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| | I behaved somewhat badly at orientation yesterday. I arrived late and caused a commotion
knocking things over on my way to find a seat at the far end of one of
the two long, long conference tables. My bag was exploding stuff,
and it took me a while to collect myself and get settled. I
asked questions about health insurance that caused the HR-bot to
backtrack and repeat herself because she misunderstood what I was
asking, and then an obnoxiously slick-looking, pastel-button-down
wearing youngish man who, if I overheard correctly, is an English Ph.D.
with a teaching post (figures) had to translate my question for me and
ask it again. I kept getting up to go pee and causing a rumpus
and I stole handfuls of post-it pads that were set out in little
baskets on the conference table so we could mark up our packets and
brochures as we followed along. Because I did
not feel the need to pay attention to the slide shows about all the
wonderful perqs Stanford has to offer and because the lectures on HRAs,
retirement plans, and long-term investing was both painfully boring and
utterly beyond my powers of comprehension, I unfocused my ears, pulled
out my laptop, and turned my attention to the html and css I was
writing. Essentially, I was behaving at any unbearably boring
Stanford lecture.
Aside from a few conspiratorial
smiles I got from a fat, sassy older woman in a colorful blouse across
from me who I assume was some wise-cracking humanities appointee fresh
from an east coast institution, recognising me as one of her own kind
and sending me her tacit approval, everyone else clearly dissapproved
of me. A young Asian woman, irritatingly tidy (she was eating her scone with knife and fork) and preppiliy
dressed, was sitting across from me, right next to Prof. Sass and kept
shooting me looks that were if not nasty then at least mildly
disgusted. On the rare occaision I lifted my eyes from the laptop
screen, I would catch her sort of tsk-tsking me with her eyes.
Then she'd quickly glance away. They all thought I was a young,
dumb, ill-mannered brat. As well they should have. My
dress, which I had grabbed that morning without thinking, was
inappropriately low-cut. I didn't notice how ho-baggy I looked
until mid-morning when I spilled half a thimble of half-&-half on
my lap. I looked down to survey the damage and saw my cleavage
looking back up at me, smiling. No, not smiling. It
was smirking. Smirking menacingly.
Neither surprising nor entertaining, my boredom and impoliteness at an
HR function. But you will need to know all this for later on.
Because my insurance is not all set up, I was told by the hospital
yesterday that the quickest way to get seen was not by scheduling an
appointment but by calling this morning and requesting a same-day
visit. I did. This morning, I called and was given a 10:20
appointment with a general practitioner. Brett drove us because
we'd both slept in a little late and because I'm picking him up later
today anyway; I snoozed in the car. Brett grabbed me some Google
feed and I drove back up to P.A.. It was 10:07 by the time I was
on Campus Drive, but the street I was looking for was not where I
remembered it to be. I was driving at a crawl, reading street
signs, looking, feeling abused and shaky. I turned into a
dead-end road to pull a U when I noticed the red and blue lights
flashing behind me.
"Do you know why I pulled you over?"
"No."
"You ran a stop sign."
He asked for my licence, registration and proof of insurance.
License? No problem Registration? There was shuffling
involved, the glove compartment unleasing its contents into the rest of
the mess and filth on the floor, but eventually I found a square of
carstock whose numbers and words were printed in an old sans-serif
typwriter font and which looked out-dated and inefficient enough to be
properly beaurocratic and offical (think: Weight Watchers,
pre-computerized booklets, when we had actual paper, alphebetized files
to carry up to the scales with us so the staff could write a number
in); I asked if it was my registration and it was.
Insurance? Sorry. No go. I lose. He was
not impressed when I offered to show him the electronic copy on my
laptop.
I got a moving violation for the stop light and for the insurance, an
appointment in Palo Alto traffic court where I have to prove that I do
have insurance by producing "just a print-out of that thing."
I was sniffing back tears as he explained to me what I could do to
clear my record (traffic school) and how it wasn't such a big deal.
He was extremely nice, actually. I wasn't upset over the tickets,
I was just feeling late and ill-treated by the universe and he seemed
so competent and kind as he gave me directions to the clinic I was
looking for that I lost my hold of myself just a little.
I pull into the parking structure about twenty minutes after I was
scheduled to show up at the office and immedeatly proceed to drive my
car into a parked tow-truck. Hard. But I finished pulling
into the spot and didn't pause to check the damage on my own car as I
hurried away. In the wrong direction.
I don't know how late I was when I got there. In the exam room,
the nurse took my vitals. I knew I'd been off the wagon a lot
latelly. I avoided going last week because I didn't want to
weigh-in, and I don't know what I was expecting, but it wasn't
142lbs. I mean, that can't be accurate. I was 136 a week
and a half ago. I want to be 130, which is what I was this time
last year. But I keep failing, failing, failing.
The medical assistant looks over my chart and asks questions. She
asks, "so the reason you are here [pause] is [pause as she adjusts her
face] a blump?"
A blump? I stare blankly at her for at least fifteen seconds as I
try to understand what she is saying. A blump? What?
Could that be the medical term for--
She interrupts my thought: "A lump. A lump in your breast."
"Oh, yes," I say. "Right."
"Your right breast?"
"No. Left one."
She leaves. The doctor comes in and she's young, which already I
don't like. She's young and she's preppy and she's Asian.
She looks somewhat familiar, but then there are a lot of doctors and
residents at Stanford that are young, preppy and Asian. I don't
think much of it. She's looking at my chart, asking me more
questions. All of a sudden she interrupts herself; "Wait, you
were at the orientation yesterday, weren't you? Yes, I was
sitting directly across from you."
Of course. My dissapprover.
My confidence in this doctor is dealt another blow. Strike two.
I rattle off my list of medications: Zoloft, 150mg; Wellbutrin 100mg
twice a day; Ritalin, 20mg three times a day (though it is actually
ususually four); and birth control. "And who writes these
prescriptions?" she asks, and it seems like she is asking, "and what is
that person doing with a medical licensce?" too.
"Dr. Harriet R---" say I.
"And who is Dr. R--?" she asks.
"Um, a doctor. A psychaitrist." She looks at me like I've
just told her I take pills given to me by my imaginary friend.
"I've been seeing her for, like, four and a half years."
"Oh, that's good. That's greaaate." Her voice is
purposefully soft and ingratiating and she speaks slowly while nodding
her head with what I suppose is meant to be understood as
compassion. She is incredibly condescending. Strike three,
but it's not over.
I had written A.D.D. as one my medical problems on my history
sheet. I see her looking over at it and then she asks, "So, the
Ritalin you take, is that to help with conentration" --I am about to
answer yes, when she continues-- "or do you actually have A.D.D.?"
What the fuck is that? "Um, both?" I stutter, dumbfounded.
It can't be possible that she doesn't know what A.D.D. stands for, it
just can't. Is she implying something, the preppy bitch? I
so do not understand what she is asking.
"And what kind of birth control do you use?"
"Ortho Tri-Cyclin,"
"How long have you been taking it?"
"About four or five years. Well, for a very brief time I was on
Ortho TriCyclinLo, but that was disastrous, it totally did not work. "
"In what way was it disastrous?" she asks.
"Oh, in the way that I, you know, got pregnant."
"Maybe it was too Lo!" she says. Then she giggles. ha ha.
"And do you smoke?" she asks, even though she knows I do, the goddamn sheet I filled out is right in front of her.
"Yes," I say. I know exactly where this is going.
"How much?"
"I don't know exactly. Maybe seven or eight cigarettes a day."
"Who writes your prescriptions for the pill?"
I tell her I don't know her name, but it's the nurse-practitioner at
Vaden whose latexed digits have paid call to nearly every student
vagina.
"Vay -der," she sounds out very slowly. "What's Vader? What's that?"
I have to explain it's Vaden, and it's the student health
clinic. She asks about my visits with nurse at Vader
(meaning, she asks how
they could possibly continue to write prescriptions for the pill),
until I realize she must think I go there and get a new prescription
every month. Which is retarded. I explain to her that birth
control
prescriptions (in my experience) are prescribed by the dozen, so I only
have to see the nurse once a year and then every month I just have to
pick up a pack from the pharmacy.
She tells me that smoking in combination with the pill is risky, that
smoking while on the pill puts me at risk for blod clots. I know
she has to say these things, but I thought she was a little over the
top. She kept saying how she would never have prescribed contraceptives for me and how she never
allows patients who smoke to take the pill. And how, if I were
her regular patient (by now, of course, I'm thanking my stars that I'm
not), she would take me off the pill. She asks me if I've tried
to quit and said yes, I had, but hey, I'm smoking again.
She frowns disapprovingly. "For now, I won't change this, but
next time you're here, we'll have to discuss this. I don't let my
patients smoke and take any contraception at all. It puts you at
such a high risk for clots."
I realized later, that it wasn't the Vaden nurse who had prescribed
this round of B.C., it was the gynocologist I saw last winter, when I
got pregnant, who I trust infinately more that this woman. I
understand smoking while on the pill increases the risk of blood clots,
I really do, and I know that blood clots are nasty and bad. But
the idea that she would have me on no hormonal contraceptive is
idiotic. Beyond idiotic. I am twenty-two. I have lots
of sex. And, AND, I GOT PREGNANT WHILE ON THE PILL (with PERFECT
USE). Duh. I just told her that I got pregnant when they
dropped me down to a lower dose of hormone. Taking me off
completely? Bad idea! Big, fat, shiny, in-flashy-letters
BAD IDEA. Bad, bad, don't-even-think it idea. Reducing
hormonal birth control = horrible idea, already tested and proved to be
horrible.
The thing is that the doctor I saw today, Dr. Dumb, is just so
young. I know what she was suggesting is probably, techincally
what she is supposed to say. She was probably taught not to
encourage women to smoke on the pill and she's just following what she
learned in class and in her textbook. But the thing is, that
telling me to stop taking the pill because I smoke is inane. Of
course my risk factor is higher than it would if I didn't smoke, but my
risk factor of getting pregnant if I'm not on the pill is so great,
it's not even a risk. It's a flat-out guarantee. The gyno I
saw was an older woman, very business-like and matter-of-fact.
Her brusqueness was very reassuring, like she'd seen it all before,
like she was just too solid and competent to bother to slow her speech
or otherwise condescend. The gyno knew I smoked and after she
scraped my uterus with what looked like a shoehorn and hoovered the
products of conception out of me and into a glass jar, she wrote me a
prescription for a B.C. pill with a high dose of hormone. She
didn't suggest I cease taking hormonal B.C.; in fact, she was all but
frisbeeing the disks of pills into my throat (or
something). Because if some one is twenty-two, has intercourse
with a man or men, is fertile as all fuck, as has been proven by a
recent unwanted pregnancy that happened while on the low dose pill, and
not only doesn't want to be pregnant but also would be medically
advised against pregnancy (i.e. psychiatric illnesses + medication
+ fertilized human egg = dolphin fetus), then the
increased risk factor is worth it. Duh. I'm not
saying it's optimal, but it's reasonable. In fact, it's the
only choice that's reasonable.
Jesus gay this is a long post, and I'm not even up to the breast
exam. I bet Dr. Dumb loves PowerPoint. Dr. Dumb totally
loves PowerPoint presentations. And uses (blech) comic sans for a
fun, informal look. Whimsy! I don't know how I know this,
but I do. It's the feeling I get.
Anyway, what was I talking about? Oh yeah, my tit. I
explain that last week, I noticed what I thought was a bruise, but that
the color had gotten darker rather than lighter as the week went
on. Then I was poking around a couple nights ago and noticed a
bump. It's a sizable bump, near the bruise, just north of my
nipple. Dr. Dumb asked me how I thought I had bruised
myself. Had I had a bump or a hit? I told her no. So
what did you think it was from? "Well, I thought it was a, uh,
hickey. But then I was out of town for the holiday weekend, away
from my boyfriend, and the skin darkened and reddened, so I had second
thoughts about its bruiseness." She asked family history, and I
explained: my mother's sister has breast cancer; my father's mother had
breast cancer when she was my age. She asked about my immedeate
family. Neither of my parents has cancer, and I have no
siblings. "Technically," she said, "traditionally, the extended
family-- your aunt and grandmother-- don't count, they don't increase
your chances of having breast cancer." She poked my boob a
little, but the more I think about it, the more I think she did a
really poor job of feeling me up. It was the quickest breast exam
I ever had. Even the Vader nurse takes more time.
"It looks like it's probably a bruise," she said, "if you were poking,
it's possible you irritated or inflamed some tissue. Have you
ever had a breast nodule before?"
"No."
"Well, it's a benign lump. Most lumps in women your age are
benign. So what I'm going to say is just to go home and keep an
eye on it. If it's just a bruise, it might resolve on its
own. If it doesn't, then you should call and come back."
"Ok," I said, completely not trusting her. "Well, what's going to happen in a week if it does not go away?"
"Then we'll do a sonogram to find out if the mass is solid or if it's
fluid filled. But it is highly unlikely for a woman your age to
have breast cancer. Younger women tend to have lumpy bumpy
breasts. Some growths do cause changes and discoloration to the
skin, but that is probably just a bruise. Given your age and that
you have no family history--"
"But I do have family history. My grandmother had breast cancer very young."
"Techincally, that doesn't count. There is no history of cancer in your immedeate family."
"But," I said, "the is only one other person with breasts in my immedeate family."
I did not want to wait a week, I said. "Well, that's what we do,"
she said. I was still unhappy. "It's a good sign that the
lump appeared suddenly, though." I explained that I only noticed
it a couple days ago because I was intrigued by the bruising and
prodding. I don't do regular breast exams.
"Well, if it is a tumor," she said, "it is probably not going to matter if we wait just a week."
No, really. She said that. She finally relented, "Ok, she
said, since you are so concerned, I will see you in three days.
Well, on Monday, because for Friday there is really no point. I'm
making an exception for you. Normally I would say in a week or
two. But because I don't want you to worry, I'll let you come
back earlier."
Well, gee, thanks.
She was getting ready to leave and she asked me, "oh, by the way, is
this weird for you? I mean, that we met at the thing yesterday?"
"No," I said. It wasn't weird for me because we'd met. It was bad for me because I didn't like her.
Most likely, it is just a bruise. I was a little frayed the past
two days worrying, but I'm not freaking out right now. It is
probably just a bruise, but I want to hear that from someone other than
Dr. Dumb.
Tonight: insurance forms! Tomorrow: quest for a new physician!
| | | Posted 9/7/2005 1:58 PM - 37 Views - 0 eProps - 0 comments
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