping blood on my face, he asked if I might like to have a band-aid. Being a very old-fashioned, patient-centered doctor, he actually went and got it himself! Of course, that took a while for him to find one, but I thought it was quite sweet of him.
The check-out process had me sitting with a nurse, so I was finally able to get some medical advice. (Grin.) After she had scheduled me for a follow-up test the doctor wanted (there is an opening at 1:15 today - do you want it? Sure, why not. Things are not gong so well at work now, anyway), she looked under the band-aid and recommended stitches and a tetanus shot. Oh. Rats.
Finished checking out ("$30 copay, please." Umm, I thought it was $15? "Nope, this is a specialist." Oh, that is right. One of the insurance increases this year. )
So, out to the car, armed with my cell phone. The call record is something like this:
1) Ring. Hello, Kim? I am sorry, but I have to cancel our lunch date.
2) Ring. Hello, Dr. Primary Care? (Oops, I apparently still have her old office number programmed in my cell, but she changed practices a year ago.) Yes, thanks, I would like the new number.
3) Ring. Hello? Oh, okay, press 3 to speak to a nurse. Okay, press 2 to speak to my own doctor's nurse. Hello? Oh, voice mail. "If this is an emergency, hang up and call 911. Otherwise, leave a message and the nurse will return your call by the end of the business day tomorrow." Tomorrow? I need another choice! Option A and B don't work for me. Aack! Can I talk to a real person?
4) Ring. Hello? Okay, this time I will press 1 to schedule and appointment. Oh, a real person! Hello! Yes, I need to know if someone in your office can do stitches, or should I just go to the Urgent Care center right across from where I am now? Yes, I already tried to ask a nurse, but I got voice mail and I need to know now what to do...(Receptionist assures me to just hold on; she is transferring me to the "live line" for the nurses so it won't go to voice mail.) Hello? "If this is an emergency..." Aack! She lied! Voice mail again.
5) Ring. Hello? Yes, it is me again. Please, can you find a real person for me to talk to? Yes, I'll hold. (new person comes on the line)
Hello? Yes, I need stitches. Can I come to your office now, or can I get approval to go to the Urgent Care center right across the street from where I am now? What? My face. I need stitches on my face. Yes, I'll hold. (Now person #2 has agreed to go find a nurse and ask in person - this is progress!)
Hello? Oh, you don't do stitches in the office if it is on the face? So, I should go to the Urgent Care? No? Oh, I see, because it is the face you won't do it and you recommend the E.R. so I can get a plastic surgeon if needed. Okay. Can you at least look up my record and tell me when my last tetanus shot was? Great. What? Oh, of course not. You don't have my records, because it has only been a year since my doctor changed practices; you couldn't possibly have found my records there yet. Yes, thanks anyway.
6) Ring. Hello? Yes, I need to cancel my 1:15 appointment. Yes, I know I just made it an hour ago, but I need to go to the E.R. instead. Yes, thanks for understanding. I will reschedule soon.
7) Ring. Hello? Jeremy, um, I guess I need to go to the E.R. I'll let you know when I am done. Yes, well, it is a long story...No, I don't think I should just come home and let you put a butterfly bandage on it. Yes, you did do a great job with a butterfly bandage that time I got my temple split with a canoe paddle, but a nurse just told me I should have stitches.
I then proceeded to the E.R. I decided to try the closest hospital (Blodgett). I had never been there before, but I knew that the E.R. downtown (Butterworth) could be a bit busy. My doctor's office told me to go to St. Mary's because they are affiliated there, but I have never been there and that was just as far as Butterworth. So, Blodgett it was. After all, how hard can it be to get a tetanus shot and some stitches?
Well, I got the quick part, actually. I walked in and was ushered immediately into triage. (Hah! My blood pressure was fine, despite that series of phone calls.) So they weren't really busy, good for me. Even better for me - the entire computer system had just gone down. So, they couldn't do any of the official registration procedures that usually take forever. I was in an examining room, meeting my nurse, within 5 minutes of arrival. A person from admissions actually came and sat down in my room with me, with a clipboard, because she couldn't sit at her computer and have me come to her. How pleasant!
Of course, I then discovered that my repairs would be handled by Tom, the Physician's Assistant. Now, I have nothing against P.A.s. I have been treated by them often. But I thought the point of going to the E.R. was to find a plastic surgeon, not a P.A. Argh. Then, he had a P.A. student tailing him, so I got to hear the whole thought process out loud.
"Well, 90% of the time, I recommend stitches. But that is for areas under tension. I don't think that spot on your cheek is under much tension; I think I will glue it instead." Ummm, okay. "I just need to get approval from the Attending ... be right back!" I had grading along, so at least I was getting some work done, in between all the popping in and out.
The P.A. returned quickly. "So, actually, a change in plans. I think we will do stitches after all, just because it is on your face." (Hmm. The Attending changed your plans without even looking at me? Should this give me confidence in your ability to assess, diagnose, and choose treatment?)
So the stitching up went pretty smoothly, except for a few more reassuring monologues from the P.A. to his student. "You see, as I flush with this saline, how the cheek swells way up? [In an aside to me, "Don't worry, your body will re-absorb all that fluid eventually." Good to know.] That is where the wash fluid is being taken up by the subcutaneous tissue. So that is an indication that the laceration actually affected the tissue much deeper than we had realized." [Well, gee, that is more reassurance that diagnosis skills are spot-on.]
Time to check out. Amazingly quick and smooth with the computers down. "Sign here - Bye!" says my nurse. Bye? Is that all? Okay. "Oh, wait, the computers just came back online. You better stop in here and see if they need more info." Well of COURSE they do.
"Co-pay, $100, please." What? It is only $50! "Nope, it says right on the card..." Oh, of course, another bit of inflation in insurance this year. Note to self: next time I whack myself on the face, do it last year, when the copay is only $50.
Aah, so just a mere 4 hours after I left the office to pick up the van, headed back to get some work done. Another productive day, underway. Well, nothing can stop me now. Except why do I suddenly feel a headache coming on, I wonder?
Of course, we can't leave an empty day on the calendar. So, we had decided to use this "non-teaching" day to fill in a few errands. We took the van in for an oil change/transmission fluid change/tire rotation, then I dropped Jeremy, Maggie, and John back home and went in to the office, feeling virtuous.
A couple of hours later, I got the call to reverse the process and take everyone back to get the finished van. As always, these things take a few minutes longer than I expect. I had a routine doctor's check-up that I didn't want to be late for, so I was in a bit of a hurry. And the van was parked on a hill, so the door swung open more quickly than I expected. But neither is really an explanation as to why I managed to smack myself soundly in the face with the door when I pulled it open.
Ouch! And then, OUCH! Wow, that really smarts. Still, I was a bit surprised to pull my hand away from my cheek and find it covered in blood. I still don't know if there was something sharp on that door (that I haven't since found) or it was an impressive impact wound (like splitting a melon?). But there was a gash about an inch long across my face, and it was spurting.
So, I was already late to see my doctor - what could I do but press an old McDonald's napkin to my face and drive away? Sounds convenient, but unfortunately, this appointment was with a neurologist. They are apparently not so savvy with trauma wounds. About half-way through the appointment, as he noticed the dripping blood on my face, he asked if I might like to have a band-aid. Being a very old-fashioned, patient-centered doctor, he actually went and got it himself! Of course, that took a while for him to find one, but I thought it was quite sweet of him.
The check-out process had me sitting with a nurse, so I was finally able to get some medical advice. (Grin.) After she had scheduled me for a follow-up test the doctor wanted (there is an opening at 1:15 today - do you want it? Sure, why not. Things are not gong so well at work now, anyway), she looked under the band-aid and recommended stitches and a tetanus shot. Oh. Rats.
Finished checking out ("$30 copay, please." Umm, I thought it was $15? "Nope, this is a specialist." Oh, that is right. One of the insurance increases this year. )
So, out to the car, armed with my cell phone. The call record is something like this:
1) Ring. Hello, Kim? I am sorry, but I have to cancel our lunch date.
2) Ring. Hello, Dr. Primary Care? (Oops, I apparently still have her old office number programmed in my cell, but she changed practices a year ago.) Yes, thanks, I would like the new number.
3) Ring. Hello? Oh, okay, press 3 to speak to a nurse. Okay, press 2 to speak to my own doctor's nurse. Hello? Oh, voice mail. "If this is an emergency, hang up and call 911. Otherwise, leave a message and the nurse will return your call by the end of the business day tomorrow." Tomorrow? I need another choice! Option A and B don't work for me. Aack! Can I talk to a real person?
4) Ring. Hello? Okay, this time I will press 1 to schedule and appointment. Oh, a real person! Hello! Yes, I need to know if someone in your office can do stitches, or should I just go to the Urgent Care center right across from where I am now? Yes, I already tried to ask a nurse, but I got voice mail and I need to know now what to do...(Receptionist assures me to just hold on; she is transferring me to the "live line" for the nurses so it won't go to voice mail.) Hello? "If this is an emergency..." Aack! She lied! Voice mail again.
5) Ring. Hello? Yes, it is me again. Please, can you find a real person for me to talk to? Yes, I'll hold. (new person comes on the line)
Hello? Yes, I need stitches. Can I come to your office now, or can I get approval to go to the Urgent Care center right across the street from where I am now? What? My face. I need stitches on my face. Yes, I'll hold. (Now person #2 has agreed to go find a nurse and ask in person - this is progress!)
Hello? Oh, you don't do stitches in the office if it is on the face? So, I should go to the Urgent Care? No? Oh, I see, because it is the face you won't do it and you recommend the E.R. so I can get a plastic surgeon if needed. Okay. Can you at least look up my record and tell me when my last tetanus shot was? Great. What? Oh, of course not. You don't have my records, because it has only been a year since my doctor changed practices; you couldn't possibly have found my records there yet. Yes, thanks anyway.
6) Ring. Hello? Yes, I need to cancel my 1:15 appointment. Yes, I know I just made it an hour ago, but I need to go to the E.R. instead. Yes, thanks for understanding. I will reschedule soon.
7) Ring. Hello? Jeremy, um, I guess I need to go to the E.R. I'll let you know when I am done. Yes, well, it is a long story...No, I don't think I should just come home and let you put a butterfly bandage on it. Yes, you did do a great job with a butterfly bandage that time I got my temple split with a canoe paddle, but a nurse just told me I should have stitches.
I then proceeded to the E.R. I decided to try the closest hospital (Blodgett). I had never been there before, but I knew that the E.R. downtown (Butterworth) could be a bit busy. My doctor's office told me to go to St. Mary's because they are affiliated there, but I have never been there and that was just as far as Butterworth. So, Blodgett it was. After all, how hard can it be to get a tetanus shot and some stitches?
Well, I got the quick part, actually. I walked in and was ushered immediately into triage. (Hah! My blood pressure was fine, despite that series of phone calls.) So they weren't really busy, good for me. Even better for me - the entire computer system had just gone down. So, they couldn't do any of the official registration procedures that usually take forever. I was in an examining room, meeting my nurse, within 5 minutes of arrival. A person from admissions actually came and sat down in my room with me, with a clipboard, because she couldn't sit at her computer and have me come to her. How pleasant!
Of course, I then discovered that my repairs would be handled by Tom, the Physician's Assistant. Now, I have nothing against P.A.s. I have been treated by them often. But I thought the point of going to the E.R. was to find a plastic surgeon, not a P.A. Argh. Then, he had a P.A. student tailing him, so I got to hear the whole thought process out loud.
"Well, 90% of the time, I recommend stitches. But that is for areas under tension. I don't think that spot on your cheek is under much tension; I think I will glue it instead." Ummm, okay. "I just need to get approval from the Attending ... be right back!" I had grading along, so at least I was getting some work done, in between all the popping in and out.
The P.A. returned quickly. "So, actually, a change in plans. I think we will do stitches after all, just because it is on your face." (Hmm. The Attending changed your plans without even looking at me? Should this give me confidence in your ability to assess, diagnose, and choose treatment?)
So the stitching up went pretty smoothly, except for a few more reassuring monologues from the P.A. to his student. "You see, as I flush with this saline, how the cheek swells way up? [In an aside to me, "Don't worry, your body will re-absorb all that fluid eventually." Good to know.] That is where the wash fluid is being taken up by the subcutaneous tissue. So that is an indication that the laceration actually affected the tissue much deeper than we had realized." [Well, gee, that is more reassurance that diagnosis skills are spot-on.]
Time to check out. Amazingly quick and smooth with the computers down. "Sign here - Bye!" says my nurse. Bye? Is that all? Okay. "Oh, wait, the computers just came back online. You better stop in here and see if they need more info." Well of COURSE they do.
"Co-pay, $100, please." What? It is only $50! "Nope, it says right on the card..." Oh, of course, another bit of inflation in insurance this year. Note to self: next time I whack myself on the face, do it last year, when the copay is only $50.
Aah, so just a mere 4 hours after I left the office to pick up the van, headed back to get some work done. Another productive day, underway. Well, nothing can stop me now. Except why do I suddenly feel a headache coming on, I wonder?
