IR Sucks

Since nothing happened yesterday, Dalton and I committed ourselves today to making something happen. By the time I arrived at USC, Dalton had already laid into one of the attending physicians. Because USC is a teaching hospital, there is a constant parade of "Doctors" in and out of his room. I say "Doctors" because I think that most of them are MD's finishing up their residency. The Oncolgy Team is literally about 10 people who walk into patient rooms and act like they know what's going on with your case. Problem is, they haven't been right yet, and they tend to ask stupid questions. One of these "doctors" showed up early this morning and proceeded to tell Dalton, "Well, what we need to do is get a catheter put into the vein in your chest so that we can start chemo, and we need to get a feeding tube in so that we can get you some nutrition." Since we had already heard this about 10 times already, Dalton replied, "I am well aware of what needs to be done. What I don't understand is why it hasn't happened yet. And, if you can't make it happen, then I want to talk to the person who can. The "doctor" defensively remarked, "The surgeon and your primary doctor, Dr. Iqbal are the ones who makes those decisions."

"Then those are the only people I want to talk to."

Dr. Iqbal came by about 9am visibly irritated that nothing had happened yesterday, and she promised us that she would get things moving. Apparently, she went out to the nurses station and began yelling at folks to get on the stick. Bt 11am, we had seen the surgeon, Dr. Lipham, and had confirmed with him and Dr. Iqbal that both the feeding tube and the catheter would be inserted under general anesthetia tomorrow. We resigned ourselves to playing scrabble and reading our way throught the day, grateful that there was a plan and a timeline.

As a side note, doctors are a funny breed. There are those able and willing to make a decision, there are those who like to assert they can make a decision but really can't, and there are the nodders who simply agree with whatever someone else said. The only ones worth having are the first type. So, when the "Team" showed up and proceed to tell us that they were working on getting the cather and the feeding tube in (blah, blah, blah), we just ignored them. However, when one of the junior helper guys chimed in with the brilliant question, "So, you're still not able to swallow, YET?" I actually laughed in his face. Is the tumor just going to magically start shrinking? If he could swallow, Dalton wouldn't be in this place. He'd be at home eating steak and potatoes and having a glass of wine. What an idiot! In retrospect, I think he was a student trying to impress the head doctor and I clearly crushed his ego. Oh well, time to toughten up junior. Timid doctors are useless.

Surgeons are our favorites. I guess because they actually have to cut somebody open and really dig into their job (ha, ha), they tend to be very confident. That is great for patients because 1) you feel like they are in the know and 2) you feel like they actually have control. Go surgeons. When I grow up I want to be just like them.

Had things gone as planned, today would have been a great day. Instead, Bubba the transport guy showed up at four o'clock, threw open the door to Dalton's room and accusingly asked, "Do you have your chart?"
"Uhh, no, but who are you?"
"I'm taking you down to angio."
"To where? And why?"
"I don't know, they just give me orders."
"Well, find someone who does know."
Just then, Dalton's nurse scurried by and said, "They just called from IR and want you down there stat. I'll have to run the IV on the way down."
"HOLD ON A MINUTE! What is IR and why are they taking me there."
"I guess they were able to squeeze you in last minute and they want you down there now so they can put in the cathter."

In retrospect, we should have stopped this nonsense then and there, but we felt helpless and didn't know what to do, so Dalton grudingly got into the wheelchair and wen't down to IR, which by the way is Interventional Radiology. The folks at IR were clearly in a hurry and they didn't give him nearly enough pain medicine, so he was screaming during the procedure and remembers everthing about them cutting the 1/2 inch incision and shoving the tube under the skin, through the vein, and four inches down the chest wall to it's exit point. By the time I saw him, he was in so much pain that he wouldn't even look at me. The kicker is that Dr. Iqbal showed up about 1/2 hour later and brightly asked, "How are you doing?" Turns out, she had no idea that IR had done this and was still under the impression that it was happening tomorrow at the same time the feeding tube went in. She apologized profusely, and told us that if that ever happens again, we should ask for the nurse to page her. Good to know. Hope she doesn't mind a lot of pages.