Thursday, June 16, 2011

Let's Get Clinical

 This blog will be posted some time after it was written due to an outside directive to not talk about my living donor experience until after I have donated.  If you are reading this, it is because I have completed the donation process. 

February 23, 2011

Today I had my least favourite appointment to date. As you know, I was to meet with the nephrologist (we'll call her Dr. N.) and thought I would finally have the answer as to my suitability to donate. Not only do I still not have an answer to that, but I have more tests to do that rate high in the inconvenience category. To top it off, for the first time in this process I was left with the feeling that I might not be a realistic candidate because I did not perform well in the interrogation or the quick five minute physical exam.

Maybe interrogation is the wrong word. However when the first question posed to me was "What is the impetus of your decision" you can kind of tell how the conversation was going to go. Dr. N is clearly quite brilliant-it comes across in her language, how she carries herself and her obvious knowledge of human anatomy and medical conditions. However what was a bit troubling to me was her "bedside manner".  For example, she used several four and five syllable words frequently that could easily have been substituted with "regular speak". I am a smart lady with a pretty extensive vocabulary and I was finding myself having to listen carefully to what she was saying while mentally scrambling to decode some of the words (these for the most part were not even Latin-based medical or anatomical terms). It was intimidating to say the least. That, paired with her very stoic, emotionless demeanor was difficult to deal with.  Early on in the conversation I was asked to tell her all the risks I knew about the procedure.  Is this a test? I felt anxiety as I tried to remember all the risks I've repeatedly read on medical sights and personal blogs. She couldn't possible expect me to list them all.  Except I really think she did. When I stopped (or gave up) she suggested I was only focusing on the surgical and immediate risks.  I had to remind her I had given several long term risks. After pausing to think about it, she conceded that I had but it still left me feeling like I hadn't done well on a pop quiz-like I should have been more prepared. The rest of the appointment went much the same way. Several times I caught myself rambling partially because of how nervous she made me and also because she never changed her expression, never spoke to stop me and I felt like I needed to keep going until she acknowledged I had said all the right things.

Of course our favourite topic of social media came up. Have I mentioned how "over that" I am? I appreciate that as she said "she needs to hear I am okay with it".  But really?  Did she?  Because at least three others in the program have already asked that in about ten different ways on about five different occasions respectively. I do not agree with the policy but I am respecting it. I don't think its right in all regards but I am complying.  All the while holding no ill will towards to creators or enforcers of the policy. So please stop asking about it-the horse is dead and way over-beaten.

When the interrogation was done, she asked the program coordinator to leave the room so she could do an physical exam. It was quick. Dr. N's only negative comments at that point were that my legs were a bit swollen. I let her know that for a good 25 years my legs have been swollen despite my weight, time of the month, blood pressure or what moon we were in. I don't know why they swell but its never been a cause for concern with any previous doctors. I always assumed it was because of my knees and in the last few years a not great ankle.

It turns out that back in November, I was not given two tests that are now mandatory for new people entering the program. Dr N and the program coordinator hmmed and hawed in front of me a few times about it.  Truthfully it would have been better if they just gave it to me rather than giving me any hope that  wouldn't have to do them. Both are "24 hour tests" (one urine, one blood pressure) and more than anything it just extends the "waiting".  I appreciate they need to know if I am healthy enough but at the same time, I'm starting to want to get off this roller coaster.

I can't really articulate how overall this appointment made me feel except to say that for the first time I felt like I was being judged in a negative way. While I know Dr. N is there to protect me, and make sure medically I am safe to donate, I did not get the feeling that she had any interest in me as a person or had any intentions of being a "support" in this process. I don't mean that she should be there to cheer me on or hold my hand. But she didn't make me feel very good about what I am wanting to do. In fact she came off as though she were looking for reasons to declare me ineligible. It's as though she wasn't really sure she supports organ donation or though I was stupid for wanting to look into this. She didn't make me feel like she cared about anything to be honest except numbers, cells and stats. She talked about me, using medical terms, like I wasn't in the room or able to hear her. I wanted to wave my arms and say "helloooo....over here!"

Perhaps my impatience and frustration is starting to tire me out.  Maybe the fact that I've been fighting (unsuccessfully) a cold for a few days is making me more sensitive. Regardless, it just wasn't a positive experience and has left me feeling unsettled, small and kind of sad.


  1. mmmmm...not such a pleasant experience. Doctors can be so different. When I had Maxime, the doctors and nurses at The Montfort Hospital in Ottawa were incredible and I felt extremely cared for.

  2. They can be so different. I have to be honest, in my life I have had great experiences with many doctors and have always felt not only cared for, but like I was part of the process/decision making and not an inanimate object in it.I fully appreciate how there are doctors who struggle with the ethics involved in taking a totally healthy person like me, taking an organ from them and putting them at risk. I am not sure if that was what her issue was but I do know how I felt after that appointment and for weeks after. It was unfortunate it had to happen as it really was one of just a few blips in what was otherwise a positive experience