A long day/P.S.

To: Mark Keroack, MD, Baystate CEO

From: Linda Edwards, Patient

I experienced the best and worst of Baystate today.

There were a few staff members who were friendly, respectful, and professional. My experience with them was in keeping with what I expect, and I would imagine, with what you expect. There were a few others I interacted with though, that were a disappointment. I think you probably want to know about them too, so I’m sharing my experience.

I have cancer. I was having a port implanted in my chest in preparation for chemotherapy. This is all new to me and I was a little nervous when I visited today.

I arrived for my 11:30 am appointment at about 11:15. I had been told to go to the old emergency room entrance. Some of the original ER signage was still outside, there was paper covering some of the windows, and when we entered, the sign on the wall said something about infusion. It was all a little confusing. Are we in the right place? I think they said to use this entrance.

We went through the interior door. “I’m not sure I’m in the right place,” I told a man who was sitting at what appeared to be a check in desk. He smiled and was quick to make me feel taken care of. He confirmed my appointment, got up from his chair, and escorted my husband and me down the hall and around the corner to pod #7. He told me another staff member would be with me shortly.

We were greeted by Roman, a smiling staff member in cranberry-colored scrubs, who introduced himself and asked me to change into the plastic-bagged gown and socks that were lying on the bed. After I changed into the blue print gown and mustard colored socks, I opened the curtain. Roman came back in and took my temperature. I think he took my blood pressure too. He told me Scott would be my nurse and I could expect him shortly.

Scott appeared, introduced himself, and explained what would happen next. He set up an IV.  “Do you know what a port looks like?” When I said no, he took one out of a small plastic canister, and showed me a small piece of purple plastic about the size of a quarter. It had a white plastic tube attached to it. He briefly explained how it worked.

Scott told me the actual procedure would take place in another area, the heart and vascular interventional area, and then I would be brought back to pod #7 for recovery. He told us he would call over to that area and try to get a timing estimate, but as soon as they were ready for me, someone would come to get me. I think it was about noon.

At about 1:15 pm, my husband asked Scott if he had any estimate on when someone would be coming to get me. Scott said he would check again. He told us that emergencies took precedence over my procedure, and that might explain the delay.

At about 3:00 pm, Roman came with a gurney and a warm blanket. “They just called. Someone is coming to get you.” He helped me move from the bed to the gurney. Don and I exchanged goodbyes. He and Roman discussed where he should wait for me when he came back, as he was going to go find something to eat. Sitting on the gurney in the middle of the hallway, I watched Don start to walk down the hall.

“Don, wait,” I said. “I have to sit here in the middle of the hallway all by myself. Why don’t you wait with me until they come get me?”  Roman came by again and apologized. “I’m sorry for the wait. They said it would just be a few minutes.” We waited another 10-15 minutes. A curly-haired woman wearing light blue scrubs arrived. She identified herself as an xray tech and said she would bring me to the heart and vascular interventional area for the procedure. Chomping loudly on gum, she said to Don, “You can come if you want.”

I was then introduced to a part of Baystate that was not at all similar to what I had just experienced. The xray tech, whose name I can’t remember, steered the gurney through a set of double doors. We seemed to leave modern, professional “for public viewing” Baystate, and enter another place. This was the bowels of Baystate. We turned left, then right, twisting and turning through what appeared to be the back hallways of the hospital.

We went past piles of boxes, maintenance carts, and several drab hallways before we came to what appeared to be another holding area. This one didn’t have curtains draped between each area, but it was sectioned off for three or four patient areas. Several trash and soiled linen containers were directly opposite my gurney. A piece of trash that had missed the barrel was on the floor. Don glanced around and said, “This is like something you’d see in an Eastern European country.”

My gurney was positioned in one of the areas, adjacent to what appeared to be a small nurses desk area. Three women wearing light blue scrubs were gathered around the desk chatting. The xray tech started typing into the standing computer work station positioned next to my gurney. “Can I see your wrist band?” she barked. My hand had been under the blanket because I was cold. I lifted my hand and held it toward her. As the blanket came off, she noticed my other arm. “What happened to your IV?” she demanded. Scott had disconnected my IV when I went to the bathroom before transport, and it had not been reconnected.

The xray tech yelled over and asked one of the other women to reconnect it. “We’ll do it when we bring her over,” was the response. One by one, they all vanished and we were left in the hallway alone. As we scanned the area, we could see what appeared to be a patient list on a white board at the nurses station. “Ed, Linda” appeared to be the next name on the list, as all the red dots had been completed. My name had a blue dot next to it.

After several minutes, Don went over to review my chart, which had been left on the computer table next to me. “Dr. Fdadfadf is doing your procedure,” he said, as he flipped through page by page. A Google search brought us a photo and his credentials. About ten minutes later, Dr. Fdadfadf appeared in the hallway. He extended his hand, introduced himself, and said, “I apologize for the delay. I had a personal situation. An acute personal situation.” Um, okay. I appreciated the apology, but I didn’t really need to hear why he might be distracted today.

I was told by a different woman in scrubs that it was time for me to be moved into the procedure room. Don kissed me, waved goodbye, and walked down the hall. The woman who was pushing my gurney felt the need to mock him. She sarcastically copied his wave and laughed. I’d now been waiting almost four hours for this to start. His waving goodbye did not seem humorous to me.

Once in the procedure room, I was instructed to move from the gurney to the table. I have only done this a couple of times in my life, but was made to feel as though I was doing it wrong. Three women in scrubs introduced themselves, although I don’t remember any of their names. The woman to my right swabbed down my skin with the amber colored liquid that I think is meant to make the area sterile. She then draped the area and asked me to turn my head to the left. She positioned a vertical drape in front of my face.

I laid there as the three women busied themselves with various preparations. I listened as they chattered about their personal lives and weekend plans. The woman who had positioned herself to my left wrapped things up by sharing the dream she had had the night before about a mass murderer she had run into. The dream ended with her killing him.

She asked me if I had a preference for the music they would play during the procedure. “No, I really don’t care,” I said. “No really,” she said. “What do you like?” Again, I said, “I really don’t care.” “Are you sure? We have Pandora. You can have whatever you would like.” Again, I said, “Really, I don’t care. How about whatever the doctor would like?”

“So, where are you from?” “What do you do?” “Do you have any kids?” “What do they do?” I was trying hard to maintain my composure. Apparently my one word answers were not effective. “I’m sorry,” I said. “I can see you’re trying to help me be relaxed, but I’m not feeling particularly chatty.” This didn’t stop her.

I guess she thought I must have had some medical training, because she explained that I would notice that the medication she was injecting into my IV would be happening much faster than normal. Actually, I probably wound not have noticed. “You might also feel it’s entering your system faster and you might taste it.” Um, okay. I’m aware by the sound of her voice and her appearance that she must be about my daughter’s age. I’m sure you are smart, but you really have a lot to learn about reading body language and dealing with people.

Dr. Fdadfadf came in and explained that he would be using the sonogram to note the specific area for the port to be installed. As he moved the wand over my skin, he asked the nurse standing to my left to look at the screen. “Do you know what that is?” he asked. “That is the carotid artery,” he said. He pointed to several areas and asked her what they were. She answered wrong each time. Can I play? I’m pretty sure that’s my thyroid.

For the next half hour or so, Dr. Fdadfadf pulled and patted, installing the port. I tried to guess what was happening, but I did not feel anything specific, and he did not provide any commentary.

“You’re all done Linda.”

I was suddenly teary and my back hurt as I tried to sit up and move from the table to the gurney. One of the techs asked, “Are you all right?” I felt beaten up, both literally and figuratively. I was wheeled back to pod #7. Scott and Roman were there to greet me. “I am glad to see you,” I said.

Roman asked what he could get me to eat and drink, offering everything from crackers to sandwiches. Scott reviewed the discharge instructions, smiled, and said he hoped he didn’t see me again any time soon. After some saltines and ice water, I got dressed. Scott shook my hand as we opened up the curtain. About 5:15 pm, we headed home.

Dr. Keroack, it was a long day. Probably longer than it needed to be. But it was made made longer and more difficult by a group of people who seemed to forget the goal. Installing the port was only part of the equation. Delivering compassionate care in an honest, respectful manner is equally important.

Thank you for listening.