This October means more to me than usual. Last year, a lump showed up in my mammogram. Actually, to be more accurate, the lump had shown up in the films from the year before but wasn't picked up by the radiologist. Looking at the comparative films now, the spot seems pretty easy to see, but perhaps that is hindsight talking. Once I found out that I had a lump, I needed to set up further tests. I went to the breast health center at a local hospital--keep in mind that this is a facility meant specifically for dealing with diagnostic tests and treatment--for more mammography. While I appreciate that this facility has the equipment, and professionals, necessary for dealing with breast health (and ultimately that is what is most important), I have to wonder about who designs these places. Every medical facility seems engineered for discomfort and dis-ease. You sit in stiff chairs, thumb your way through trashy magazines that have seen better days, and all the while have dimwitted talk shows blasting at you from mounted flatscreens.
After spending an afternoon shivering in a flimsy hospital gown and having further films done, I came to the conclusion that the lump would need to be biopsied. And I, ME--not my doctor or the radiologist--had to come to that conclusion. The amount of information I received from the experts was terrifyingly vague and terminology impenetrable. I was essentially told I could have biopsy, or not. Well, why wouldn't I? Well, because some people don't want to. Oh, and that helps me how? All I got were blank looks and slightly shrugged shoulders. I set up the appointment and waited nervously for the day of the test.
The biopsy was not the worst procedure, but it wasn't great. There wasn't pain, but lots of pressure as they made their way over to the lump. Then they extracted bits of it (there is a lot of pressure and a sound that resembles a nail gun). Here's what I remember: feeling both invaded (by the procedure, not the individuals) and annoyed by the music that was playing, an odd array of old rock/dance hits. So I'm having a biopsy while listening to the B-52's (the absurdity of it all). Oh, and before any of this happened I had to arrange payment for whatever wouldn't be covered by insurance. I was presented with a bill for several hundred dollars and was told that if I paid that day with credit card 30% would be taken off the cost. I handed over my plastic, because as horrifying as it all was the thought of paying $250 more than I had to was even worse. I couldn't help but think about those who don't have that option either not having the money or the credit card.
Our medical system does a good job of providing patients with tests, procedures, operations and drugs. What our system doesn't offer is a calming, nurturing and healing environment that puts patients at ease and helps them emotionally on the road to understanding what is happening, to making decisions based on that information and to getting well. After I had my biopsy, I was told to wait in a back hallway. It was cold, but blissfully quiet. A nurse came by later and apologized to me for having to put me in an area where there was no television. I told her I vastly preferred it--she looked at me as if I were an alien. The results came back benign, but I have to go back for a six-month screening in November and I'm not looking forward to it (though you can bet I'll be taking my own reading material).
The combination of a frenetic and uncomfortable environment, and unwillingness on the part of practitioners to be clear and compassionate in their explanations and to provide counsel, the cost of healthcare and illness, and the physical and mental stress of it all is a prescription for disaster. We ought to be able to do better. My daughter, in her quest to watch all of Robin Williams' films, was watching "Patch Adams" recently. I find the film a little sappy, but I take to heart the message of designing a system prepared to heal people. I see no reason why the American medical system cannot provide better overall comfort and care to its users. Here's what I see as a start:
- Emailed links sent to a patient about a procedure/test they will be having so that they can learn about it immediately and not rely on their own research. The problem with looking for medical information on your own is that you are likely to see conflicting information, misinformation, horror stories and someone who wants to tell you that colloidal silver cures everything. What people need is quick, thorough, balanced and reliable information.
- Waiting rooms that are clean, comfortable, pleasant and nurturing. Soothing color schemes, chairs that one can sit in for long periods of time (as you often do), soft calming music, a nice selection of teas, real mugs (as opposed to bad coffee, powdered creamer and styrofoam cups). And how about some edifying distraction? If the television must be going, then why not have something like "The Blue Planet" playing? Or any historical series by Ken Burns? Or Julia Childs' "French Chef" series? Why not magazines like Smithsonian, or National Geographic, or Cooks Illustrated, or garden magazines? How about sets of specialty encyclopedias? Books on botany, or architecture, or art history?
- Practitioners who understand that all possibilities of sickness are stressful to the patient and that a patient feels vulnerable in this situation.
- Doctors who introduce themselves with their first and last names, not as "Dr. So-and So". Instead, how about something like, "I'm Jim Burton and I'll be helping to take care of you."
- Hospitals and facilities that take care of their workers! Stop allowing medical companies to bring "goodies" to medical offices. Overhaul the dining options, provide healthful food to employees, give them opportunities to move, work out, provide incentives for healthy lifestyles.
- Caring follow-up. How about a card saying "we hope you are doing well, and we'll see you again for a check-up on . . . ". Or, "we're going to do our best to see you through this."
I'll end by dedicating all that I've written to my high school friend, Audrey Chapman, who died at the age of 42 from breast cancer. She was a kind and compassionate person and I hope that someone along her medical journey provided her the same care she showed for others.
Artfully yours, Lisabeth