My initial consultation with Dr. X was delightful. We discussed lab values, a gastroenterology article I was writing, a pending conference in Philadelphia, and the necessity of my having a first-ever screening colonoscopy. (Since I have always encouraged my patients to have colonoscopies, I figured I should follow my own advice.) I was thankful that I had been given an appointment so quickly to have the procedure.
That was where my satisfaction ended.
Arriving early for my appointment, with my driver (an RN and very good friend) accompanying me, I sat in the waiting room until I was called to the holding area in the back. There, with several other patients, I was required to remove all my clothes and put on a one-size-fits-no-one gown. I lay down on a gurney, with a light blanket over me. An IV was started.
I waited.
And I waited.…
Hungry, tired, and dehydrated, I was forced to listen to loud, obnoxious music and the piercing screams of a female patient coming from the procedure area. The barely audible murmuring of the nurses escalated my tension and disquiet. The room was freezing. I was getting colder and colder.
Close to an hour passed before I was wheeled into the colonoscopy suite, where I was required to lie in the left lateral position for more than 10 minutes, with my buttocks exposed. Eventually my arm became numb and I had to move it, but a nurse quickly put it back where it had been. It was necessary to be “in position,” you see, and ready for the procedure.
Another nurse wearing scrubs stepped into the room with a full syringe in her hand. “Oops, wrong room!” she said cheerfully, exiting as quickly as she had arrived. How comforting.
At long last, Dr. X showed up. He hastily reviewed what was going to happen. As we talked, I was “Charlene” and he was “Doctor.”
Finally, midazolam was administered and I was out.
Next thing I knew, I was waking up and being told by Dr. X that I had a mild case of diverticulosis. He said he would call me later in the day.
When I look back on this demeaning encounter with our health care system, my first thought is wishing Dr. X could be subjected to everything I experienced. But on a more pragmatic note, I’ve tried to come up with some suggestions that might prevent other patients from going through the same humiliating, anxiety-provoking experience I had.
• Why not set realistic times for appointments? The practice of “batching” patients only makes them feel less than human. Believe me, it’s not a nice feeling.
• If one Fleet prep works perfectly well before a colonoscopy, why subject a patient to a second?—which was Dr. X’s order for me. After a total reaming of my gut from the first prep, the second one really hurt and actually burned.
• Offer a small dose of diazepam or some other antianxiety agent in the pre-procedure area. It may be declined, but I personally would have appreciated the thoughtfulness and would have accepted. Instead, I was told by a nurse, “The doctor has to be here before I give you any medicine.”
• Music is a wonderful thing, studies show, for use in colonoscopy suites. Encourage patients to bring their own iPods, MP3 players, or CD players. Self-chosen music has been proven to reduce medication requirements and anxiety.
• How about warming IV fluids before administering them? Or at least warm the blanket you give to patients. (Or better yet, provide blankets.) And advise patients to bring a warm pair of socks.
• Dim those glaring lights.
• Place patients “in position” only when the procedure is about to begin. To do so for an extended period of time is not only unnecessary but also dehumanizing—unless you’re running an assembly-line operation. The extra few seconds that are saved cannot possibly be worth the protracted patient discomfort and embarrassment.
• Use similar salutations. If a physician deserves to be called “Doctor,” rather than “Paul,” then the patient deserves to be called “Ms. Morris,” not “Charlene.” It shows respect.
When Dr. X called later that day, he started to explain that I had these “little pockets or pouches” in my intestines. I reminded him I was a colleague and was familiar with diverticulosis. I said nothing about what happened that morning. I was still groggy from the anesthetic. The unpleasantness of it all really didn’t hit me until later.
Perhaps my ordeal was an isolated suboptimal experience. If so, then having that explained to me at some point during my hour-plus of misery would have been helpful.
It does help to recall the few positives. I’m glad that the initial consultation with Dr. X was enjoyable. And I am grateful to the nurse who got my IV started in one stick.
I’m also delighted to know that I won’t need another colonoscopy for 10 years.
Charlene M. Morris practices family medicine at Pamlico Medical Center in Bayboro, North Carolina.