Come On Now Camel, It's Only a Straw

I had to press Reset the other day.

I was being sucked into the self-pity vortex. Stephen Fry would have disapproved. 

I was sore. Cranky. Sleep deprived. Beginning to mutter things about pulling the drain out myself if the doctors wouldn't do it. Suggesting I would have taken my own discharge if they hadn't let me out.

I chose to offload this emotional cargo in my surgeon's office. 
Poor man. 
He had been looking forward to showing me the scans which displayed what a great job he had done, and the histology results which showed how little cancer was left. 
He had been anticipating one of those consultations, few and far between in his line of work, where everyone is delighted with everything and we all pat each other on the back. 

But oh no, actual here-and-now emotion had to come along and ruin it. He did try to use the phrase "bigger picture" to stop me snivelling, but he may as well have said "there, there."

{Which, as an aside, brings me to a revelation I had about Pain Specialists. Their job, fundamentally, IS to say "they're there." Yes, those painful sensations you have DO exist. You are experiencing them, therefore they are real. Pain is not a palpable, visible thing, it is a state of being which is hard to quantify and even harder to accurately describe. It is an intensely personal experience, and the worst thing about it is being unable to "prove" its existence to other people. So acknowledgement of its presence, and its impact, is often all that someone needs. 
Anyway, that's my profound thought for the day.}

So I wept and I snotted and I heard words catching in my throat as I tried to describe how hard it had been for me to go back into hospital and leave my family again. 

He listened. He acknowledged. He berated me for not having called him sooner. 
He was so right. The "Don't mind me, I'll be fine" trick really doesn't help anyone, and could have saved him a box of Kleenex. 

I did feel a hell of a lot better after an old inconsolable wail though. Once again, the children have the right idea. Play around, get hurt, bawl your eyes out, shriek the house down, then go back to playing away happily again three minutes later. 

I had made my escape from hospital a few days earlier thanks to the wonderful OPAT service, which meant a nurse was calling out to me three times a day to give me IV antibiotics. She waded her way through dirty washing and discarded Lego and half-eaten Weetabix to hook me up, check my temperature and chat about how great community medicine is. There was something nicely reassuring about having a personal healthcare provider in your own home three times a day. I felt like some kind of 18th century duchess.

I got the sutures removed from my drain site. Oh the bliss, the indescribable bliss, of being able to turn more than two inches to the left or right while lying in bed, without searing pain. They discovered I had fluid on my lung, which had increased significantly since the week before. That would explain the breathlessness then. 

I got home again, and the temperature went up again. Bugger.

But aha, clever me, this time I know what to do! I text the Man in Charge. He phones me back, tells me what to do overnight, arranges for me to get fixed the next day. 
I avoid the Emergency Room, I avoid abandoning my brood, I save more Kleenex. 

I go and see the Antibiotic Man first thing, he sorts me out with some more of those. 
I go to the Can Fix Anything With A Scan And A Needle Man, and he drains off a litre or so of lung fluid (which looks remarkably like the home brew we made once that nearly sent us all blind.) 
I head off home again after a couple of hours. I am beginning to wonder why they bother with hospital beds at all - Outpatient Inpatient Care is the way to go. 
I get a phone call while I'm in the coffee shop to go back for a quick dose of different antibiotic to tide me over until my home delivery arrives the next day. Another 30 minutes, in and out, job done. Two and a half hours. Probably 90% of the patients lying in beds in there had less than that amount of actual medicining done to them in the past 24 hours. And it has cost 90 times more to keep them there. 

Having a needle stuck through your ribcage is a very sore thing. Nobody I said this to seemed the least bit surprised, yet I never once thought about it when I did it to patients myself. But it improved, and I slept, and I rolled over in the bed without waking up. Such a good feeling. 

I tore into life the next day. Grocery shopping, fridge cleaning, laundry sorting, library visiting, dinner making. 

I crawled out of bed the day after. Ooops. May have overstretched myself a wee bit. 




But it felt a damn sight better than feeling sorry for myself.

Live from the Trenches

I nearly always write this blog in retrospect, after the fact, not a blow-by-blow minute-by-minute livetweeting affair. How old-fashioned of me.

But now that I am here, at the coal face, bang in the middle of the ever-topical trolley crisis, I feel it is my duty to post a report from the Front. 

I have passed the 12-hour mark on the trolley. 

The formula for newsworthiness, aka the Sympathy Coefficient = Age (years) x Waiting Time (hours) + Human Interest Details (severe disability/terminal illness/dog just died)

I don’t score particularly highly here so I am not going to make it onto TV3 news just yet. 

It started off well enough, empty waiting room when I arrived, pleasant man at the desk (though he didn’t introduce himself, #hellomynemesis would be disgusted). Nice nurse with a Jedi name and bustling efficiency got my bloods and whatnot sorted in a few minutes. Put me in a side room. Called the team down to see me. Not a huge amount of listening to my story or examining of my belly or any of that other GP nonsense. Just, “get a scan, wait for blood results”.

I was brought down for my scan quite quickly. At this stage I had decided to feel sorry for myself, and to regret having brought myself back into this circle of hell. I had to drink a load of gack and wait in my wheelchair, slumped over, in pain, nauseated, cranky. 

The move onto the CT table was excruciating. It’s funny how pain really does have a threshold, and when that is breached the misery gates are fully open, letting the waves of self-pity flood through and wash away any resilience you may have. I cried away inside the machine until they were done. When I came out, my wheelchair had been pinched. The radiologist of whom I was most terrified when I was an intern came in, looked around, went out, then came back in again and asked me if I was me. He said I didn’t look like a patient. I gave him my wan smile that means “you bloody try being me, buddy”. He asked if I could walk and the smile got wanner. He went off and found a wheelchair. He brought me round to another room and I met, again, a poor registrar who is sick of looking at me - as a tutor, then a patient in one hospital, then a patient in another hospital, and back here again now. They were very patient with me while I winced and ooched my way onto another table, stuck a bit of dye into my drain, and then ouched and eeked my way back into the wheelchair. All good, no blockage of the drain, no abscess, no bile leak, no major intra-abdominal pussiness. That cheered me up. Home now so, I said to myself.

Yes but. This is not an in-and-out kind of place. I had already been “admitted”. That means someone has written down a few pages of stuff about me on special sheets. They have put the surgical stockings on me. They have invested good time and effort into asking whether I have a bedroom downstairs at home, and all my own teeth. This is not to be wasted, just because I want to get home to roast the chicken before it goes out of date tomorrow. 

So I get moved to the Observation Room, which must be further up the admission ladder than the nice quiet private side room. It’s a nice bright place with four cubicles but eventually five patients, and a massive clear plate glass window facing out to the nurses’ station and the rest of the ED mayhem. Now I know what the meerkats in Fota feel like. I was even lying on my back scratching my belly nonchalantly after an hour or two. 

My three room mates are obviously pros. Two of them have already spent the night here. They were chummy. But then the third chap arrived and the mood went from polite conversation to all-out hilarity. Number 3 was from Kerry originally but had moved to the north city suburbs. “Tis a long shtory”. By god it is, but I have gleaned most of it in the eight or so hours that have followed. 

Privacy is not a feature of the Observation Room.

Given that I am nosier than an aardvark, this suits me quite well, as long as I can keep myself to myself in the corner with the curtain mostly closed. Thankfully my hacking cough sounds particularly tuberculous. And the grunts and groans every time I move are indicative of someone who is Fierce Sick Altogether. So I reckon I have gotten away with being the anti-social weirdo, and can eavesdrop away in peace. 

I should put in a disclaimer to say that the following account has been altered to remove any potentially identifying features, in the interests of patient confidentiality. But since I didn’t know any of them, and barely saw their faces, I think we are safe enough. 

Lady in Number 1 has been vomiting for weeks, no one knows why. She sounds very chipper to me. She is waiting for CT scans and OGD and something else. She’s from West Cork, which really means she’s from another country but lives in West Cork. She has to arrange various lifts with various people depending on what day she is being discharged. But her phone battery is low so she can only talk to two people per hour and for the briefest of ten minute chats.

Number 2 when I arrived was a middle class chap who was getting into the spirit of the place, fair play to him. He was whisked away to a ward before I could figure out what was wrong with him. He was definitely an experienced patient though, he had that air of knowing how the place worked. 

He was swiftly replaced by a 20-year-old woman with pyelonephritis and a mother. 

This was very much to the liking of Number 3, who has already made at least two female healthcare professionals do that laugh which means, “If you make one more suggestive comment I will get a clumsy male colleague to catheterise you with a hosepipe." Her mother doesn’t seem to mind. 

Number 1 thinks he is hilarious, and has been referring to him as “Healy-Rae” for the past six hours, laughing uproariously at her own profound wit each time she does so. 

In all fairness to Number 3, he is a bit misunderstood. He is a single man, with a brother as a next-of-kin whom he last spoke to about a month ago, and whom he has no intention of informing of his current admission. We have learned over the course of the day that he lives alone, used to drink too much, was homeless for a while, gave up smoking a year ago. 

A Teutonic doctor told him fairly loudly and fairly brusquely that there was a shadow on his chest xray. Any eejit knows what that means. She told him his inflammatory markers were high, and his white cells, so he may have pneumonia. 

She told him lots of other stuff but this, I expect, is what he heard: blah blah blah SHADOW, blah blah LUNGS, blah blah PNEUMONIA, blah blah blah MORE TESTS, CANNOT BE SURE, CANCER, BLOOD.

He was quiet for a while. So was everyone else. 

He made a comment to the next nurse who came in about getting him a bed on the ward. He told her he wasn’t physically or mentally well enough to be in A&E. She, and his trolley buddies, laughed, because they assumed he was continuing on with his Gas Man ribaldry. He gave in. The next time he said something about getting a bed because “shure, I might be did tomarra!”

His consultant came in eventually and said some of the same things, but prefaced by, “We are still in the dark, we won’t know anything until the tests are done, so it may be serious but it also may be just a simple infection."

At this stage, number 5 had joined us. Number 5 is a patient in my practice. I don’t know him, but I know of him. I know his wife. I know he has had significant health issues in the past three years, involving cancer, and that we share consultants. I didn’t know that he recently had had further spread and that that was one of the main reasons he was in the ED today. 

He spoke to number 3 after the consultant left. He told him that he had lung cancer, too. (Maybe missing Dr Whatsit’s point that there was no actual diagnosis of anything yet). He told him that the worst part is the waiting, the not knowing, the initial shock. He said this was the lowest point, and that things would get easier from now on. He was generous with his advice and reassuring in his tone. The fact that he looked like hammered shite and not a million miles from death’s door may not have been so useful to Healy-Rae’s optimism, however.  

So in our room we have two definite metastatic cancers, one possible lung cancer/lymphoma, one potential gastric carcinoma and a poor young one who needs her mother to help her to the bathroom and brush her hair. 

Outside the Observation Room, looking in, we have a young mum with a screaming baby (another patient of my practice), two drunks (one who has urinated merrily on the floor while sitting in his seat), a posh lady with a sore foot, and an ancient looking fella with a tilt to one side who is being sat on a particularly unsteady looking chair while having his blood pressure checked.  There is another patient of mine who I have previously suspected of Munchausen’s by Proxy. She has no children with her as far as I can see, so we can downgrade that to plain old Munchausen’s. She looks at me, and looks again, and wonders. 

The greatest source of amusement in our room is the incessant alarms from the drip machines.  Number 2 (the First) had trained them all how to press the Silence Alarm button, so they are all at it now. Number 3 keeps saying how much like Guantanamo Bay it is in here. Our Cuban nurse says nothing. 

A debate starts about the safety of men wearing jewellery while operating heavy machinery. We are blessed to have in our presence, one World Authority on Nearly Everything, one Kerry Authority on Most Things, and three willing listeners (I’m counting the mother, not me). Nuclear devices, brain transplants, watching telly on your iPad - there really is nothing these boys don’t have opinions about. No great knowledge of personal hygiene is apparent, however, and the place is beginning to hum. 

The nurses change shift. I draw the new one towards me with a conspiratorial whisper. “I’m a doctor and one of the patients in here is a patient of mine [not strictly true] so can you pull the curtain around me a bit more?” “Oh I will, and I’ll see about getting you moved.” 

Result. 

I’ve called in another favour and the Night Sister is aware of my “need” to jump the queue for a bed, on no grounds other than I Can Take No More of This. 

             *********************************************************************************

I got out. At half past midnight I was wheeled by a very pleasant Eastern European porter back over to the old part of the hospital. I told him I had worked here when the nuns were still around. He rolled me gently over the bumps. 

I got into my pyjamas and into the bed. Not a fancy bed, but 30 centimetres, two pillows and one sheet better than the trolley I had been on. The nurse was kind and caring, offering toast and analgesia, chatting about serious and not-so-serious things. 

I fell fast asleep. I dreamed about being in A&E which sort of defeated the purpose. 

I was wakened at 6 for the antibiotic. My lovely baby had woken at home at a similar time and I imagined her little toothy smile and her demand for “brakkie”. It is so much better being there than here but I’m going to go back to being brave and stoic. 

I am on the day ward, where I have been many times before. There is a steady stream of people coming in for colonoscopies and OGDs and excisions of skin lesions.

A young fella in the bed next to me came back from his scopes and was put in the bed by the nurse. Two minutes after she left the room he hopped up, put on his clothes and scooted out the door. He came back from the shop with a packet of crisps, a can of Coke and the newspaper. Oh to be so rebellious, or so ignorant of nurses’ wrath when you disobey the rules. He scoffed down his Tayto and slurped back the fizz. 

The SHO came in to him after he had stashed the evidence. She told him about his Helicobacter infection and his slight hiatus hernia. He burped a bit. 

He phoned his mother to get her to collect him. He tried to leave the ward again but got caught. He said he was going to make a phonecall. She told him he could use his phone in his bed. He was foiled. 

He sat in the seat and read his paper. She came in to get him to sign his discharge forms. “Where did you get the paper?” 

“I got it on the way back from upstairs.” 

“No you didn’t.” 

“I got it in the shop.” 

“What part of ‘don’t leave the ward’ do you not understand?”

I giggled from behind my curtain. 

Hiccup

I was supposed to write up a witty in-depth account of my post-op recovery, with little anecdotes about my fellow patients in ICU, and the time I got the nurse to put a post-it on my door to stop the endless stream of cleaners and care assistants and students who were playing havoc with my nap schedule. 

I was discharged a week ago and I thought surely by now I'd be back at my little desk, tapping away on the keyboard, self-therapising by writing it all down. 

But I haven't been up to it. 

I still need a good 2 hour nap every day. I can just about manage a walk up and down my road with the two-year-old, and she's thinking, "Keep up, lady".

And now I'm back in the bloody hospital again. Temperatures and pain and a cough and funny-coloured stuff coming out of my really uncomfortable drain. 

I came to A&E this morning and was truly convinced I would be home in a few hours. Everyone here seems to think otherwise. They are big fans of admitting people in these places. God forbid someone could just make a diagnosis and management plan within a couple of hours and send you on your merry way. 

So that's where we're at. A slight setback in the otherwise impeccably smooth path from riddled to cured. 

“Sarah’s Alright”

 (Guest Post from the Superhero)

The pre-operation assessment went well, I thought. Nurses came and went, and asked Sarah their questions about bloods and scans and consent – questions I’m beginning to understand, even feel familiar with. Then himself came in, the surgeon. I’ve met him a few times at this stage. The first meeting was about 17 months ago. That meeting was after his first close-up look at the infamous liver. I recall phrases like “it’s widespread” and “I know it sounds trite, but stay positive”, or the opening gambit – “how much do you know?”.

He’s a really nice guy, the surgeon. When I bumped into him after the first operation his outlook was pretty encouraging. After that chat, I hung on words like “consolidate” and “it’s going well”. It was all cordial and friendly when he popped in last week ahead of cutting my wife open so he could have a right go at her liver. He was estimating times and he figured that, after the anaesthetist was done, the operation itself would last around two and a half hours. He would phone me when it was done. Grand job. She’ll be in the recovery room by around 5.30, thereabouts, and down to the ward some time after 7pm. I’ll head back in around 6.30, I said. 

I’m getting very familiar with the hospitals of my home town. When 6.30pm came, I bounded up stairwell two, armed with a book, sandwich and bottle of water – I fully knew I might be waiting a while. “Brigid’s” was the most likely post-operation destination so I approached the nurses’s station there and waited for someone to lift her head from her paperwork. Seconds later, the nurse that had checked us in that morning passed by and kindly offered to find out which ward was lined up. She also offered to phone “recovery” to see if the operation was over.

She was nice enough, the nurse, but is inclined towards doleful expressions and slightly anxious tones. At least that’s how I perceived her when she let me know that, “no, she’s not in recovery yet”. No worries, I thought, that’s to be expected. Sure, nothing happens on time around here. The nurse brought me down to a different ward in the new part of the hospital where the observation room behind the nurses’ station had been reserved – they took my phone number and would call once Sarah was on the ward.

There’s a nice, rounded seating area in the hospital, just beyond the glazed foot bridge from the old building to the new one, with lovely views over the river and ‘Middle Parish’ in town. I sat down there around 6.40pm, reading, people watching, and checking the time on my phone every 15 minutes. At 7.30pm, I saw the same nurse on her way across the bridge and she stopped to check in with me. When I told her I had no news she kindly offered to phone again to see if the surgery was finished. On her return, she started off with (slightly dramatic inhale) “so, ok…” “hmmmm” my brain said to me. It was all fine, though, all fine, nobody told her it wasn’t all fine and they usually would, if it wasn’t, like.

What she told me was that they were likely to be in theatre for at least another hour and that I could add another 3 or 4 hours on top of that for recovery. “Do you live far away?” she asked. I wasn’t going anywhere. “Will I see if I can find a room with a TV for you?” she asked. I told her I was fine with my book (The Sense of an Ending by Julian Barnes, it’s quite good – I was only messing with my anxious head carrying a title like that around though). We agreed a plan. Leave it until 9pm and then go to the ward and ask the nurses to “phone up”.

I stuck to the plan. I went to the vacant nurses’ station at 9pm. When a nurse approached I explained who I was. She smiled sympathetically and said “no, sorry, she’s not out yet”, quickly followed up with “can I get you tea?”.

I found the next half hour tough enough. For one thing, some man joined me in the seating area with his packet of Hunky Dory cheese and onion crisps. For what felt like an age all I could hear was MUNch, MUnch, Munch, munch pause… MUNch, MUnch, Munch, munch pause…I’m sure he didn’t particularly want to be there either but I had to move and sit on a window sill on the bridge.

In that half hour I did have some positive thoughts, like “this is a good sign”, I also started looking at various windows on the floor above and began to wonder “where exactly is theatre?” About 9.15 I got it in my head that the next communication to me needed to be by phone. If someone started to approach me in person that would be a bad sign. I decided that the opening words of that phonecall should be “Sarah’s alright”.

At 9.31pm my phone rang. It was a hospital landline. Good. A tired sounding surgeon introduced himself, apologised for the lateness of the call, said things went well and then launched into a fairly technical account of events. At 9.35pm I phoned my mother-in-law who was minding our kids, while wondering about her daughter. “Sarah’s alright” I began…

Six and a half hours of surgery is something I can barely comprehend and when I next saw my wife she was on a trolley bound for the intensive care unit. It was less scary than I would have imagined in ICU and the staff were really sound. It was all very practical. I was allowed in almost straight away. Then ordered outside five minutes later so they could x-ray. Then invited back in. “Stand on this side”, “take this phone number”, “move that wire”, “sit down”, “dip that sponge in water for your dehydrated wife” etc. Then himself popped in again about midnight. They work hard, those surgeons.

Pre-operative Assessment

Right then.
Time to catch up a bit. 

My last post was all about waiting around. Well there weren't too much of that once the ball got rolling. 

The Top Man had suggested we do our little job on a Friday. His nurse phoned me a few days later to say there was a slight problem with the date. I immediately assumed another delay. Nope. They wanted me to come in on Tuesday instead. This meant a very rapid brain reshuffle as I tried to figure out what to do about work and washing and finding the good pyjamas. 

They very kindly accommodated me in the preassessment clinic in the early hours of the morning so that I could get to work, get home, get packed and head off with my three oldest friends to celebrate us getting even older. I am a big fan of that these days. 

We had a lovely time, but the body isn't really able for celebration-levels of fizzy wine any more, and those little background anxiety feelings that you don't notice until it's too late meant I missed out on the great night's sleep I was banking on. Still there would be plenty of time to sleep when I got my general anaesthetic. 

The disco party for fourteen 8-year-old girls went remarkably well I thought. And it meant the house was clean, briefly, which is the best anyone can hope for if you ask me. 

Every patient I saw on the Monday could have been a candidate for a long essay question in some ICGP exam; at one point I thought someone was putting them up to it ("make sure to mention the chest pains just as you're walking out the door.")
But I got through them all, and all the paperwork and bloods and what-if messages for the nurses. I told most of the patients I was having an operation and would see them in six weeks. They paused briefly and said good luck, but left it at that. That wasn't so hard now, was it? 
I have told our receptionist to tell our most gossippy patient that I'm having a little op (I bloody hate that word op), so that the entire community will soon know and will be reassured by the normality of that as a reason for my absence. They have been understandably a bit bewildered by my come-as-I-please attitude to work in recent months, so this might settle them a bit. 

I tried much harder this time to acknowledge my tendency to be a bit jumpy and bad-tempered when I'm anxious, and kept the preparing for hospital until the kids went to bed. Helped a lot by the fact I wasn't going in there until mid-morning, so no need for taxis at dawn and frantic goodnights. So we had a nice evening and a relaxed bedtime story and generally maintained our Waltons-ness.
I walked the kids to school the next day, to get my step-count up on the old Fitbit (I've decided I am going to use it scientifically in my post-operative recovery. When I say scientifically, I mean I'm going to look at the amount of steps I've done each day and say, "aren't I great?")
I packed two bags, one for hand luggage and one for the hold.

I felt like I was waiting again. Waiting on the bed for the nurse to bring the gown. Waiting for the man to take the bloods. Waiting for my tongue to shrivel up from thirst. But it wasn't really that long, and it wasn't really that much later when I was sat in the theatre reception with my frilly blue hat on and my mouth answering the same twenty questions for the twentieth time. 
It was jointed up there. Fellas on chairs in corridors, old wans standing with all their baggage next to the recovery room, nurses scurrying up and down shouting "do you have One Mary because Three's bloods aren't back so Seven is free now".

Anaesthetists are nice people. I'm not just saying that because they carry around little syringes of Midazolam and shoot me up with them (well maybe that does cloud my judgment a wee bit). They are just nice calm reassuring people who never seem to be rushed. Christ knows what they're like once the patient is asleep, probably raving around the place to Sepultura while beating the nurses with NG tubes, but to me they are purveyors of calm serenity. (Yeah. Midazolam.)

I was awake while they put the epidural in, apparently, but I have no recollection of it. I am assured that while I was talking a fair amount of nonsensical shite, I didn't offend anyone. 

And so the next stuff happened, but I'm afraid I can't tell you much about it. 
Though I know a man who might. 

The Doctor Will See You Now

I do try to think about what it might be like for my patients, waiting in the waiting room to see me, coming in to sit down and tell me what's bothering them, hoping that I will tell them what they want to hear.
I try to judge how nervous or stressed they are, and reassure them by taking my time, letting them speak for as long as they need to, asking "how do you feel in yourself?" rather than "are you barking mad?"
I like to think I am aware of their needs and hopes and fears.

A GP visit is probably relatively low on the Doctor's Appointment Scary Scale though. Lots of my patients wait a long time to get seen by Specialists (you know, those doctors who are so clever they only had to learn one subject, not like the dumbass GPs who have to learn them all). The patient comes to me with their pain or bleeding or lump or uncontrollable tears and I do my best to fix them, but sometimes* I need to send them on to the Higher Beings. I write the letter, or (fancy) do the online referral, and think no more about it. My work there is done.

But the patient leaves me, not with a sense of relief, but with a renewed and heightened anxiety. 
"God I must be fecked, she's sending me to the Top Man."
"I'll be waiting forever and I'll die while watching the letterbox."
"I won't get better until I'm seen by the consultant." (And the corollary to that - "once I see him, I'll be sorted").

None of this dawned on me until I had to, finally, wait a teeny bit longer than I had anticipated to see my surgeon about my Next Step. So instead of the usual thing where I get an appointment before the secretary has had a chance to even type the letter, because my consultants have gone to such lengths to accommodate me over the past 16 months, my surgeon had to postpone me for a week (entirely understandably, as there had been a family bereavement). 
So I entered the realm of those hundreds of patients of mine who are crawling through the hours and minutes, counting down the seconds to the glorious moment when they will be sat in the creaky chair in the Specialist's room, leaning forward and clenching their hands, desperately waiting to hear what he has to say. 

There was going to be a smooth transfer of care of my children to their father so I could get to my appointment. He would come home from work, say hello and kiss us all, I would say goodbye and kiss them all, and head off with plenty of time to get a good parking space and have a few minutes of reading the high-quality magazines in the nice bright waiting room. 

Instead his phone rang as he came in the door. "Yes, that's me. Yes Guard I am his son. A spare key? You can hear him calling from inside the house? Is he okay?" I stopped with the keys in my hand, mouthing "do you need me to stay?", knowing that I would miss my slot with my life-saver/liver-saver.

He shooed me out the door. I got to text him from the nice bright waiting room. "Is your dad okay?" "Don't know, the ambulance is on its way."

Shaking (carefully) the hand that will be cutting into my belly. Offering condolences. Listening as carefully as I can. Trying to file away some of the words I'm not familiar with.
Hemihepatectomy. Electroporation. Mercedes-Benz incision (little joke there about my old Fiesta). Second opinion. Think about it and get back to me. 

Forty minutes and not a stone unturned. But I retain about 20% of it. I am able to transmit about half of that when I get home to dinner and bath and It's My Turn To Pick The Story. 

We recruit a babysitter and go the hospital to find out what's happening with my father-in-law.




I will try to think about all of this the next time I call a patient in from the waiting room.









*5% of the time, in fact. The other 95 patients out of a hundred I manage to sort out myself.