I saw a TV documentary once about the civil service in India and how it was, for the public, one of the most impenetrable bureaucracies ever created. Our visit to MD Anderson yesterday brought that back to mind. The medical staff there was very competent and nice, but they were hidden behind a wall of clerical staff for whom serving the needs of the patients apparently ranks very low on the priority list. Besides the one who veritably oozed attitude, or the one whose short-term memory was measured in nanoseconds, were the ones who, because of poor education or lack of intelligence, were mere functionaries in a system of rules designed to limit the damage available to someone of poor education and lacking intelligence. It was mind-numbing and soul-sapping.
We’d been told that our appointment was at 8:30, and that new patients needed to arrive an hour earlier for registration. “So,” I repeated back to the person calling, “appointment at 8:30, show up at registration at 7:30.” So, when we got to Houston, we dutifully show up at 7:30, thanks to Kimberly’s masterful navigation of the highway system, and getting up way too early.
The attitude-droid checks us in at the registration desk, and says “Have a seat, someone will call you.” We find chairs in the large waiting area. 40 minutes later, after quite a long time of not being called, and seeing more recent arrivals rescued from the oblivion of the waiting room, I go back up to the desk. A helpful volunteer intercedes to offer assistance. (She has, perhaps, been trained to prevent patients from bothering the attitude-droid.) “My appointment was supposed to be at 8:30, and nobody’s called us, and it’s already 8:10,” I say, calmly but with a hint of agitation. And so I found myself on the way to Bangalore…
Attitude-droid chimes in with the assertion that my appointment is at 9:30. A long back-and-forth ensues about what we were or were not told by the scheduler, and blame is repeatedly deflected. The never-mistaken computer record of our schedule is cited as authority, and finally grudgingly accepted as, if not the truth, the Way It’s Going To Be, since it becomes clear that, if Attitude-droid and Helpful Volunteer believe in the divinity of the computer schedule, so also do the doctor’s minions upstairs. We will not miss our chance to see the doctor, we will just never have that hour of our lives back. Sigh.
(And why did Attitude-droid not say something, when we checked in TWO hours early, instead of the already well-padded one hour? Because she is Attitude-droid, and angry about her life and her job, and really wishes patients would go away so she could do her job, even though she hates that job and her job is to talk to patients. Perhaps you are getting the picture?)
I’ll skip over the ridiculous registration process snafus and annoyances, and just get to our arrival at the Head and Neck Center. Oh-my-oh-my. There is a line for the check-in window. It is so long as to have lost all definition as a line, since it is moving so slowly, and the waiting area is so crowded, that it is hard to tell who is just waiting, and who is waiting to get to the window. They start a line at a different window, back down the hall, the way we came, and through a doorway. We abandon the first line, and move to the other. Thankfully, this one is being tended by a higher-level droid, who has figured out that the sooner she finishes with the line, the sooner she gets to go back to whatever she normally does. Sadly, not everyone ahead of us in line has been paying attention. One does not have her 8-page history form, and claims never to have seen such a thing. One does not understand that the question “Who are you checking in for?” refers to which doctor, not which patient, and keeps repeating her daughter’s name. Finally we are checked in, which allows us to join the many others waiting in the crowded waiting area. The train to Bangalore does not arrive.
Though our appointment was for “9:30,” we do not get into an exam room until after 10:30. How can a system be an hour behind schedule so early in the day, I wonder. I spend much time pondering this, since I have the time. There is a charming ritual whereby an assistant calls you, you go have your weight, BP and temperature checked, and then you are cast out, back into the waiting room. Just in case you thought there might actually be some end to the waiting. Ha. Got you.
(While having my vitals checked, I talk to the med-droid “Suzanne” about how behind everything is, and how crowded. She talks about how one of the doctors has just returned from being away, and has a backlog of patients. She talks about how new patients take longer, and how that same doctor has 8 new patients today, an unusually large number. I question the logic of scheduling what sounds like more than a day’s worth of new patient intakes on the first day back after absence, when there is also a backlog of existing patients. She says something about how it’s hard to say no to someone with cancer, who may have been waiting.)
Once cast back into the waiting room, I spend time pondering the ethics of that situation. Is it better to tell them the truth, and give them a later appointment, or lie, giving them an appointment you can’t realistically keep? As someone with cancer, I think about whether I would have preferred the straightforward “no” of a later appointment to the passive-aggressive “no” of this waiting room. It becomes clear that our 8:30 appointment was probably moved, but no one contacted us, because, really, such details don’t matter.
I’ll cut this story short, as it has already run on, and besides, I have to go back there for another round of appointments shortly. There may or may not be significant news later.