Friday, December 21, 2012

Big City Doctors

Probing Politics of the GOPBack when I worked in Manhattan, all my doctors were also in Manhattan. I may have been living way the hell out in Queens or Brooklyn, but most of my doctor visits were during lunchtime, so that worked. Also, when you have migraines (and mine are especially difficult in the morning) and sleep inertia (it is too a thing), you often have to get all the way to the office before you know if you're actually sick or just needed a little more caffeine.

When I started freelancing, I started finding doctors closer to home. The problem? Some of them sucked. Like showed up to open the office an hour late and didn't even apologize. Or shrugged off two inconclusive scans (inconclusive because they were done by an incompetent person) and didn't order any more scans because...I dunno...she acted like the whole thing was a test to see if she should keep sending people to that radiology place like I was a secret shopper and not a patient.

Of course the problem with Manhattan doctors is that they include a class of elite doctors who are really good at what they do, but don't bother taking insurance because it's too much bullshit. So you have to pay them up front whatever they damn well please and then pray your insurance will reimburse you. And if they charge $800 for an office visit, and your insurance says they should only charge $300 and reimburse you based on that, well tough titties. Which then becomes a pre-existing condition.

When I worked on staff, I sometimes went to these doctors, at least until one decided that she was going to charge $100 if you called the office for a prescription refill. Which, yeah, no. But as a freelancer, I just don't have disposable income to throw around on fancy things like out of network medical care.

But I still prefer Manhattan doctors. Where else can you go in for a mammogram and be told to "drape your arm over the board like the railing of a beautiful veranda" in a Russian accent? It's also nice to be able to have an ultrasound done immediately when the doctor wants to get a closer look at that thing in my left boob which is nothing, and has been nothing for something like fifteen years now, can you people stop scaring me and doing the super-squishie mammo that makes me ache just thinking about it? (Pro-tip: when you go to the same place for a few years, they finally do stop worrying about the nothing. Who knew? You get your card punched five times and you get to skip the super-squishie.)

The inconclusive scan I mentioned before? It was of my ovaries - my grandmother died of ovarian cancer, so I just need to have them looked at every decade or so. On my first visit, the technician did an external ultrasound. She told me nothing, but when I got to the doctor, I discovered that the tech couldn't see my ovaries because of my body type. Um, I'm not 700 pounds here. It should've been possible to press the ultrasound wand hard enough to displace the blubber enough for her to catch a glimpse. But no.

On my second visit, it was trans-vag-a-go-go. She still couldn't see my ovaries, and felt perfectly justified in writing this in a report. Like they had popped around back for a smoke. She was actually pissed that my doctor had sent me back for another scan, started complaining about her day and since I had a migraine and had been stuck listening to crap TV in the waiting room for an hour after my appointment time, I told her to go fuck herself. 

I am not sorry, embarrassed or ashamed of this.

After relaying this whole fiasco to my Manhattan gyn (out of network, but for once a year, I'll splurge), she hooked me up with a referral to THE guy for this sort of thing. And he takes insurance, bless him.

It was like going from Motel 6 to the Ritz. There was no TV in the waiting room. The nurse didn't tell me to drink a ton of water beforehand - I'm not sure if that's because she assumed I'd know that, or because this guy is just that good. I drank anyway, just in case.

The nurse led me to the exam room, and let me chance in private. (In Brooklyn, I'd been expected to disrobe while the tech fiddled around with the equipment in the same room. Classy.) When the doctor and nurse joined me, he actually asked me why I needed a scan, so he'd know what to look for.

Now, my gyn had told me that he was likely to start transvag, because he wasn't going to mess around. What no one had warned me was that thanks to Jon Stewart and Stephen Colbert, transvaginal ultrasound wands are now hilarious to me. Remember when there was all that nonsense about the mandatory pre-abortion scans, and each of them held up a wand on their show and said, "no, that's not invasive at all"?

Yeah, that's still funny months later when a doctor kindly shows you one and explains that he's going to have you insert it.

I'm getting the church giggles now just writing about it, but with god's divine help, I was able to hold it together at the doctor's office. Because all I could think of when watching those bits on TV was how the hell did their production staff get transvag wands with 4 hours notice? Did they borrow an old one from a doctor? Did they track down a medical equipment sales rep? This is really not what I wanted to be discussing with a doctor and nurse I'd just met while I was wearing nothing below the belt.

So I kept my shizz together and the doctor started scanning, and even showed me the screen. 

"That's your right ovary,"

What I said: "Hmm."

What I wanted to say: "If you say so."

I did not say this because the human brain really has a hard time cracking jokes while remaining aware of the big statue of liberty torch inserted into one's hoo-hah.

The image was as blurry as a big foot photo, and what he said was my ovary looked like black nothingness. I didn't give it much thought at the time, but was that because that's how ovaries look? Or had they really popped around back for a smoke and that was just the space where they should've been?

When he got to the left side, he stopped talking and I realized that he'd found something worth looking at. I refused to panic because I'd been tricked too many times by the nothing in my left boob. I may have gotten a little concerned when he decided to do an external ultrasound to get a better look, but the ultrasound gel was pre-heated, which is a really nice touch, so that calmed me right down. (Need I tell you that in Brooklyn, the ultrasound gel wasn't heated? You don't get that kind of pampering on the mean streets of Marine Park.)

When he was done, he told me it was just a little uterine fibroid, nothing to worry about. I know this is nothing to worry about because he did everything but tap on my abdomen and yell "hello, little fibroid there," and he didn't tell me I needed to see my doctor immediately, which he would have if it had been something to worry about. Because Manhattan doctors don't fuck around.


  1. I semi-recently had to have a trans-vag ultrasound, and I learned from the tech that the drinking tons of water thing is because SOME women -- mostly overweight ones -- need the full bladder to be able to see stuff.

    Also, he had me put the wand in. I thought that was overkill for being respectful or whatever, but hey, nice touch.

    I don't live in NYC. Used to, though.

  2. Maybe your left side is the problem...

  3. I skipped my yearly for about three years after a traumatic experience where this new ladydoc got my clam all jammed and decided that was the perfect moment to tell me I was fat and should stop being fat right then. Because I was unaware.
    Then when I moved to Mexico, I went to a new gyno and she did the whole camera thing too, with the screen on the wall. A little warning before it's High Def Cervix Hour would've been greatly appreciated.


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